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Chief of Consulting Staff 



Library of Health 

Complete Guide to Prevention and Cure 
of Disease 

CONTAINING PRACTICAL INFORMATION ON 

Anatomy, Physiology and Preventive Medicine ; Curative Medicine, First 
Aid Measures, Diagnosis, Nursing, Sexology, Simple Home Remedies, 
Care of the Teeth, Occupational Diseases, Garden Plant Remedies, 
Alcohol and Narcotics, Treatment by Fifteen Schools of Medi- 
cine, Beauty Culture, Physical Culture, the Science of 
Breathing and the Dictionary of Drugs. 

TWENTY BOOKS— ONE VOLUME 



B. FRANK SCHOLL, Ph.G., M.D. 

Jefferson Medical College, Philadelphia College of Pharmacy 
JOHN FORSYTH LITTLE, M.D. FRANK E. MILLER, A.M., M.D. 

^Demonstrator of Anatomy, Jefferson Medical College, Consulting 'Physician St. Joseph's Hospital, 

Philadelphia New York City 

ASSISTED BY A LARGE AND COMPETENT STAFF OF 
PRACTITIONERS, LECTURERS AND TEACHERS 

REPRESENTING THE 

FOREMOST COLLEGES AND 
UNIVERSITIES IN THE WORLD 



AMERICAN HEALTH SOCIETY 

PHILADELPHIA. PA., 
U. S. A. 



cp-5 



Copyright, 1916 

E. J. STANLEY 

All Rights Reserved, Including that of Translation into Foreign Languages, 
Including the Scandinavian 



Entered at Stationer's 

Hall, London 

March, 1916 



APR -5 1916 



CIA427568 



CONTRIBUTORS 



B. F. Scholl, Ph. G., M, D., 

Jefferson Medical College, Philadelphia. 

Sesereno Lachapelle, M. D., 

Professor of Anatomy, Laval University, Montreal, Canada. 

Benito Bordas, M. D., 

Specialist in Febrile Diseases, Mantanzas, Cuba. 

Wm. L. Powell, M. D., 

University of Virginia ; Specialist in Internal Medicine. 

Hideyo Noguchi, M. D., 

Kockefeller Institute, N". Y. ; formerly of Tokio College, Tokio, Japan. 

George Noble, M. D., 

Professor of Chest Diseases, Royal Institute, Vienna. 

H. Webster Jones, M. D., 

Specialist in Diseases of Children, London. 

Prof. Van Werth, 

Specialist in Venereal Diseases, University of Dresden. 

John Forsyth Little, M. B., 

Demonstrator of Anatomy, Jefferson Medical College, Philadelphia. 

Silverio Dominguez, M. D., 

Specialist in Constitutional Diseases, Buenos Aires. 

Prof. M. Hoff, 

Specialist in Consumption and Germ Treatment of Disease, Vienna. 

C. C. Vanderbeck, M. D., Ph. G., 

Lecturer on Hygiene, Wagner Institute, Philadelphia. 

Domingo Orvananos, M. D., 

Specialist in Diseases of the Circulatory System. 



111 



IV CONTRIBUTORS. 

A. 0. Mencki, M. D., 

Imperial Institute of Experimental Medicine, Petrograd. 

Aubrey W. Marchand, D. C, 

Formerly Custodian Spinographical Laboratory, Palmer School of 
Chiropractic, Davenport, la. 

Anne McFarland Sharpe, B, A., M. D., 

Medical Superintendent North Chicago Hospital, Chicago. Author 
of " Nervous Troubles Among Women," etc. 

Jose Peon Y. Contreras, M. D., 

Specialist in Tropical Diseases, Merida de Yucatan, Mexico. 

William H. Ford, A. M., M. D., 

Late President of Philadelphia Board of Health. 

W. W. Meyers, A. M., M., D., 

Specialist in Nervous Diseases, University of Maryland. 

Win, F. Craig, A. M., M. D., 

Instructor in Anatomy, Medico-Chirurgical College, Philadelphia. 

A. M. Stafford, M. D., 

Specialist in Diseases of the Nose and Throat, Western University, Pa. 

F, E, Miller, A. M., M. D., 

Consulting Physician, St. Joseph's Hospital, New York City. 

Eugene Davis, M. D., 

Specialist in Polyclinic Hospital, Philadelphia. 

L. E. Fortier, M. D., 

Professor in Anatomy and Physiology, University Laval, Montreal. 

A. W. Daniell, M. D., 

Jefferson Medical College ; Ex-Surgeon Penna. K. E. Co. 

E. F. Roeber, M. D., 

Member Berlin Medical Institute. Kneipp System of Natural Healing. 

Jean Latauche, M. D., 

Lecturer on Clinical Diseases, Hospital of Charity, Paris. 

S. Iwasaki, M. D., 

Chief of Medical Institute, Nagasaki, Japan. 



GENERAL ARRANGEMENT 



Although contained in one volume this work is 
divided into twenty Books, which in their turn are 
subdivided into chapters or parts. 

At the back of the whole work will be found a 
complete General Index of all matters contained in 
the different Books and their subdivisions, so that 
any disease or any remedy in any part of the work 
may be quickly located. But, in addition to this 
General Index, each chapter or part is prefixed with 
a special index of its own, thus giving immediate 
location of items to be consulted in the special sub- 
ject at the time under consideration. For example, 
let us take the common disease Asthma. On con- 
sulting the General Index we find the main article 
to be on page 523. Turning to the index at the be- 
ginning of this chapter (Part VLof Book IV) we 
may find the causes, symptoms and varieties of 
Asthma. 

If what we wish is not found in this general 
article, we again refer to the General Index; and we 
have special treatments of the disease in other parts 
of the work, such as Simple Remedies, Prescriptions, 
Homeopathic Treatment, Exercises, etc. This plan 
has been carried out all through the work. 



Table of Contents 



Book I The Human Body 35 

A Description of the Colored Anatomical Charts Comprising 
the Manikin Accompanying this Work 

Book II Anatomy and Physiology 73 

Book III Preventive Medicine 127 

Part I The Prevention of Disease by Elimination of Disease Carriers. 127 

Part II Water in Its Hygienic Relations 147 

Part III Pure Air as a Condition of Health 181 

Part IV The Hygiene of Foods and Drinks 207 

Part V Outward Enemies to Health 231 

Part VI The Germ Theory of Disease 237 

Part VII The Construction of Sanitary Dwelling Houses 247 

Part VIII Importance of the Removal of Excreta 257 

Book IV Curative Medicine 261 

Part I The Eruptive Diseases 261 

Part II The Constitutional Diseases 353 

Part III Diseases of the Nervous System 401 

Part IV Diseases of the Eye, Ear and Nose 451 

Part V Diseases of the Circulatory and Absorbent Systems 493 

Part VI Diseases of the Respiratory System 523 

Part VII Diseases of the Digestive System 555 

Part VIII Diseases of the Genito-Urinary System, Including the Venereal 

Diseases 599 

Part IX The Urine in Health and Disease with a Series of Home Tests. 631 

Part X Diseases Peculiar to Women 639 

Part XI Diseases of the Skin, Hair and Nails 711 

Part XII Diseases of the Bones and Muscles 733 

Part XIII Diseases of Children 757 

Part XIV Diseases and Conditions which may be Treated Surgically.... 783 

Part XV Anesthetics and Soporifics 813 

Book V First Aid to the Injured 825 

Part I Accidents and Emergencies 825 

Part II Bandaging 873 

Part III Poisons and Their Antidotes 881 

Book VI The Diagnosis of Disease 917 

With a Table of Symptoms Arranged Alphabetically for 
Ready Reference 

Book VII The Sick Room in the Home 985 

Part I A Treatise on the Science of Nursing 985 

Part II The Care of the Convalescent 1043 

Part III Diet in its Relation to Disease with a Table of Suitable and 

Unsuitable Foods for Nearly Fifty Diseases 1050 

Part IV The Care of the Aged 1087 

V 



y { TABLE OF CONTENTS. 

Book VIII Sexology 1107 

Part I Courtship and Matrimony 1107 

Part II The Mother and the Child, Being a Treatise on the Care of 
the Mother Before and During Child-birth and of the Child 
Through Infancy 1129 

Book IX Home Administration of Medicine 1199 

Part I The Ideal Home Medicine Chest 1199 

Part II Foods and Their Digestion 1209 

Part III Tables of Weights and Measures, Doses, Pulse Rate, Den- 
tition, etc., etc 1223 

Part IV Standard Medical Prescriptions and Simple Formulas 1233 

Part V New Remedies, Their Properties, Doses and Manner of Using. 1251 

Book X Simple Remedies for Many Ills. What To Do in the 

Absence of a Doctor 1259 

Book XI The Care and Diseases of the Teeth 1301 

Book XII The Occupational Diseases 1331 

With a Table of Industrial Poisons arranged alphabetically, 
showing the effects produced by each and giving special 
measures of relief therefrom 

Book XIII Medical Materials, Their Properties and Uses .1375 

Part I Inorganic or Mineral Materials 1375 

Part II Organic or Vegetable Materials 1385 

Book XIV Alcohol and Narcotics 1479 

The Newest and Best Cures for the Drink, Tobacco and Drug 

Habits 

Book XV The Treatment of Disease by Various Schools of Medicine. 1495 

Part I Homeopathy 1495 

Part II Osteopathy = 1508 

Part III Massage 1518 

Part IV Chiropractic 1524 

Part V Hydrotherapy 1527 

Part VI Eclectic Medicine 1545 

Part VII The Japanese Method 1557 

Part VIII The German Home Treatment 1571 

Part IX Electricity and the X-Ray 1588 

Part X Mental Healing, Including Mesmerism, Hypnotism, Mind Cure, 

Christian Science and Telepathy 1591 

Part XI Human Science: Phrenology, Physiognomy and Palmistry.... 1604 

Book XVI Beauty Culture and Self-Care for Women . 1623 

Book XVII Physical Culture and Body-Building 1649 

Book XVIII The Science of Breath and a Series of Remedial Exercises. 1689 

Book XIX Jiu-Jitsu 1809 

Book XX Latin-English Dictionary of Drugs 1713 



LIST OF ILLUSTRATIONS 



PAGE. 

Abdominal Binder 1144 

Aconite. (Colored Plate) 1423 

Acromio-Clavicular and Shoulder Joints 88 

Ague Eoot. (Colored Plate) 1405 

Air Passages of the Lungs 184 

Alimentary Canal from Throat to Anus 101, 216 

Ankle Joint, Section of • 88 

Anterior Splint for Fracture of Arm 872 

Apple. (Colored Plate) 1395 

Application of a Bandage 805 

Applying the Diaper 1144 

Arm Bones 83, 84 

Arteries, The 511 

Artery of the Arm Ill, 793 

Artificial Respiration — Mechanical 856 

x\rtificial Respiration — Schafer System 853 

Asparagus. (Colored Plates) 1398, 1415 

Atlas or First Cervical Vertebras 80 

Balancing and Stretching Exercise 1684 

Bandage for Burn on Arm 873 

for the Eye 873 

to Fix Shoulders Back 873 

for Fractured Collar Bone • 873 

for Fractured Knee-Cap 873 

for the Head 873 

for Lower Part of Leg 873 

for Mouth-breathing 1643 

for Outstanding Ears 1643 

Barberry. (Colored Plate) 1433 

Base of Brain, Sectional View of 117 

Bathing the Infant 1150 

Beet. (Colored Plate) 1399 

Belladonna. (Colored Plate) 1429 

Bilberry. (Colored Plate) 1439 

Bitter-sweet Nightshade. (Colored Plate) 1435 

vii 



Vlll LIST OF ILLUSTRATIONS. 

PAGE. 

Blackberry. (Colored Plate) 1427 

Black Briony. (Colored Plate) 1437 

Blood Corpuscles, Magnified 105 

Board as Splint for Fracture Below the Knee 873 

Bone Fractures • 806 

Bone, Section of 75 

Bones of Forearm Acting as Levers 744 

Bones of the Hand (Carpus) 84 

Brain, The 407 

Brain and Cord 121 

Breast Bandages 878 

Broomstick Exercise 1685 

Brushing the Hair 1643 

Brushing the Teeth 1643 

Burrow of Itch Insect . . . • 729 

Buttock and Back of Thigh 124 

Calamint. (Colored Plate) 1413 

Calcified Trichina? 751 

Caraway. (Colored Plate) 1435 

Carrot. (Colored Plate) 1425 

Cartilage, Section of 76 

Cathartic. (Colored Plate) ' 1425 

Cathartic Eamno. (Colored Plate) 1409 

Celery. (Colored Plate) 1402 

Cells of Human Organism 210 

Cervical Cord, Section of 122 

Chamomile. (Colored Plate) 1435 

Changing Sheets 998 

Character Lines of the Hand 1617 

Chart. — Hours of Feeding 1145 

Chart. — Hours of Sleep 1145 

Checking Hemorrhage in Hand or Wrist 794 

Chicken-pox. (Colored Plate) 766 

Chittim Bark. (Colored Plate) 1405 

Cholera Germ 328 

Cholera Germs. (Colored Plate) 238 

Cigar-box Splint Applied to Fracture of Ankle 872 

Ciliated Epithelial Tissue 74 

Circulation in Frog's Foot 220 

Cleansing Breath 1696 



LIST OF ILLUSTRATIONS. IX 

PAGE. 

Coat Sleeve Sling 872 

Cold Compress 1642 

Colt's. Foot. (Colored Plate) .".... 1419 

Common Bramble. (Colored Plate) 1427 

Common Hedge Nettle. (Colored Plate) 1407 

Comparison of Breast-fed and Bottle-fed Infants 1145 

Constituents of Foods . . 227 

Correct Position for Complete Breathing 1696 

Course of Femoral Artery 795 

Cross-section of Head 1308 

Crow-Foot. (Colored Plate) , . . 1431 

Crystalline Lens 454 

Currants. (Colored Plate) 1419 

Curvature of Lens . • . . 466 

Daily Kecord 1021 

Dandelion. (Colored Plate) 1427 

Dental Caries. (Colored Plate) 1318 

Dental Floss 1643 

Diagnosis Charts 916 

Diagram of Both Circulations 222 

Diagram of Circulation „ 221 

Digestive System 1302 

Digitalis. (Colored Plate) 1431 

Dill. (Colored Plate) 1437 

Diseases of the Teeth. (Colored Plate) 1300 

Dislocation of Lower Jaw 809 

Dissection of Front of Forearm Ill, 123 

Dorsal Vertebra? , 79 

Double Handkerchief Sling 872 

Dressing for Broken Leg SOS 

Drying the Face 1642 

Ear, Section of 472 

Ear, The 474 

Eczema. (Colored Plate) 714 

Effect of Alcohol on the Stomach and Intestines. (Colored Plate) 1480 

Elder. (Colored Plate) 1433 

Electric Battery Treatment 1589 

Emergency Splint for Ankle Made from Cigar-box 872 

Emergency Splint for Fracture of Knee-Cap 872 



X LIST OF ILLUSTRATIONS. 

PAGE. 

Encysted Trichinse 747 

Epithelial Tissue 74 

Epithelium. 'Columnar 74 

Example of Physical Development 1650 

Exercise for the Abdomen 1674 

for Abdomen and Trunk 1674 

for Abdominal Muscles 1658 

for the Back 1656, 1674 

for the Bust • 1674 

with Chair 1684 

for the Chest "..... 1674 

for Constipation 1674 

for Eemale Weakness 1674 

for Grace and Agility 1674 

for the Hips 1674 

in Tiu-Jitsu. (Fifty-four Photographs) , 1714 

for Muscles of the Front of the Body 1658 

for Prolapsed Organs 1675 

for the Spine 1656 

for the Stomach and Abdomen 1658 

for the Trunk of the Body 1658 

with Two Chairs 1684 

Eye. Section of 452 

Eve. The 461 

Face. Nerves of 118 

Fat. Section of 76 

Femur, or Thigh Bone 87 

Fennel. (Colored Plate) 1409 

Fibula, or Minor Shin Bone 87 

Filling Upper Lobe of Eight Lung 1696 

Flax. (Colored Plate) 1425 

Flesh Brush 1642 

Folding the Diaper 1144 

Folds of the Intestines 218 

Foot Bones 87 

Four-tailed Bandage for the Chin 876 

Foxglove. (Colored Plate) 1431 

Fracture of Both Bones of Forearm 807 

Fracture of Humerus 808 

Front and Side Views of the Teeth and Jaws 1307 



LIST OF ILLUSTRATIONS, XI 

PAGE. 

Garlic. (Colored Plate) '. 1417 

General Exercises for Women 1674 

Geranium. (Colored Plate) 1435 

Glandular Epithelium 74 

Golden Thistle. (Colored Plate) 1411 

Grape. (Colored Plate) 1397 

Grape-Fruit. (Colored Plate) 1395 

Great Mullein. (Colored Plate) 1429 

Hand Bandages 875 

Hand Wrestling 1685 

Head, Arteries of 109 

Head Bandage 872 

Heart, The 499 

Heart and Lungs, Sectional View 106 

Heart Cavities, Bight Side 502 

Heart, Showing Arteries. (Colored Plate) 504 

Heart, Showing Auricles and Ventricles .-. . 107 

Hedge Mustard. (Colored Plate) 1407 

Hedgewort. (Colored Plate) 1439 

Hellebore. (Colored Plate) 1421 

Hemlock. (Colored Plate) 1433 

Henbane. (Colored Plate) 1413 

Hip Joint, Socket and Ligaments 88 

Home Tests for Urine. (Colored Plate) 634 

Hookworms 310 

Hops. (Colored Plate) 1415 

Horse Chestnut. (Colored Plate) 1425 

Horse-Badish. (Colored Plate) T . 1417 

How to Stop Bleeding 846 

How to Stop Bleeding. (Colored Plate) 848 

Human Milk Containing Colostrum Corpuscles 228 

Human Skeleton. (Colored Plate) 736 

Human Skeleton. (Full Page) . 78 

Humerus 83 

Ideal Sick Boom 999 

Ice As a Cosmetic 1642 

Infant Bathing Table 1144 

Internal Organs. (Colored Plate) 504 

Iris. (Colored Plate) 1427 

Itch Insect 728 



Xii LIST OF ILLUSTRATIONS. 

PAGE. 

Japanese Ladies 1558 

Jiu-Jitsu. (Fifty-four Photographs) 1714 

Juniper. (Colored Plate) 1419 

Kidney Disease. (Colored Plate) 590 

Laeteals and Lymphatics 219 

Laurel. (Colored Plate) 1437 

Leg, Arteries of 112 

Leg, Front View of 124 

Lemon, The. (Colored Plate) 1394 

Licorice. (Colored Plate) 1427 

Lily of the Valley. (Colored' Plate) 1423 

Lime-Tree. (Colored Plate) 1411 

Liver Complaint. (Colored Plate) 590 

Liver. Section of. (Colored Plate) 504 

Liver, Showing Lobes and Bile Duct 102 

Lousewort. (Colored Plate) 1411 

Lumbar Vertebra? 79 

Lungs 106,- 183 

Lungs and Their Diseases 535 

Lungs. (Colored Plate) • 504 

Lying-in Room 1144 

Lymphatics 103, 104 

Mammary Gland - 691 

Manikin of the Body. (Colored Plate) 40 

Manikin of the Eye, Ear, Hand, Foot and Leg. (Colored Plates) 60 

Manikin of the Head. (Colored Plate) 36 

Marshmallow. (Colored Plate) 1415 

Massage of the Body 1642 

for the Bust . . . * 1643 

for Double Chin 1643 

for the Eyes 1642 

for the Face 1643 

of the Scalp 1643 

for Wrinkles 1643 

Meadow Saffron. (Colored Plate) 1417 

Measles. (Colored Plate) 760 

Mezereon. (Colored Plate) J 1437 

Mountain Balm. (Colored Plate) 1413 

Muscles of the Back 92 

Back of Thigh 97 



LIST OF ILLUSTRATIONS. Xlll 

PAGE. 

of the Body, Back View 89 

of the Body, Front View 90 

of the Chest '. 93 

of Face, Jaw and Neck 91 

of Forearm 94 

of Front of the Leg 97 

of the Larynx 529 

Muscular System. (Colored Plate) -. . . 752 

Mustard. (Colored Plate) 1413 

Neck, Arteries of 110 

Nerve Cells 76 

Fifth 119 

Vitalizing Breath 1696 

Nerves, The 425 

of the Face and Scalp 118 

Leading to Roots of the Teeth 1324 

Magnified 77 

Ninth, Tenth and Eleventh 120 

of the Side of the Face 441 

of the Thigh 96, 123 

Nettle. (Colored Plate) • 1429 

Non-striated Muscle . 77 

Normal and Pinched Nerves 1524 

Nursing Chart 1020 

Nutritive Proportions of Foods 224 

Oak-Tree. (Colored Plate) ' 1433 

Onion. (Colored Plate) 1400 

Operation for Cataract 464 

Oregon Wild Grape. (Colored Plate) 1396 

Ovary and Mammary Gland 691 

Parsley. (Colored Plate) 1431 

Pavement Epithelial Tissue 74 

Pelvis of the Male - 1 SQ 

Pennyroyal. (Colored Plate) 1421 

Peony. (Colored Plate) 142:$ 

Peppermint. (Colored Plate) 1437 

Perforated St. John's Wort. (Colored Plate) 1423 

Peritoneum, Showing Involved Organs 102 

Periwinkle. (Colored Plate) 1439 

Permanent Teeth of Right Side , 1306 



XIV LIST OF ILLUSTRATIONS. 

PAGE. 

Plantain. (Colored Plate) 1421 

Poppy. (Colored Plate) • 1421 

Position for Bottle-Feeding 1161 

Position for Breast-Feeding 1145 

Positions of the Vocal Cords 528 

Posterior Splint for Fracture of Arm 872 

Prevention of Wrinkles 1642 

Properly Made Bed 999 

Proportions of Healthy Child's Body 1145 

Pulmotor 856 

Pumpkin. (Colored Plate) 1400 

Pyorrhoea Alveolaris 1322 

Quieting the Baby 1161 

Eacemose Gland 74 

Radius • 84 

Recurrent Bandage 874 

Red and White Blood Corpuscles 223 

Red-berried Trailing Arbutus. (Colored Plate) *. 1411 

Red Pepper. (Colored Plate) 1403 

Removing Blackheads 1642 

Removing Superfluous Hair 1642 

Rescue from Drowning 853 

Ribs Showing Thorax 82 

Rigg ? s Disease 1322 

Right and Wrong Ways of Holding Baby 1160 

Ringworm on the Hair 723 

Roller Bandage 873 

Rooster Fight 1685 

Rosemary. (Colored Plate) 1429 

Saffron. (Colored Plate) 1407 

Sage. (Colored Plate) 1413 

Salivary Gland 98 

Salvia. (Colored Plate) 1413 

Santal Wood. (Colored Plate) 1405 

Scald Head. (Colored Plate) 715 

Scalp, Serves of 118 

Scapula or Back of Shoulder 83 

Scarlatina. (Colored Plate) 761 

Scarlet Fever. (Colored Plate) 761 

Scurvy-Grass. (Colored Plate) r 1417 



LIST OF ILLUSTRATIONS. XV 

PAGE. 

Sebaceous Gland, Magnified 721 

Semilunar Valves of the Heart 108 

Shoulder Joints 88 

Simple Bandage for Foot and Ankle 873 

Simple Gland 74 

Simple Spiral Bandage 872 

Simple Spiral Bandage over Splint 872 

Skin, The 712 

Skull, Front View of 81 

Small-pox, Confluent or Enmassed Form. (Colored Plate) 266 

Small-pox, Discrete or Separate Form. (Colored Plate) 266 

Spinal Column 79 

Spinal Cord • 121 

Spinal F'oramina 1524 

Spiral Beverse Bandage . . . . 872 

Stavesacre. (Colored Plate) 1411 

Stimulating the Hair Boots 1643 

Stomach, The 100 

Stomach. (Colored Plate) 504 

Stomach Tubule 100 

Stone Boot. (Colored Plate) 1405 

Straw Lily. (Colored Plate) 1427 

Striated Muscle 77 

Swallowing Muscles 215 

Tansy. (Colored Plate) 1409 

Teeth of Child Between Six and Seven Years of Age 1308 

Teething Chart 1165 

Temperature Chart 1022 

Temporary Teeth in Child Aged About Four Years 1311 

Temporary Teeth of Left Side , 1305 

Temporary Teeth of Bight Side 1305 

Test for Bubber Nipples 1151 

Thigh, Arteries of • 112 

Thigh, Back View of 124 

Thorax, The 82, 116 

Thorn-Apple. (Colored Blate) 1415 

Tibia or Shin Bone 87 

Tomato. (Colored Plate) 1401 

Tongue. (Colored Plate) 91S 

Tongue, The 99, 563 



xvi list OF ILLUSTKATIOXS. 

PAGE. 

To Prevent Infant from Taking Your Cold 1145 

Transportation of the Injured 856 

Treatment of the Eyelashes 1612 

Treatment for Moles : . . 1612 

Triangular Bandage As a Sling 873, 877 

Triangular Bandage for the Head 876 

Triangular Bandage for the Foot 873 

Trichina and its Cyst 750 

Cyst 719 

in Human Muscle. (Colored Plate) , . . . . 238 

Spiralis in Human Muscles 716 

Tuberculosis Bacillus. (Colored Plate) 238 

Ulcerative Stomatitis 1322 

Ulna, or Bone of the Forearm 84 

Umbrella As Splint for Fracture Below the Knee 873 

Urinary and Generative Organs of Women 610 

Urinometer, The 631 

Vaccination. (Colored Plate) -271 

Vaccination As a Preventive of Small-pox 268 

Valerian. (Colored Plate) 1131 

Valves of the Heart 516 

Varioloid. (Colored Plate) 267 

Veins of the Leg 114 

Veins of the Upper Extremity 114 

Villi of the Small Intestine 218 

Vincent's Angina 1322 

Vocal Apparatus 527 

Vocal Cords 528 

Washing the Face 1642 

What to Do if Bitten by a Mad Dog or Poisonous Reptile. (Colored 

Plate) 828 

White Hoarhound. (Colored Plate) 1119 

Wild Strawberry. (Colored Plate) 1139 

Wolf's Bane. (Colored Plate) ". 1423 

Wood Sorrel. (Colored Plate) 1409 

Wormwood. (Colored Plate) 1425 

Wrestling 1685 

X-Ray Photograph 1588 

Yellow Fever Mosquito 295 

Yellow Goat's Beard. (Colored Plate) 1407 



INDEX TO BOOK I 

Book I describes the human body and illustrates 
it by a series of Manikins or Anatomical Charts. 

The following list of contents, alphabetically 
arranged, will enable the reader to quickly turn to 
any subject or illustration desired: 

SUBJECTS OF THE TEXT 



56, 



Abdomen, Walls of 

Appendix, Vermiform 

Arms, Blood Supply of 

Arms, Bones of 

Arteries, The 

Bladder, The 

Blood, Coagulation of 

Blood, Description of 

Blood Supply of Arm 

Blood Supply and Muscular Arrange 

ment 

Blood-vessels of the Body 

Blood-vessels of the Liver 

Body, Muscles of 

Body, Structure of 

Bones of the Face 

Bones of the Skull 

Bones of the Spinal Column 

Bones of the Thigh and Leg 

Bones of the Trunk and Arms 

Brain, Base of 

Brain Cavity , 

Brain, Consistency of 

Brain, Location of 

Brain, Mechanism of 

Brain, Sectional View of 

Brain, Shape of 

Brain, Vertical Section of 

Breathing 

Cerebellum 

Cerebrum 

Chest, Composition of 

Child, Position of at Birth 

Clitoris, The 

Coagulation of the Blood 



42 

55 
43 
43 
57 
58 
49 
48 
43 

42 

57 
53 
42 
40 
40 
39 
44 
64 
43 
38 
37 
39 
37 
37 
37 
38 
36 
47 
37 
37 
44 
57 
56 
49 



Cranium, Base of 37 

Deftness of the Fingers 66 

Development, Muscular 66 

Digestive Apparatus, Description of... 51 

Ear, Description of 59 

Ear Drum, The 60 

Eye, Description of 59 

Eye, Muscles of 59 

Eye, View of 36 

Face, Bones of 40 

Face, Muscles of 35 

Fingers, Deftness of 66 

Foot, Description of 62 

Good Health, Picture of 35 

Hand, Description of 60 

Heart, Description of 48 

Hymen, The 56 

Intestines, The 53 

Kidneys, The 58 

Knee-Pan (Knee^Cap) 64 

Leg, Bones of 64 

Leg, Description of 63 

Leg, Muscles of 63, 65 

Liver, The 52 

Liver, Blood-vessels of 53 

Lungs, The 45 

Lungs, Breathing Capacity of 47 

Lungs, Description of 45-46 

Lungs, Pleura of 45 

Mucles of the Body 42 

Muscles of the Eye 59 

Muscles of the Face 35 

Muscles of the Leg 63, 65 

Muscles of the Neck 35, 36 

Muscles of the Shoulder 43 



33 



34 



INDEX TO BOOK I. 



Muscles of the Thigh 65 

Muscular Arrangement and Blood 

Supply 42 

Muscular Development 66 

Neck, Muscles of 35, 36 

Nerve, Sciatic 64 

Nose, The 38 

Olfactory Nerve 38 

Ovaries 56 

Pancreas, The 53 

Pelvis, The 44 

Picture of Good Health 35 

Position of Child at Birth 57 

Pylorus, The 52 

Respiration 47 

Ribs, The 44 

Sciatic Nerve, The 64 

Shoulder Joints, The 44 



Shoulder, Muscles of 43 

Skull, Bones of 39 

Skull, Shape of 39 

Spinal Column 40, 44 

Spinal Column, Bones of 44 

Spleen, The 58 

Stomach, The 52 

Thigh Bones 64 

Thorax, The 42 

Toes, The 62 

Tongue, The 38 

Trunk, Bones of 43 

Urethra, The 56 

Vagina, The 56 

Veins, The 58 

Vermiform Appendix 55 

Voice, The 66 

Womb, The 56 



LIST OF ILLUSTRATIONS 



Body, Manikin of 40 

Ear, " 60 

Eye, " 60 

Foot, a " 60 



Hand, Manikin of 60 

Head, " " 36 

Leg, " " 60 



Book I. 



THE HUMAN BODY. 



A Description of the Colored Anatomical Charts Composing the Manikin 

Accompanying this Work. 

CHART I. 

A PICTURE OF GOOD HEALTH. 

This exquisitely beautiful and artistic Anatomical Plate presents the 
head and face of a young man in the enjoyment of perfect health. Apart 
from the subject it so accurately and faithfully represents, it is in itself a 
valuable life-like portraiture of the human head and face, and shows to 
what perfection the art of anatomical plate printing has attained. Note 
the prominent perceptive faculties, the high forehead, features character- 
istic of a large brain and a massive and unimpaired intellect. Mark the 
open expression of the eye ! how true to nature and life-like. Observe the 
compressed lips, denoting firmness of character and determination of 
purpose. Look attentively at the bright, open, manly countenance; there 
are no signs of mental decrepitude, physical bodily infirmities, nervous 
fear, or exhaustion of brain power or life-force in the expression of the 
noble, ruddy and healthy face. It is, as its name implies, typical of Per- 
fect Health! 

Muscles of the Face and Neck. — This fine plate is a remarkably real- 
istic and accurate representation of the head and neck, after the outer 
skin has been removed. It shows the bare skull, together with the ad- 
mirable and skilful arrangement of the muscles of the face and neck ; also 
the external part of the ear. There are, also, numerous blood-vessels 
noticed meandering over the parts exposed to view, by means of which 
this muscular area receives its supply of nutrient blood. The large, broad 
muscle observed over the forehead is the one by which we elevate the 
brow, and in conjunction with the orbicular muscle that is seen surround- 
ing the eye, we can contract the brow, as in "scowling." 

Muscles of the Face. — The muscles of the face are those employed to 
give variety of expression to the countenance It is through the medium 

(35) 



36 THE HUMAN BODY. 

of these small but useful muscles that public speakers can give facial 
emphasis to their flow of rhetorical eloquence; the tragedian employs 
them to give dramatic effect to the various characters he impersonates, 
and the low comedian and "clown" cultivate them for facial contortion 
and "guying" characterization. The numerous muscles observed about 
the neck are those which give elasticity and mobility to the head. It is 
by means of these muscles that the head can rotate on its axis, bend for- 
ward, backward, sidewise, and pose in the diversified attitudes and various 
positions it can be made to assume. 

THE BRAIN; AND A VERTICAL SECTION OF THE FACE AND NECK. 

What the Plate Shows — As we progress in our anatomical course of 
study, our attention is firmly and deeply fixed in wonder and amazement 
at the marvelous mechanism revealed in the sublime profundity and 
grandeur brought out in this magnificent artistic plate. It brings before 
our astonished vision the beautiful proportions and symmetry of the 
human brain as it lays in situ within its bony castle ; and as we look upon 
its wavy convolutions we naturally turn our thoughts to the hidden mys- 
teries of mind and to its superiority over matter, and to the illimitable 
intellectual properties, powers and capacity of the mind, that lay quietly 
slumbering in the depths of the human brain, for the mind of man sur- 
passeth all things of human conception or construction. Below this mighty 
throne of reason and intelligence, on the left, we observe the cerebellum 
or lesser brain, the fount from whence all the vegetative or organic func- 
tions of life — as respiration, beating of the heart, digestion, etc. — receive 
their inspiration and supply of vital force. 

View of the Eye. — We can likewise view the human eye as it lays in 
position in its bony socket, and wonder at our Creator's munificence and 
benevolence in providing us with such a delicate instrument of vision with 
which to light our way about in the world, and view the magnificent beau- 
ties of nature that surround us on every -hand. Here, too, we observe the 
teeth, those essential pre-requisites to personal beauty, and valuable ad- 
juncts to the powers of articulation and speech, protruding through the 
gums, their roots being visible above and below the gums; and in the 
lower set we see the dental nerve distributing its nervous supply to their 
individual and collective roots. 

The Neck Muscles — This beautiful illustration brings out in bold re- 
lief the superficial and deep muscles of the neck, and, at the same time, 
we observe a faithful delineation, not only of the relative position of the 




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SECTIONAL VIEW OF THE BRAIN, FACE AND THROAT. 37 

carotid artery and jugular vein, but also of the manner in which, the mus- 
cular and fleshy part of the neck receives its nervous supply. 

VIEW OF THE BASE OF THE CRANIUM. 

Brain Cavity. — Here in this remarkable illustration we have pre- 
sented to us one of the most wonderful views in the anatomy of the skull, 
or, in fact, t of any part of the human frame. It is a view of the floor of 
the cranial cavity on which that curious and mysterious, but sublime 
organ, the brain, rests. The marvelous skill and ingenuity therein dis- 
played, of the complex mechanism surveyed, the beautiful and intricate 
manner in which the nerves of special sense are so elaborately set forth, 
the complicated profusion and exquisite design manifest in the distribu- 
tion of blood-vessels for the nourishment and support of the special organ 
of reason and intelligence — all claim our closest and undivided attention, 
and we are unconsciously led to revere the Omniscience of Him who 
could conceive of such intricate architecture, and perform such delicate, 
unique and perfect workmanship. The large opening observed in the 
floor of the cranial cavity is the foramen magnum, through which the 
spinal cord, together with the cerebro-spinal nerves, escape. 

SECTIONAL VIEW OF THE BRAIN, FACE AND THROAT. 

The Brain in its Bony Citadel. — The artist, with true anatomical in- 
stinct and a rare technical ability in regard to accuracy and minute detail, 
has performed his part of the work in this illustration with such faithful 
fidelity to nature that one cannot withhold a word of praise at the 
grand style and elaborate manner of its execution. This elegant and 
artistic anatomical plate represents the brain held firmly in position within 
its strong, bony citadel, but cleft in twain from above downward, thus 
showing its internal mechanism and construction; besides which it gives 
the internal arrangements of the nose, tongue, throat and neck. 

Order of Brain Mechanism. — Commencing from above and descending 
downward we observe the following important structures, to wit: The 
fascia or skin covering the cranial bones ; and then a section of the bones 
themselves, showing their laminated structures. Between the bones of 
the skull and the brain are seen the meningeal coats of the brain, which 
serve the double purpose of supplying it with blood-vessels and protecting 
that delicate organ from pressure or injury. 

Cerebrum and Cerebellum — We observe that the cerebrum, the seat 
of mind and volition, is much larger than the cerebellum or little brain ; 



38 THE HUMAN" BODY. 

and as though that was not enough area for the evolution of the mind, 
we see this part of the brain most curiously wrinkled and folded into 
various sized convolutions, thus increasing the mental surface. The more 
numerous these convolutions are, the higher and more noble the mental 
faculties and intellectual powers become. The hemisphere of the brain, 
here shown, is seen to be divided into three lobes, the frontal, middle and 
posterior. The Corpus Callosum, or the great commissure of the brain, 
is most faithfully represented, and immediately below is seen the Fornix. 
The peculiar appearance of the cerebellum or little brain presents a tree- 
like resemblance, whence it is called the arbor vitce, or the tree of life. 

The Olfactory Nerve. — The olfactory nerve is graphically displayed, 
branches of which are seen passing in all directions over the mucous mem- 
brane of the nose. A little to the left of the olfactory nerve is seen the 
posterior nares, and immediately below the pharynx and epiglottis, the 
oesophagus or gullet, the larynx and trachea or wind-pipe. 

The Tongue. — The tongue, or organ of taste and instrument of speech, 
is most accurately represented, the muscular fibres of which are seen 
running in different but determinate ways, thus giving to this important 
organ variety and regularity of motion and aiding it to assume numerous 
shapes and forms. The cervical portion of the spinal column is seen, with 
the fleshy part of the back of the neck attached. This plate is one that 
commends itself to our deep and careful study. 

VIEW OF THE BASE OF THE BRAIN, AND THE THOUGHTS IT 

SUGGESTS. 

Shape of Brain. — As so graphically delineated in this beautiful as 
well as natural illustration of the human brain, we glean a knowledge 
of the origin and source of its blood supply; the arteries are observed to 
distribute numerous branches in various directions along and over its sur- 
face, many of which penetrate its substance. As noticed, the brain pre- 
sents an ovoid or egg-shaped appearance, divided into two equal, lateral 
halves — hemispheres as they are called — thus virtually giving us two 
brains, the same as we have two eyes, two arms and two legs. With this 
surplus of brains, as it were, at our command, we are naturally led to ask 
the question, who can define the metes and bounds of the mind ? Or de- 
scribe the limits of our intellectual capacity ? Who can fathom the depths 
of thought? Or circumscribe our mental, educational or scientifical ac- 
quirements, when health crowns the human temple with its rubicund 
mantle ? Echo answers who ! 

Beauty of the Brain Views. — Every view of the human brain wo have 



BONES OF THE HEAD, FACE AND NECK. 39 

seen in this series of magnificent and unparalleled anatomical plates has 
inspired onr admiration and held us spell-bound in utter astonishment and 
amazement at the limitless attributes, the diversified powers, and the 
variety of functions this wondrous and mysterious organ is called upon 
to perform in the hourly transaction and business pursuits of daily 
human life. And yet, notwithstanding the marvelous properties of this 
elaborate organ, it is the least solid and most unsubstantial looking body 
of the human casket. 

Consistency of the Brain. — It consists of eighty per cent, of water, 
seven per cent, of albumen, some phosphorized fat and a few other minor 
substances. Such is the composition of the mighty and powerful organ 
which rules the world. Whilst the brain is the seat of sensation, yet it 
can be cut, burned or electrified without causing pain in itself. Strange, 
passing strange, are the properties and powers of the brain! 

BONES OF THE HEAD, FACE AND NECK. 

Bones of the Skull — This illustration gives an accurate and faithful 
representation of the head, face and neck, surrounded by an outline of 
the fleshy parts as they appear in the human frame. The bones of the 
head, eight in number, constitute the skull, and those of the face, four- 
teen in number, compose a strong, hard, bony case, which encloses and 
affords a suitable protection for the brain and the four organs of special 
sense, viz.: sight, smell, taste and hearing. All of these bones are im- 
movable, except the lower jaw, which moves by means of a hinge- joint, 
and permits of the opening and closing of the mouth. 

Bones Seen in the Plate. — The bones of the skull observed in this 
beautiful plate are: the frontal, which forms the forehead or front part 
of the skull; the parietal, constituting a portion of the side and top of 
the head ; the occipital, forming the lower and back part of the skull, and 
the temporal, which forms the lower part of the side and a part of the 
base of the cranium. These several bones are joined together by notched 
seams, after the manner carpenters call "dove-tailing." 

Shape of the Skull. — The skull, as will be seen, is oval, which adapts 
it to the conformation of the brain, besides giving it greater resistance to 
pressure. The stronger and smaller end is in front, where danger is 
greatest to the brain, whilst the projections before and behind shield its 
less protected parts. The peculiar conformation and shape of the skull 
forms a strong shelter for the brain — an organ so delicate that if not so 
strongly guarded from injury, an ordinary blow falling upon it would 
destrov it forever. 



-±0 THE HITMAN BODY. 

Bones of the Face. — The bones of the face shown in this plate are the 
nasal bone, forming the arch of the nose, the malar, which gives promi- 
nence to the cheek, the upper jaw, containing the upper teeth, and the 
lower jaw, containing the under teeth. 

The Spinal Column — That portion of the spinal column noticed in the 
illustration consists of the cervical vertebra?. Each vertebra is composed 
of a body, with seven spinous processes projecting from it. The body is 
perforated by a ring, through which is seen running the spinal cord, giv- 
ing off nerves between each separate bone. A ring of cartilage is seen 
inserted between each separate vertebra, the object of which is to prevent 
any jar reaching the brain when we run, jump, walk or stumble. 



CHART II. 
THE INTERNAL WONDERS OF THE HUMAN BODY REVEALED. 

THE HUMAN BODY AND ITS MARVELOUS PERFECTION. 

Wonderful Structure of the Body. — The human body is the highest 
form of animal life. It is full of beautiful proportions and divinely sym- 
metrical in shape, form, mould and outline. We look with honest pride 
and glowing admiration upon the many accomplishments that man has 
achieved in the world around us. We see his skill displayed in the various 
arts and sciences, and we look with awe upon the projects of his intellect 
and reason, the realization of which is but a small question of time ! We 
boast of our ships, our steamboats and our steam cars; we are justly proud 
of our bridges, our viaducts and the progress of our engineering skill ; we 
grow enthusiastic over our telegraphs, our telephones, our electric lights ; 
we feel a degree of national pride in the achievements and successes of 
Edison, the wizard of Menlo Park; but where, let us ask, in the whole 
range of events, the acquirements of arts, the accomplishments of me- 
chanics, the achievements of architecture, the attainments of engineering, 
or the successes and promises of electrical sciences, can we find such an- 
other structure as the human body, that curious, yet perfect world of 
wonders ! 

Man the Most Complex Body. — It embodies an epitome of the whole 
universe ! Man is more elaborate, more complex, more God-like, than 
any other living organism ; more wonderful, more beautiful, more mar- 
velous, than any work of human ingenuity, conception or construction. 




COPYRIGHT 1915 BY E J. STANLEY 



CHART 2. 



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COPYRIGHT 1915 BY E J. STANLEY 



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CHART 2. 



MAN THE MOST COMPLETE BODY. 41 

Indeed, the mechanism, the skill and the workmanship displayed in the 
human body is simply perfection itself. In conception, it is divine; in 
design, perfect; in architecture, grand; in construction, wonderful; in 
beauty, lovely ; in form, symmetrical ; in outline, sublime ; in strength, 
great; in arrangements, marvelous; in mobility, transcendant ; in adapt- 
ability, unexcelled; in fine, when studied in all its parts and their rela- 
tionship to each other, we are led to exclaim with the Psalmist David, 
that the human body is "fearfully and wonderfully made." 

Man the Most Complete Body. — The all-wise Creator, when He first 
made man, made him perfect. He formed every organ of the body with 
direct reference to the function to be performed. Every bone, muscle, 
nerve, organ and tissue formed in the construction of this wondrous or- 
ganism is made of the right kind of material; is of the proper form and 
size; placed in the right position to subserve best the purpose for which 
they were individually and collectively designed, and to perform the 
peculiar duties assigned to each. We cannot talk with the ears, smell 
with the eyes, see with the no^e, nor walk with the tongue. We cannot 
think with the lungs, nor breathe with the brain. The stomach was not 
designed to propel the blood over the system, nor the heart to digest food. 

The Complete Organs and Structures — The muscles which give form 
and shape to the body would be powerless instruments of movement if 
devoid of the bones of the skeleton. Thus we see that every organ and 
structure was formed with direct reference to the accomplishment of a 
certain definite object. Hence, the bones form a frame work, to protect 
the delicate organs of mind, respiration, circulation, digestion and excre- 
tion, to serve as levers on which the muscles may act to produce motion, 
and to preserve the form and shape of the body; the muscles, such as we 
observe in this plate, give form, shape and symmetrical proportions to 
the body, and produce its varied motions ; by means of the brain we think, 
feel and act; the nerves of the eye take cognizance of external objects, 
and convey their impressions to the brain; the auditory nerve distin- 
guishes sounds; the olfactory nerve identifies and separates^the different 
odors brought into contact with it, and the sentient nerves of the skin 
are fully impressed with the touch of external objects, carry the impres- 
sion of their character and size to the brain, and the motor nerves carry 
the commands of the will to the muscular system, that the behests of the 
mind may be obeyed and carried out ; the heart receives the impure blood 
from all parts of the body, and sends it to the lungs to be purified, then 
receives it back again and forces it with enormous power even unto the 
most remote and minute part of the system ; the arteries and veins are 



42 THE HUMAN BODY. 

made for the express purpose of conveying the "pabulum of life" from the 
heart, and to carry the vitiated and poisonous fluid to the heart ; the lungs 
throw off the carbonic acid in the venous blood and replace it by oxygen ; 
the stomach, by and with the aid of the salivary, biliary, pancreatic and 
intestinal juices, digests the food and transforms it into blood; the kid- 
neys are designed as filters, to aid in the purification of the blood; thus 
we observe that the various tissues and organs of the body have each their 
own especial use in the human economy, and their exact and definite func- 
tion to perform ; and as a result of the sum total of the proper required 
performance of all these different functions, we have not only harmony 
and health, but happiness of mind, soul and body as well. 

MUSCLES OF THE TRUNK OF THE HUMAN BODY. 

Muscular Arrangement and Blood Supply. — In this exquisite and mag- 
nificent colored engraving we have a grand view of the wonderful ar- 
rangement of the muscles of the trunk of the human body, together with 
the muscular arrangement of the arms and likewise their blood supply. 
The trunk of the body is divided into two compartments — the thorax 
and abdomen. 

The Thorax. — The thorax derives its name from the Greek word 
tlioreo, and signifies "I leap/' because the heart leaps in it. It is covered 
on the front part by large muscles ; the pectoralis major, or large muscle 
of the breast, is observed on the left side of the chest, whilst on the right 
it is removed and exposes the pectoralis minor, or small muscle of the 
breast. The dove-tailed muscle observed on each side is the serratus 
magnus, and is employed in expanding and contracting the chest in the 
act of breathing. The muscles of the chest walls, in a deep inspiration, 
exert a force equal to lifting a weight of 750 pounds. 

Walls of the Abdomen. — The muscular walls of the abdomen are 
nicely arranged and beautifully adapted to the functions they perforin. 
On the left side we see the large oblique muscle, so named because of the 
direction its fibres run, and on the right side we observe the rectus muscle, 
the transverse muscle and internal oblique muscle, all of which are strong, 
broad muscles, whilst the manner in which they are so scientifically ar- 
ranged gives additional strength to the abdominal walls, without deterior- 
ating from its great mobility, and at the same time avoiding all pressure 
of the organs contained within this large cavity. There are ninety-one 
muscles on each side of the trunk, or one hundred and eighty-two in all, 
ninety of which are pairs, and two are single. 



BOXES OF THE TBUXK AND ARMS. -±3 

Muscles of the Shoulder. — The large triangular muscle of the shoulder 
— the deltoid — is one of great strength, as in fact are all the muscles of 
the arm. If you grasp the arm tightly just ahove the elbow- joint, and 
then bend the fore-arm, you will feel the biceps muscle of the arm become 
firm, hard and prominent ; now straighten it again and it becomes re- 
laxed, whilst the muscles on the back of the arm become hard and prom- 
inent. The muscles of the fore-arm are the flexors and pronators; that 
is, they flex the arm and turn the palm downward. In each upper 
extremity or arm there are fifty-three muscles, and we obserYe here the 
nicest and most economical method of packing away the muscles that 
could be improYised, securing strength, giving elegance to its form and 
shape and facilitating its mobility. 

Blood Supply of Ann — On the right arm we obtain a glimpse of the 
blood supply of the arm ; we see the brachial artery giving off numerous 
branches, and observe the radial and ulnar arteries doing the same thing; 
thus securing ample nourishment to preserve the health, strength and 
beauty of the arm. 

BONES OF THE TRUNK AND ARMS. 

Different Forms of Bones. — On turning over this flap we are brought 
face to face with a grim looking but useful object — the frame work of 
the trunk and arms. The skeleton is of a ghastly appearance and em- 
blematic of death ; its unsightly look sends a thrill of horror through 
us, and we instinctively recoil from it. Yet it subserves a useful purpose 
in the human body, and the ugly looking bones, when carefully examined, 
abound in nice contrivances and ingenious workmanship ; whilst each 
individual bone is designed for the especial duty it has to perform. Hence 
the bones differ in form ; some are long, as in the arms and legs ; some 
are short and thick, giving strength and compactness, as in the lumbar 
portion Of the spine ; some are flat, for covering a cavity, as the skull and 
pelvis, and others used for a special purpose are irregular, as in the hands 
and feet. 

Combined lightness and Strength.— But notwithstanding this diver- 
sity in form, the general plan constantly kept in view by the Divine 
Architect has been the central idea of combining lightness with the great- 
est possible degree of strength. The bones of the arms and legs are round, 
or triangular, and hollow, thus giving with the same weight a greater 
degree of strength than if solid, besides affording a larger surface for the 
attachment of muscles. 



-1-t THE HUMAN BODY. 

Composition of the Chest. — The chest is composed of bones, cartilages 
and ligaments. Its natural form is that of a cone diminishing upward; 
and it affords lodgment for the heart, lungs and large blood-vessels. Its 
walls are formed posteriorly by the seven dorsal bones of the spinal col- 
umn, and the ribs as far as the angle, the sides by the body of the 
ribs, and front by the ribs, the costal cartilages and the breast bone. 

The Ribs. — The ribs are twenty-four in number, arranged in pairs, 
twelve on each side of the chest. At the back they are fastened to the 
spine, and in front the seven upper pairs are tied by cartilages to the 
breast bone, three are fastened to each other and the cartilage above, and 
two, the floating ribs, are loose. The long, slender ribs give lightness; 
their arched form confers strength, and the cartilages impart elasticity; 
thus the three most essential pre-requisites of the chest for the protection 
of the delicate organs contained within this cavity are secured, whilst the 
freest motion in respiration is ensured. 

The Pelvis. — The pelvis is an irregular-shaped basin, formed by the 
hip bones and the pubic bones in front. In the upper and back part is 
the foot of the spinal column, consisting of a wedge-shaped bone called 
the sacrum. It is observed firmly planted between the wide spreading 
hip bones of the pelvis, like the keystone of an arch, and gives a strong 
support to the burden above. 

The Spinal Column. — The spinal column, the lumbar portion of which 
is here seen, consists of twenty-four bones, between which are placed 
pads of cartilage. Such is the elasticity of these cushions of cartilage, 
that, though they become condensed through the day, making us shorter 
in the evening than in the morning, they resume their normal thickness 
while we are lying in bed at night. The perfection in the architecture 
of the spine surpasses belief; its various uses seem a bundle of contra- 
dictions. 

Bones of the Spinal Column — The twenty-four bones of which it con- 
sists are so stiffly locked together as to form a chain that will bear and 
support the heaviest of burdens, yet so flexible that it will bend like India 
rubber; within this wondrous column hides a delicate nerve that would 
thrill at the gentlest touch, yet so securely does it rest in its bony couch 
that it feels not the slightest jar or shock; and resting upon this remark- 
able pillar of bones is borne the brain, without a tremor or a fear of 
danger; to it are found clinging the vital organs of the chest and abdomen, 
secure in the protection it affords. 

The Shoulder Joint. — The shoulder joint, formed as it is by the 
shoulder-blade (scapula), collar bone (clavicle), and the arm bone, is most 



THE LUNGS ; their mechanism AND WONDERS. 4:5 

beautifully designed and executed. It comprises a shallow ball and socket- 
joint, thus affording the freest rotary movements. The shallowness of the 
socket, however, accounts for the frequent dislocations of this joint; but 
that is compensated for by the easy, graceful carriage and swing of the 
arm, which a deeper socket would not permit. 

The Collar Bone. — The collar bone is fastened at one end to the breast 
bone and first rib, and at the other end to the shoulder blade. It thus 
holds. the shoulder- joint out from the chest, aids in protecting the import- 
ant vessels of the axilla, and gives the arm a greater range of freedom, 
mobility and play. 

THE LUNGS; THEIR MECHANISM AND WONDERS. 

What the Lungs Are. — The lungs ! Dense looking objects, and yet 
how light and buoyant ! This beautiful anatomical chart shows us a front 
view of the chest and lungs, with the lungs enclosed within the bony 
basket-work of the chest. The lungs are two large, conical bodies, placed 
one on each side of the chest, and occupy the greater part of its cavity. 
During life they accurately adapt themselves to the varying dimensions 
of the chest ; for, unhappily, the foibles of fashion very frequently cause 
restriction of the lungs, by interfering with the resistance and freedom 
of movement of the ribs, so essential to health, by tight lacing and the 
barbarous usage of corsets. 

Pleura of the Lungs. — In this chart we see also the pleura or the in- 
vesting membrane of the lungs, and right below it the diaphragm or 
midriff. 

Two Distinct Lungs. — Although the lungs are two in number, as far 
as their structure is concerned, and are perfectly distinct from each other, 
having, as we observe in the chart underneath this one, the heart and 
blood-vessels between them, yet as regards their functions they may be 
considered the same, since they receive their blood from a single vessel, 
the pulmonary artery, and the air by one canal, the trachea or wind-pipe, 
and act in common with each other. 

Size and Shape of Lungs. — As will be observed, the lungs are not 
quite the same size or shape; the right lung, although somewhat shorter 
and thicker than the left, is the larger and stronger, being divided into 
three lobes; whilst the left is the smaller and weaker, divided into two 
lobes only, and hence more frequently subject to disease. 

Weight and Shape of Lungs. — The weight of the lungs varies very 
much; but in general they average about forty-two ounces in the male; 



46 THE HUMAN BODY. 

thirty-six in the female; the right lung being about two ounces heavier 
than the left. Each lung is conical in shape, with a broad concave base 
resting on the convex surface of the midriff, the apex directed upward and 
extending into the root of the neck about one inch above the level of 
the first rib. 

Interior Arrangement of Lungs. — On turning this flap over we find a 
vertical section of the lungs, showing their interior arrangements. The 
lower end of the trachea divides, one portion going to each lung. These 
again subdivide and continue to subdivide in geometrical order, growing 
smaller and smaller with each division, and extending to every part of 
the lungs, finally terminating in a cluster of air cells, bound together by 
cellular tissue and forming a lobule. These lobules vary in size ac- 
cordingly as they are located on the surface of the lung or deeper in its 
tissues. Each lobule is separate and distinct from the other, and forms 
in itself a perfect and independent lung in miniature. 

Function of the Lobules. — In this arrangement we see the boundless 
wisdom of the Creator displayed, for were it not for this Avise and perfect 
provision — one of the very greatest importance in the process of respira- 
tion, since it enables each individual lobule to perform its functions inde- 
pendently of the rest — tubercular disease, bronchitis and inflammation 
of the lungs would not only be incurable, but would prove to be very 
rapidly fatal. 

Lung Air Cells. — Each air cell varies in size from the seventieth to 
the one two-hundredth part of an inch in diameter. The number of air 
cells in the two lungs is truly surprising, there being certainly not less 
than 600,000,000, though according to Dr. Addison's computation there 
are 1,700,000,000, equivalent to 1,500 square feet of surface on which 
the process of purifying the blood is constantly and continuously going 
on in a healthy lung. 

Blood-vessels. — On the next flap we have a graphic illustration of the 
internal arrangements of the blood-vessels of the lungs and bronchial 
tubes. The pulmonary artery, arising from the right ventricle of the 
heart, conveys the venous blood to the lungs. It penetrates the lungs and 
divides and subdivides into branches, which accompany the bronchial 
tubes and terminate in a dense capillary net-work upon the walls of the 
air cells, where the blood undergoes that magical change, giving up its 
poisonous qualities and becoming revivified and healthful. 

Pulmonary Veins. — Erom this net-work of arteries and air cells the 
radicles of the pulmonary veins arise, and, coalescing into larger and 
larger branches, at length accompany the arteries and return the blood to 



47 

the left auricle of the heart in a purified condition. The pulmonary ar- 
teries and veins differ from the same vessels in other parts of the body, 
since the former conveys venous blood, and the latter arterial blood. 

Breathing. — Kespiration, or the act of breathing, consists of the alter- 
nate inspiration and expiration of air to and from the lungs; in the pro- 
cess of which the lungs themselves are almost passive instruments, since 
their contraction and expansion takes place by means of the muscles which 
surround the chest. The diaphragm or midriff, which, when at rest and 
the lungs empty, forms a beautiful dome to the abdominal cavity, becomes 
depressed during the inspiratory process, and presses the walls of the 
abdomen outward. At the same time the ribs become elevated, thus in- 
creasing the size of the chest. Thereupon the elastic lungs expand to 
occupy the entire space, whilst the current of air, in obedience to a well- 
known physical law, rushes down the wind-pipe and enters the numerous 
air-cells, the result of which is inspiration. In expiration the reverse of 
this takes place. We bend forward, draw the abdominal walls inward, 
press the diaphragm upward, whilst the ribs are pulled downward. All 
these acts simultaneously performed decrease the size of the chest, and 
force or expel the air from the lungs. 

Breathing Capacity of Lungs. — The breathing capacity of the lungs 
bears a close correspondence to the stature of man. For an ordinary- 
sized man of about five feet eight inches in height, it will be 230 cubic 
inches, or about one gallon of air, and for each additional inch in stature 
up to six feet, there will be an increase of eight cubic inches. In a forcible 
expiration all the air in the lungs is not expelled; there still remains be- 
hind 100 cubic inches. Thus, with this uuexpelled air, the breathing 
capacity of an ordinary-sized man is about 330 cubic inches, or equivalent 
to 11 pints of air. Of the 230 cubic inches, 100 can only be forced into 
the lungs by the exercise of great effort, and is available for emergencies, 
as striking a heavy blow, or for the purpose of training, as in singing, 
rowing, running, climbing, etc. ; but the extra amount of air always on 
hand in the lungs is of great value, since it enables the lungs to perform 
their functions continuously, even under severe and violent exertions. 

Giving Up of Oxygen. — The atmospheric air laden with its life-sus- 
taining property, oxygen, having passed into the lungs, gives up that 
vital element and receives in its place the carbonic acid gas, water, and 
other refuse materials which the blood has picked up in its journey 
through the body, and which are no longer fitted to circulate in the blood 
and preserve the vitality of the body. ~No tonic invigorates so well as a 
few, deep, full inspirations of pure, cold air. 



48 THE HUMAN BODY. 

Circuit of the Blood. — The blood thus purified passes back to the 
heart to go on its circuit through the body, every organ of which renews 
its energy and vigor from the magician's fiery wand, pure, healthy blood ; 
while the air exhaled carries off the impurities. 

Change in Color of the Blood. — During this process the blood changes 
from a dark purple to a bright red. Pure air is the cheapest necessity 
and the greatest luxury of life. Let it not be the rarest. The relative pro- 
portion of the respirations -to the pulsations of the heart is about 1 to 4^ 
or 5 ; and the quantity of air required to keep the blood pure is very great. 
Indeed, respiration is the falling weight, the bent spring, which keeps 
the clock of life in motion ; the inspirations and expirations are the strokes 
of the pendulum which regulate it. 

Delicacy of the Organs. — The perfection of the organs which carry 
on this stupendous office challenges our warmest admiration. So delicately 
are they arranged that the slightest pressure will cause intense pain, yet 
tons of air surge to and fro through their intricate passages, and bathe 
their innumerable cells without our knowledge, so to speak, of its coming 
and going. We annually perform over 8,400,000 acts of breathing, in- 
hale over 150,000 feet of air, and purify nearly 4,000 tons of blood ! 
This gigantic and unburdensome process goes on constantly, never weary- 
ing or worrying us when in robust health, and we are struck dumfounded 
with amazement when the cold calculations of science reveal to us its 
magnitude and marvelousness. 

Second TJse of Breathing. — Nor is this stupendousness all. Nature 
dislikes a waste of energy. In addition to and by a wise adaptation and 
economy, the process of respiration is made to subserve a second use no 
less important than that of purifying the blood — the power of speech. 
The exhaled air, laden though it may be with the human detritus and 
off-scourings of the body, in passing through the vocal organs can be trans- 
formed into prayers of faith, songs of hope and words of good cheer, 
kindly encouragement and expressions of love! 

THE HEART AND ITS WONDERS. 

What the Blood Is.— The blood— the pabulum of life— has not in- 
aptly been termed "Liquid Flesh." But it is more than that, since it con- 
tains the materials so essential and so requisite for the building up and 
repair of every organ and tissue of which the body is composed. The 
blood is the liquid by means of which the circulation in the body is car- 
ried on; it permeates every nook and corner of the system, and is com- 



THE HEART AND ITS WONDERS. 4:9 

posed of a thin, colorless fluid, the plasma, filled with red disks, so small, 
flat and thin that it requires 3,500, placed side by side, to measure one 
inch, and no less than 18,000, placed one upon the other, to make a col- 
umn one inch in height. These disks are continually forming and as con- 
stantly dying. 

Coagulation of the Blood. — According to Dr. Draper, of Xew York, 
20,000,000 die at a single breath ! Blood when exposed to the air coagu- 
lates, and the value of this peculiar yet intrinsic property cannot be over- 
estimated. When an artery is ruptured bleeding takes place, the blood 
coagulates and forms a plug, thus preventing further hemorrhage. Thus 
we observe with what Divine foresight and wisdom, not only the wants 
of the body are provided for, but also the accidents to which it is liable. 

Size, Shape and Location of the Heart — In this beautiful anatomical 
chart we obtain an accurate idea of the relative size, shape and position of 
that wonderful engine, the heart, whose tireless efforts to keep the wheels 
of life in motion are truly surprising, and fill us with amazement at the 
prodigious work it daily performs. The heart is an irregular, pear-shaped, 
hollow, muscular organ, placed obliquely in the lower and front part of 
the chest, between the two lungs and inclining to the left of the centre. 
The base is directed toward the spine and corresponds with the fourth and 
fifth dorsal spinal bone, while the apex points between the cartilages of 
the fifth and sixth ribs on the left side. In this illustration the peri- 
cardium, or loose sac in which the heart is enclosed, is removed, and we 
see the coronary artery with its branches distributed over the outer sur- 
face of the complex and restless organ. 

Heart a Double Organ. — On looking at the heart one would think 
it was a single, solid organ. It is not, however, but a double organ, divided 
into four compartments ; the two upper ones, from their supposed resem- 
blance to a dog's ear, are called auricles, and the lower ones, from resem- 
bling a little stomach, are called ventricles. The auricle and ventricle on 
each side communicate with one another, but the right and left halves 
of the heart are each separate and distinct organs, and perform different 
functions — the right side propels the dark, vitiated and impure blood, 
whilst the left deals with the bright crimson, life-giving and life-sus- 
taining blood. 

Use of the Auricles. — The auricles serve as reservoirs to receive the 
blood — the right, as it comes dark and foul from its tour of the body; 
the left, as it filters bright and pure from the oxygenated forest of the 
lungs — and to furnish it to the ventricles as they ncod it. This is graphic- 
ally shown on the chart, the large blue vein, formed by the jugular and 
4 



-t 



50 THE HUMAN BODY. 



subclavian veins, is seen descending downward and emptying into the 
right auricle; the red pulmonary vein, formed by the coalescing of ite 
numerous branches, conveying rich, pure blood from the lungs and de- 
positing it in the left auricle. Corresponding to the lightness of tne work 
they perform, the walls of the auricles are comparatively thin and weak. 

Ventricles of the Heart. — The walls of the left ventricle, which pro- 
pels the blood to the remotest corners of the human frame, are corre- 
spondingly thicker and stronger than those of the right, which forces the 
blood to the lungs only. Arising from the right ventricle is seen the 
blue pulmonary artery, conveying its foul, poisonous, vitiated and venous 
stream to the lungs, while from the left ventricle is observed the large 
main artery of the circulatory system — the aorta — from the arch of which 
arise the right and left carotid arteries. 

Changes in the Human Body — The human body is in a constant state 
of change. In the midst of life there is death. The blood disks die and 
new ones are born into life. Every act of life is destructive as well as 
constructive. Not a thought can be evolved but numerous brain cells die ; 
not a wink of the eye, a smell of a lovely rose, nor a muscular movement, 
but results in the death of some part of the machinery involved. Every 
process of life is a process of death. The scales of the epidermis are con- 
stantly falling off and being replaced by fresh cells from beneath, and it 
is on the continuance of this interchange that our life, health and vigor 
depends. The more rapidly this change goes on, and fresh, vigorous, 
healthy tissues take the place of the old lifeless ones, the more elasticity, 
buoyancy and strength we possess — the more healthy and robust we 
become. 

Work of the Heart. — No slave ever performed his work more patient- 
ly than the heart. Its quivering task is essential to life and health. It is 
the fountain from whence the spirit flows, and on the faithful perform- 
ance of its functions every party of the body depends for the warm stream 
of life, motion and vigor which it unstintingly furnishes. The ancients 
believed the heart to be the seat of love. Within its walls were located 
all that Avas pure, true, good and noble, as well as the evil passions of the 
soul. And although modern science has found the seat of mind, reason, 
consciousness and the mental powers to be located in the brain, and thus 
robbed the heart of its romance, yet it has revealed wonders connected 
with this small organ, that certainly eclipse the mysteries associated with 
it iu the past. Pit-a-pat! pit-a-pat! throbs this marvelous engine, and in 
n sponse to its constant throbbing the blood bounds along the myriad of 
tubes, conveying messages of life and health. 



THE DIGESTIVE APPARATUS A^'D ITS WONDERS. 51 

Constancy of Heart Work. — Our mind cannot stop its beatings; _ can- 
not stop itself; sleep does not interfere with its workings, and our daily 
labor only strengthens its force and regularity. This wonderful organ 
throbs on night and day, week in and week out, the year round, with 
ceaseless, tireless energy. It beats at the rate of 100,000 strokes per 
day, 40,000,000 per year, and not unfrequently, 2,800,000,000 without 
a single stoppage. It is the most powerful engine known to science. Its 
daily work is equal to one-third of that of all the muscles of the body. If 
it should expend its entire force in lifting its own weight vertically, it 
would rise 20,000 feet in an hour. The greatest exploit ever accomplished 
by a locomotive was to lift itself through less than one-eighth of that 
distance. Vast and constant as is this perpetual throbbing, so perfect is 
the machinery with which it is carried on, that there are those who do 
not even know where the heart lies until disease or accident reveal its 
location. 

Vitality of the Heart. — Its vitality is as amazing as its strength. 
While life exists this tireless organ never stops. In disease, as long as 
a nutter of this wondrous organ exists, we know the spark of life has not 
altogether vanished, and new hope is begotten that health may be restored. 
During such long lives as we sometimes see, the heart has propelled no 
less than 500,000 tons of blood ; and yet, during all this patient, unfalter- 
ing and unflinching labor, it has repaired itself as the waste has occurred. 

Heart Rhythms — The rhythm of its beats never fails until death 
breaks into the casket and seizes the ever throbbing pendulum at the 
command of the great Master Workman, silencing the quivering muscles 
of the heart and compelling the wheels of life to stand still. 

THE DIGESTIVE APPARATUS AND ITS WONDERS. 

Value of the Plates. — Seeing is believing ; nay , it is more, it is know- 
ing and remembering. The mere reading of a statement on any particular 
subject does not always advance our knowledge of the matter in question. 
The observation of a fact, or its proper illustration by appropriate dia- 
grams, such as we observe these anatomical charts to be, not only em- 
phasizes the point considered, but aids us in remembering the principal 
features connected with the functions performed, thus advancing our 
knowledge of the subject discussed, and educational progress is made. 

Quantity and Variety of Foods. — As we have already seen, the human 
body consists of numerous mechanics or artisans, who are constantly at 
work repairing and upbuilding the unceasing destruction that is contin- 



52 THE HUMAN BODY. 

ually going on. If fresh food be not daily supplied, this work would soon 
cease, and the lamp of life nicker out. To replace this constant waste we 
require nearly three pounds of solid food, and fully three pounds of liquid 
food for our daily allowance. But to convert the pent-up energies of 
bread, meat and vegetables into the tissues of our own mechanism re- 
quires a number of differently constructed organs, and these we now 
desire to draw your attention to in this beautiful chart. The organs con- 
sist of the stomach, liver, pancreas and intestines, which comprise the 
principal organs concerned in the process of digestion. 

The Stomach. — The stomach is an irregular expansion of the gullet 
or oesophagus, and is the receptacle which receives the food when swal- 
lowed. Its shape has been, not inaptly, likened to the Scotch bagpipe. 
It will hold about three pints, though it is capable of considerable dis- 
tension. When moderately filled with food it measures about twelve 
inches in length by four inches in diameter at its widest end. The walls 
of the stomach consist of four distinct coats, held together by fine areolar 
tissue, and are arranged in the following order, from within outward: 
the mucous, the areolar, the muscular and the serous. The inner mucous 
coat is a smooth, soft, rather thick, pulpy membrane, loosely connected 
with the muscular coat, and secretes the gastric digestive fluid of the 
stomach. 

Fine View of Stomach Coatings. — On turning over the flap we obtain 
a very fine view of this remarkable membrane. The areolar coat is placed 
between the muscular and mucous coats, and connects with both. The 
muscular coat is very thick and stout, and composed of three sets of fibres, 
the longitudinal, circular and oblique, which form three distinct layers. 
The outer coat is a thin, smooth, transparent and elastic membrane, de- 
rived from the peritoneum, and well lubricated to prevent friction. 
When the fibres of the muscular wall contract, a peculiar churning move- 
ment of the stomach is produced, thus securing the thorough mixing of its 
contents, that every particle may come into contact with the solvent prop- 
erties of the gastric juice. 

The Pyloric Gate — At the smaller end the muscular fibres contract 
and form a gateway — the pylorus, as it is called — which carefully guards 
the exit from the stomach, and allows no food to escape until properly 
prepared. The gastric blood-vessels are seen distributing themselves over 
the outer surface of the organ, thus ensuring its nutrition and repair. 

The Liver — The liver is the secreting organ by which the bile i 
formed. It is situated on the right side below the diaphragm, and is of 
a reddish-brown color. It is irregular in form, being convex on the upper 



THE DIGESTIVE APPAEATUS AND ITS WONDEES. 53 

surface, irregularly concave behind, very thin in front, and weighs about 
four pounds. It is, therefore, seen to be the largest organ or gland in 
the body. It is divided into two lobes, the right and the left, the former 
being by far the larger. On turning the flap over, we see how intricately 
it is arranged internally. 

Blood-vessels of the Liver. — The blood-vessels of the liver are the 
hepatic artery and veins, and the portal vein; the lymphatic vessels are 
numerous, and the nerves are supplied from the pneumogastric, the 
phrenic and the hepatic plexus. The liver, therefore, receives two kinds 
of blood: the arterial, by means of the hepatic artery, and the venous, 
from the portal vein, from which the bile is principally formed. The bile 
is a dark, golden fluid, of extremely bitter taste, of which three pounds 
is secreted daily. When not used in digestion it is stored away in the 
gall-bladder, a fine view of the location of which we have in this chart. 
The action of the bile on food, though not fully understood, is necessary 
for perfect digestion. 

The Pancreas, or "Sweetbread.'' — The pancreas, or "sweetbread," is a 
single glandular organ, situated transversely across the upper and back 
part of the abdomen, on a level with the last dorsal spinal bone. It is 
of an irregular, elongated form, from six to eight inches in length, an 
inch and a half in breadth, and from a half to one inch in thickness. It 
secretes about seven ounces daily of a slightly alkaline fluid containing 
an organic principle — pancreatin, which has the property of changing the 
starchy food into sugar. Whilst it has this power, yet its chief work in 
the digestive process seems to be the breaking up of the fat globules into 
myriads of minute particles which mix freely with water, and thereby 
promote their absorption by the lacteals. 

The Intestines. — The next chart shows us the manner in which the 
intestines are arranged in the abdominal cavity. The entire intestinal 
canal is about thirty feet in length, and is divided into two portions — the 
small intestines, and the large intestines ; these again are each subdivided 
into three different portions. Of the large intestines, the transverse por- 
tion is laid open, showing the internal arrangements. A section of the 
bladder is seen on this chart. 

Machinery of Digestion. — From the number and differently formed 
structures which constitute the digestive organs, it will be observed that 
that function is a very highly complex process. If the food were thrown 
directly into the circulating fluid, it could not be used for the purpose of 
nutrition. It requires for its transformation into blood, bone and muscle, 
a series of complex machinery, each part of which is specially designed 



54 THE HUMAN BODY. 

for the particular part it plays in this wonderful and complicated 
process. 

Use of Mouth and Teeth. — The mechanical part, which, although not 
shown in this chart, may he carefully studied in the chart giving the dif- 
ferent views of the head, is performed by the mouth and teeth, and the 
pulverized food is subjected to the action of the saliva. The lubricated 
morsel of food is now gathered into a ball and conveyed to the back of 
the mouth by the muscles of the cheek and tongue. On its arrival here, 
the soft palate lifts upward and closes the posterior nasal openings; 
the epiglottis shuts down over the trachea or wind-pipe, forming a bridge 
over which the food passes, thus preventing it from falling into the res- 
piratory track. 

Duty of the Throat — The muscular bands of the throat now grasp 
it and pass it down the gullet into the stomach, beyond our control. Here 
it comes into contact with the gastric juice, undergoes the churning motion 
of the stomach, is guarded over by the pylorus, thoroughly saturated and 
mixed before entering into the intestinal track, where it is subjected to 
the action of the bile, the pancreatic juice and the intestinal fluid, each 
with its special duty to perform* 

Nature's Treasures Open to Man. — All this is a very complicated and 
diversified process, the necessity for which can only be explained upon 
the hypothesis that Mature, in her exhaustless munificence, has opened 
her proud domains, and poured forth to man the treasures of every land 
and every sea for food; the cornfields wave their golden grain for him; 
the wheat, rye, oats, corn, maize, rice, each different, yet highly nutri- 
tious and sufficing; the palm, the date, the banana, the fig, the pineapple, 
spread out a delicious harvest on the air ; the luscious apple, pear, peach, 
plum, cherry, tempt his ready hand ; the potato, the beet, the turnip, the 
tomato, the cabbage, the pea, the cauliflower, and a thousand other good 
things, incite his appetite, whilst to this feast is added the flesh of birds, 
of oxen, of sheep, of swine and of fish ; that before the waving wheat and 
corn, the flesh of other animals, the fruits and farinaceous foods, the 
running water, the luscious oyster and fish, etc., can be transformed into 
the refined and spiritual organization of man, it must be thoroughly pre- 
pared by the several steps in the digestive process — then, and only then, 
is it permitted to enter into and commingle with the highly complex, 
nutritious and life-sustaining fluid, the blood. 

Great Value and Beauty of the Plate— We can understand much of 
this wonderful process. We have looked into the stomach, watched its 
peculiar actions and traced its various steps, from which the scientist is 



THE VERMIFORM APPENDIX. 55 

capable, in his laboratory of knives, mortars, baths, chemicals and filters, 
of imitating many of the operations of digestion; but just at the moment 
lie thinks himself most successful, he is compelled to pause. At the 
threshold of that "one step more," which Fontenelle required, "and he 
would surprise nature herself," he stops, and very wisely, without con- 
cealment of his designs, admires, then wonders, and finally worships with 
all the reverence of his soul. 

Transformation of Food Into Flesh — How strange this is — the trans- 
formation of food into human flesh, into human thoughts ! We eat a 
meal; it is composed of meat, bread, vegetables and liquids. The more 
solid part is ground by the teeth, mixed with the different juices, dis- 
solved, changed, organized and is swept through the body in the circula- 
tion of the blood. Each organ seizes its own particular food as it passes. 
Within the cells of the various tissues it is transformed into the soft, sen- 
sitive brain, or the hard, callous bone ; here into the nerve of sight, there 
into gristle or tendon; here briny tears are formed, there the bland saliva ; 
in the stomach, acid juice ; in the skin, acrid perspiration ; bile for di- 
gestion, oil for the hair, nails for the fingers, muscle for the strong arm 
of toil, and flesh and fat to give shape, form and beauty to the face. 

Wonderful It All Is. — Wonderful ! Within us is an Almighty Archi- 
tect, who superintends a thousand skilled laborers, that make a way which 
puzzles human comprehension ; here a fibre <y£ muscle ; there a filament 
of nerve; here constructing a bone; there uniting a tendon — fashioning 
each with the most scrupulous care and unerring nicety. Without the 
buzz of a saw, or the sound of a hammer ; without the slightest compres- 
sion, or the least particle of noise ; with a regularity, certainty and exact- 
ness, the glorious temple of man, in the image of his Creator, goes up and 
up, day by day, skilfully put together by these noiseless, tireless and 
expert workmen. 

THE VERMIFORM APPENDIX. 

The chart brings into view the location and form of that wonderful 
little organ known as the Vermiform (wormlike) Appendix (appendage). 
It is an appendage of the Csecum, or lower bowel. Its uses as a bowel 
appendage have never been established. It occurs in other animals be- 
sides man. Notwithstanding its diminutive size and uselessness as an 
organ it is the seat of that most painful and dangerous disease called 
Appendicitis, which was formerly attributed to the presence of some for- 
eign body, as a grape-seed, lodged within. But it has been found in- 
flammation of the Appendage may arise from numerous other causes. 



50 THE HUMAN BODY. • 

Many doctors insist that a surgical operation — that is, the entire removal 
of it with knife — is the proper curative agent, especially in acute cases. 
But others insist that the knife is too frequently used, and that the dis- 
ease, if taken in time, is quite surely curable by other means. 

THE CLITORIS, URETHRA, VAGINA AND HYMEN. 

These female organs show further the perfection which anatomical 
plate printing has attained. 

Clitoris. — This small organ, it will be seen, is situated at the upper 
part of the vulva, or outside parts of the female generative system, and 
is usually concealed by the lips of the pudenda. It performs a function 
during sexual intercourse similar to that performed by the penis of 
the male. 

Urethra. — This highly useful organ, common to both sexes, is, as will 
be seen by the plate, the canal, or medium, by means of which the urine 
is carried from the bladder to be voided. It is a delicately lined organ, 
furnished with retentive valves, and therefore susceptible to a variety 
of diseases. 

Vagina. — This word implies a sheath, and is applied to the canal 
which leads from the uterus (womb) to the external organs of generation 
in the female sex. Commonly, it implies such external organs, or organ, 
as depicted in the plate. 

Hymen. — The mucous membrane, or virginal membrane, at the en- 
trance of the female sexual organ, or vagina. 

BLADDER AND PART OF VAGINA. 

The function and form of the bladder are familiarly known. It is 
the recipient of the kidney secretions, and contains them till voided 
through the urinary canal. It is of tough, elastic structure, guarded at 
the exit by a contractile valve, by means of which the urine can be re- 
tained until the quantity becomes excessive. The plate brings out the 
entire urinal tract, from the bladder to the vagina, and presents a fine 
and useful anatomical and physiological study. 

WOMB, OVARIES AND VAGINA. 

The Womb. — The plate beautifully and effectively illustrates the 
location and formation of the womb, that wonderful organ which performs 
the function of parturition, and which is so constructed as to assist in all 



VIEW OF THE LARGE BLOOD-VESSELS, SPLEEN, KIDNEYS AND BLADDER. o7 

the necessary efforts of birth. Its structure is elastic and strong, and it 
expands readily to accommodate the growth of the child (foetus). While 
this is true exteriorly, its inner parts are rather delicately lined, and 
subject to a variety of painful diseases, generally designated as "Dis- 
eases of the Womb." 

The Ovaries — The organs are situated contiguously to the womb. 
They signify eggs from their shape, and they are the parts which the 
male semen acts upon to produce the phenomenon of pregnancy. Their 
enlargement by inflammation and their passage down the fallopian tubes, 
once a month during the middle period of female life, produces the con- 
dition familiarly known as menstruation. The plate also affords another 
view of the vagina. 

NATURAL POSITION OF CHILD AT TIME OF BIRTH. 

This beautiful and effective plate shows the natural position of the 
child at the time of birth. It is technically called the presentment of the 
foetus for birth. Of presentments there are many varieties, whose study 
is most interesting to the obstetrician. Some of them give rise to very 
difficult and dangerous delivery. When the presentment is natural, as 
in the figure, the comfort of the mother is increased and the doctor's 
anxiety is much allayed. 

VIEW OF THE LARGE BLOOD-VESSELS, SPLEEN, KIDNEYS AND 

BLADDER. 

Blood-Vessels of the Body. — The blood-vessels of the human body con- 
sist of the heart, arteries, veins and capillaries. The heart and its wonders 
we have already referred to. In this magnificent chart we are enabled 
to form some idea of the larger blood-vessels. We see the main arterial 
tube of the body — the aorta — from a point where it unites with the arch 
of the aorta; and in its descent downward along the spinal column it 
gives off numerous branches. 

The Arteries. — Opposite the fourth lumbar vertebra it is seen to split 
in two, and these divisions are called, from their position, the right and 
left iliac arteries. These are seen to divide again into the internal and 
external iliac arteries, the former of which is distributed to the walls and 
viscera contained in the pelvis, then proceeding to the lower limbs after 
sending two important branches to the abdominal walls. The arch of the 
aorta gives off the innominate artery, which divides into the right cnrotid 



58 THE HUMAN BODY. 

and right subclavian arteries; the left carotid and left subclavian spring 
direct from the arch of the aorta. Each carotid artery divides into the 
external and internal carotid arteries, the former being distributed to the 
external parts of the face and head; the latter supplies the brain and 
internal parts of the cranium. The subclavian arteries supply the upper 
extremities with blood. 

Intercostal Arteries — The intercostal arteries and veins are beau- 
tifully illustrated in the chart. The veins return the blood to the heart. 
The large ascending and descending vense cavse are seen in this illus- 
tration. 

Meaning 1 of Artery. — From the fact that at death the arteries are 
empty, the ancients believed them to contain air, whence their name, 
derived from aer, air, and terco, I keep, which literally means, air ducts. 

The Spleen. — The spleen is a spongy organ, of a livid color, oval in 
figure and situated in the left upper part of the abdomen and immediately 
behind the stomach. Its weight varies from four to ten ounces. It is 
largely composed of cells, but its function is little understood, though 
from its position it is believed to be in some way useful to the stomach 
during the process of digestion. 

The Kidneys. — The kidneys are two glandular bodies, having for 
their functions the secretion of urine. The form of the kidney resembles 
a French bean; its average length being from four to four and a half 
inches, two inches in breadth and one in thickness. The two kidneys are 
situated one on each side of the spine in the lumbar region, opposite the 
last two dorsal and two first lumbar vertebras ; they are of a brownish-red 
color flattened from before backward, and grooved on the interior border 
for the reception of the great vessels. 

The Veins. — The venal arteries are derived direct from the aorta; 
and the large veins terminate in the ascending large vein. On the right 
kidney is seen the super-renal capsule; whilst the left is cut vertically 
into showing the uriniferous tubes, much convoluted and inosculating with 
each other. The ureter is seen arising from the pelvis of the kidney, 
descending in an oblique manner to the bladder. These wonderful little 
organs appear to act as filters, and thus assist to keep the vital stream of 
life in as pure and as healthy a condition as possible. 

The Bladder — The bladder is a thin, membranous bag, which serves 
as a receiver of the urine secreted by the kidneys, and which remains 
there until voided by urination through the urethra. 

Bone Sections. — The sections of the bones show their cancellated ap- 
pearance, which combines lightness with strength. 



THE EYE AND ITS WONDEBS. 59 

CHART III. 
WONDERS OF SIGHT, HEARING, TOUCH AND LOCOMOTION. 

THE EYE AND ITS WONDERS. 

Beautiful Plate of the Eye. — The beautiful flesh-colored engraving at 
the right-hand top corner of this exquisite composite anatomical plate 
gives a strikingly natural, life-size representation of the human eye, to- 
gether with its external appendages, the eyebrows, the eyelids, and the 
lachrymal or tear glands. 

Muscles of the Eye. — On turning the flap we see four of the six deli- 
cate, but withal strong muscles which not only hold the eye firmly in its 
bony orbit, but also move it upward toward the canopied vaults of heaven, 
downward to view the beauties of nature on earth ; or sidewise, to the 
right or left, spanning half the horizon at a single glance ! The next 
illustration gives us a graphic and faithful delineation of the beautiful 
arrangements of the numerous curtains, humors, lenses, pigments, mem- 
branes, nervous coats and blood-vessels which enter into the composition 
of this remarkable organ, each of which is exquisitely adapted to the 
respective functions it has to perform. 

Wonders of the Eye. — The human eye is one of the most wonderful, 
as well as delicate, organs of the body. It is the window through which 
the heart, mind and soul of man shines. Sorrow or joy, grief or mirth, 
pain or pleasure, sunshine or shadow are reflected through this wondrous 
camera of light; the human passions hold their orgies in this window; 
truth and love dance their happy and joyous day-dreams before its lu- 
minous curtain; and through it accurate delineations of every object 
that comes within its range are carried to and photographed on the brain, 
the great art gallery of the soul ! Can man, with all of his great and 
scientific achievements, conceive of anything in the arcana of his accom- 
plishments more beautiful, more wonderful, or more perfect than the 
human, eye ! 

THE EAR AND ITS WONDERS. 

The External Ear. — The organ of hearing consists of three parts : the 
external ear, the middle ear or tympanum, and the internal ear or laby- 
rinth. The external part of the ear represented in this colored engraving 
is very realistic of that essential appendage to this important special organ 



60 THE HUMAN BODY. 

of sense in man. It consists of an expanded sheet of cartilage, folded in 
true trumpet fashion, for collecting the sound waves and conveying them 
to the external meatus or mouth of the auditory canal. 

The Ear Drum. — On the back of this flap is seen a strikingly natural 
representation of the middle ear, the tympanum or drum, as it is fre- 
quently called. From the bottom of the tympanum is observed the Eu- 
stachian tube, through which is conveyed air from the pharynx to the 
middle ear. Across this chamber is seen stretched three very tiny, singular 
bones, which, from their shape, are called the hammer, the anvil and 
the stapes. These delicate bones are connected together, one by ball and 
socket joint, the other by a hinge- joint and by ligaments, and are moved 
by small muscles ; they serve to convey the wave sounds across the tym- 
panum cavity to the internal ear. 

Show of Ear Canals. — The semicircular canals, and the cochlea, so 
named from its resemblance to a snail's shell, are also typically shown. 
In the next colored illustration we observe a graphic and truthful view 
of the delicate internal arrangement and mechanism of the internal part 
of the organ of hearing. Here we observe the winding stair of the coch- 
lea, over the surface of which the delicate fibrils of the auditory nerve 
expand, and the minute fibres of Corti, called from their discoverer, are 
seen arranged with geometrical precision, the longest at the bottom and 
the shortest at the top. 

Wonders of the Spiral Plate. — If this curious and artistic spiral plate, 
which is seen to wind two and one-half times round, could be unrolled 
and made to stand in an upright position, it would make a beautiful micro- 
scopic harp, not of a thousand strings, but of three thousand strings, and 
if it were possible to strike these delicate infinitesimal cords as we can 
the keyboard of an organ or piano, every conceivable variety of tone that 
the ear can distinguish would be produced and conveyed to the brain 
as the product of sound. 

THE HAND; ITS MECHANISM AND WONDERFUL ENDOWMENTS. 

Engraving of the Hand. — To tell one that this exquisite colored en- 
graving represents a human hand seems almost like questioning his sanity. 
Yet such it is ; but how few there are who can give an intelligent account 
of the hand, describe its beautiful arrangements and complex mechanism, 
or tell of its wonderful endowments. Small in compass, compact in struc- 
ture, yet so skilfully arranged are its blood-vessels and nerves, that they 
form a complete net-work over its surface. So minute are thev in their 





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EXTERNAL 
VIEW OF EYE 







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V ' E * OF F00T 



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COPYRIOHT 1£rl5 BY E. J. STANLEY 



CHART 3. 



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CHART 3. 




CHART 3 



the hand; its mechanism and wonderful endowments. 61 

distribution that the point of the finest needle cannot penetrate any part 
of the hand without piercing quite a number of them. The hand is the 
great organ of touch and prehension, and the instrument which distin- 
guishes man in the large class of mammals, since he is the only animal 
which possesses two perfect and complete hands. 

Bony Frame of the Hand. — On turning over this flap we behold the 
bony frame-work of this wonderful organ. It is seen to consist of a num- 
ber of bones., so exquisitely arranged as to combine the greatest possible 
degree of flexibility and strength. 

Palm of the Hand — Below this is given an elegant, and at the same 
time a true and correct view of the muscular arrangement of the palm 
of the hand and fingers. Over the wrist is seen the annular ligament, that 
thin, tough, strong sheath, which binds the muscular cords and holds 
them firmly in place. Thus in these three anatomical charts have we 
depicted the perfection of the human hand. 

Powers of the Hand. — And how varied and useful are its endow- 
ments ! How wondrously adapted to the uses to which it is daily applied ! 
Its elegance of outline, delicacy of mould and beauty of color has ever 
made it the attractive study of the artist ; whilst its elasticity, flexibility 
and strength, combined with its delicate and exquisite mobility, and per- 
fect adaptation as an organ of prehension, have led many philosophers to 
attribute man's high and graceful superiority even more to the hand 
than to the mind. Glowing thoughts are penned upon the pages of his- 
tory by means of the hand; it wields the artist's pencil and brush, and 
makes the bare canvas an attractive and valuable work of art ; now it 
strikes the keyboard of the piano with so delicate a touch that low, sweet, 
plaintive strains of music are brought forth; now the force of the blow 
is much greater and firmer, and louder and louder and more thrilling 
the musical strains. 

Skill of the Hand — The farmer's toil, the housewife's task, the dress- 
maker's deftness, the mechanic's skill, are all accomplished by the human 
hand. How constantly this little instrument aids us in expressing our 
feelings. It is the orator's chief aid in giving expression to his lofty 
strains of eloquence, or emphasizing his pathetic appeals. 

Various Uses of the Hand. — With the hand we affirm or reject a 
proposition with more force than with the tongue. It is the first to greet, 
and the last to bid our friends good-bye. We use it to express our joy 
and pleasure, or to give vent to our fear and horror. In the hour of peril 
we employ it in powerful supplication to Him to whom Ave look for suc- 
cor and help, and it adds force and power to the appeals of suffering, of 



62 THE HUMAN BODY. 

sorrow and of woe. It bestows its loving caresses on the downy cheek of 
the baby, invokes the blessings of Heaven, pleads for mercy, or hurls 
curses on our enemies. Indeed, we do not always seem to realize how 
many notes in the tune of human life the hand of man is made to play. 
Its beauties, its perfect adaptability, it varied endowments, and the dif- 
ferent uses to which it is applied, are almost beyond our thoughts, and he 
who is deprived of this useful member sustains a loss that none can esti- 
mate, nor the wealth of Croesus compensate. 

THE FOOT; ITS MECHANISM AND ITS WONDERFUL ENDOWMENTS. 

Arrangement and Uses of the Foot. — In this exquisite colored engrav- 
ing is represented the human foot, the organ by which we stand, walk 
or run. Look at it carefully, aye, critically, and see if you can duplicate 
it in the whole range of man's achievements ! The general arrangement 
of the bony frame-work of the foot, as seen in this illustration, is strik- 
ingly like that of the hand. The graceful arch of the foot, composed by 
the tarsal and metatarsal bones, is firmly joined together by a thick 
layer of cartilaginous structure, not only preventing a liability to dis- 
placement, but giving to it an elasticity, sprightliness and strength which 
could never be attained by a single flat bone. In the next colored illus- 
tration we have a section of the foot, showing its architectural dignity 
and perfection. On its under or plantar surface are seen stretching from 
the heel forward toward the toes a number of ligaments, the principal 
one of which is the plantar ligament, and possesses great strength and 
elasticity. 

The Toes. — The toes are observed to be straight forward in a line 
with the general contour of the foot. This is their natural position. The 
beautiful outline of the natural foot, as here represented in these several 
different views, the graceful arch of the instep, the elegance of its form, 
its marvelous elasticity and strength, all combine to make the foot not 
only of great perfection and beauty, but admirably fit it for the mani- 
fold duties it is called upon to perform. Man, in his. diversified labors 
and varied trials throughout life, is sometimes obliged to walk, run, jump, 
leap, climb, stand erect, lean forward, etc., and he depends upon the 
foot to maintain his equilibrium in the performance of these several 
duties. 

Beauty and Strength of the Foot.— Not only does the foot, too, fre- 
quently sustain heavy weights, but it must carry them as well. It like- 
wise affords a firm support. Were it not for this beautiful mechanism, 



the leg; its mechanism and wonderful endowments. 63 

the constant jarring and concussion which would be experienced in the 
act of walking would inevitably destroy those delicate organs, the brain 
and spinal cord, and death would immediately follow. How few persons 
in civilized nations have perfectly natural feet ! The beauty and utility 
of the human foot is marred; its movements are impeded by encasement 
in unnatural boots and shoes; these, instead of conforming to the form 
and shape of the foot, make the foot adapt itself to them. The conse- 
quence is corns, bunions, cross toes, ingrowing toe-nails, large joints, 
and a number of other evils from which so many suffer at the present clay. 



THE LEG; ITS MECHANISM AND ITS WONDERFUL ENDOWMENTS. 

Leg Muscles — In every part of the human frame there is witnessed 
ample evidence of design, beauty of architecture, great skill, finished 
workmanship, and a perfect adaptability to the duties to be performed. 
This fact is strikingly illustrated in the beautifully executed colored plate 
to which attention is now drawn, showing, as it does, at a glance, the 
thick, strong, muscular instruments employed and the manifold intricacies 
involved in the act of human locomotion. This exquisitely artistic anat- 
omical plate represents a front view of the thigh, leg and foot, and of 
the fifty-four fleshy levers which give form, shape, symmetry, strength 
and mobility to this useful member of the body. Quite a number of the 
most important are seen exposed to view, after the skin and fatty tissues 
have been removed. We are deeply impressed with their large size and 
great strength, both of which correspond with the requirements demanded 
in the varied work which the leg is called upon to perform. 

Use of the Leg Muscles. — The muscles observed in this plate are the 
principal instruments for carrying out the behests of the will in the acts 
of walking, running, leaping, climbing, and the graceful, gliding motions 
of the entrancing and captivating waltz ; and although we see a compli- 
cated piece of machinery, yet there is perfect order. Harmony, prompti- 
tude and exactness prevail, not only in the skilful manner in which they 
are individually and collectively arranged, but in the action of the dif- 
ferent muscles, each one of which performs its duty either independently 
of, or in connection with, its fellow lever, and that, too, without inter- 
fering in the slightest degree with the functions of the others. 

Muscular Levers. — These great muscular levers bend the body for- 
ward on the thigh, and bring the legs inward toward each other, besides 
moving the whole body to and fro when walking, etc. The long, narrow 



64: THE HUMAN BODY. 

muscle, seen running obliquely across the thigh, is the Sartorius muscle, 
so-called from the fact that it crosses the legs for the sartorial (tailor's) 
posture. It is the longest muscle in the body. 

The Knee-Pan. — The patella or knee-pan is seen held firmly in posi- 
tion, giving greater strength and security to this important joint. Around 
the ankle is observed the annular ligament, binding the long silvery 
thongs or tendons of the muscles of the legs, thus preventing their dis- 
placement. It also affords security and strength to the ankle joint, though 
not interfering with its elasticity and motion. The foot shows us the 
natural position and shape in which the toes should be when encased in 
a boot or shoe. 

Thigh and Leg Bones. — On turning the flap we see the bones of the 
thigh and leg, and a front view of the bones of the ankle joint and foot. 
As was to be naturally expected, we here find the largest, the longest and 
strongest bone in the human body, since, with every step taken, it has 
to bear the entire weight of that wonderfully and fearfully constructed 
body, and support whatever additional burdens or weights one is called 
upon to impose in the course of his daily labors. The bone is observed 
to be compressed, somewhat cylindrical in shape, but expanded at both 
ends, thus giving it the greatest possible degree of strength. At its lower 
end it articulates, and forms a hinge- joint with the knee, the strength 
and protection of which is further secured by the shape and position 
of the knee-pan. 

The Shin Bone. — The tibia or shin bone is also a very large, strong, 
triangular-shaped bone, enlarged at both ends; the lower end, however, 
where it articulates and forms a hinge- joint with the foot, is larger and 
more prominent than the upper end. And as if this bone was not suffi- 
ciently strong enough in itself to bear the weight of the body, our Cre- 
ator, with that boundless wisdom and forethought which everywhere in 
the human frame we see revealed, strengthens the legs by an additional 
bone, which is seen running on the outer side of the shin bone, and to 
which it is firmly bound at both ends. 

The Fibula. — Not only does this second bone — the fibula — give addi- 
tional strength and support to the leg proper, but it likewise increases 
the bony area or surface of the leg, to which its powerful muscular levers 
are attached. 

The Sciatic Nerve. — The large sciatic nerve, its position, course and 
distribution, is graphically outlined, and as we look upon this white, sen- 
sitive cord, we are deeply impressed with the force and truth of what 
Shakespeare makes one of his characters, Tlmon, say: 



65 



" The cold sciatica 

Cripples our senators, that their limbs may halt 
As lamely as their manners." 

Muscles of Thigh and Leg — Turning to the next colored illustration, 
we have a graphic and faithful view of the deeper muscular arrangements 
of the thigh and leg, together with a striking description of the nervous 
supply of the lower extremity. These beautiful, silvery threads are the 
wires which carry the behests of the will to the muscular levers, and 
whose commands the muscles promptly obey; and give to the leg its 
wonderful and diversified endowments. To stand erect is a very difficult 
and complex act, and the process of walking is a no less difficult or 
complex function. Few persons ever realize the peril involved in walking, 
and it has only become safe by constant practice. 

Art of Walking. — Walking requires the nicest -adjustment, prompt 
action, and the finest calculations to maintain the dignity, proper attitude, 
equipoise and balance of the body. This is well illustrated when one runs 
up against any obstacle in the dark. We observe then with what head- 
long force the body is propelled forward. In walking the first thing that 
occurs is the inclining of the body forward; the foot is then gradually 
raised upon the toes, and brought from a horizontal position into an 
almost vertical one; at the same time the knee, which was at first con- 
siderably bent, straightens out by the advancing forward movement. 
Every part of the leg and thigh has changed its position except the toes; 
that part farthest from the toes the most of all ; and gradually diminishing 
in geometrical proportions downward. 

How We Walk.— The foot is then raised from the ground and swung 
forward in true pendulum fashion. The leg in so doing becomes flexed 
at the knee-joint, and considerably shorter, and the whole weight of 
the body is transferred to and supported by the leg and foot, which is 
planted firmly on the ground. The leg and the foot which was swinging 
in the air is now brought down to the ground, the muscles passing 
through changes just the reverse of those employed in raising it. Plant- 
ing this foot firmly on the ground, to prevent the body from falling, we 
raise the other foot, swing it forward, the leg describing the same move- 
ments as before, repeating the process alternately with each leg. These 
movements constitute the act of walking; the complexity of which is 
fully illustrated by the complicated machinery employed for its perform- 
ance, as we have seen in the beautiful plates showing the wonderful and 
skilful arrangements of the bones and muscles of the leg. 



66 ANATOMY AND PHYSIOLOGY. 

Grace and Ease in Walking. — In the several beautiful anatomical 
charts illustrating the bony, muscular and internal mechanism of the 
human frame we have been consciously awakened to its complexity; we 
have been forcibly impressed at the amazing skill and wisdom displayed 
in its marvelous arrangement, and at the general order, system, harmony 
and perfection which everywhere prevails throughout the diversified con-- 
trivance of the body. But its wonders do not stop there. The graceful 
motion, the ease with which we walk, run, leap, dance, etc., demonstrate 
with what astonishing rapidity the different muscles concerned in those 
movements contract and obey the impulse of the will. 

The Voice. — The voice may utter one thousand five hundred letters 
in a minute, yet the articulation of each of those sounds requires a dif- 
ferent and distinct position of the vocal organs, the muscles of which 
move with surprising celerity and swiftness. 

Deftness of the Fingers. — In music we train the muscles of the fingers 
until they glide over the keyboard of the piano with dexterity and pre- 
cision, and perform the most simple and delightfully exquisite music 
and on to the grand, difficult and complex passage of operatic harmony. 
The mind of the skilful and professional violinist is upon the music which 
his right hand is executing by the varied movements of the bow, yet the 
muscles of his left hand and fingers are deftly engaged in determining 
the length of the space on the strings, the character and duration of 
each note; and so rapidly, carefully, aye, even unconsciously are these 
complex movements made, that not a false note is heard, though the 
variation of a single hair's breadth would cause a discord, and thus spoil 
the pleasing effect of the music, and destroy the attractiveness of its 
harmony. 

Muscle Development. — The bicep muscle in the arm of the blacksmith 
may grow strong, hard, firm, and as solid almost as a club; the legs of 
the pedestrian may become large and well developed ; the hand of a prize 
fighter may be trained to strike a stunning blow with the force of a sledge 
hammer; while the penman can describe the most beautiful curves, the 
engraver trace lines so delicate and fine as to be invisible to the naked 
eye, and the fingers of the blind acquire a delicacy of touch that almost 
compensates for the missing sense. Thus there are few conceptions of 
the designing mind which the muscular system of man cannot be made 
to execute and perform. 



INDEX TO BOOK II 



Book II treats of Anatomy and Physiology, a 
knowledge of which is essential to a proper study of 
disease. 

SUBJECTS OF THE TEXT 



Abdomen, The 93 

Abdominal Aorta no 

Absorption 104 

Air Vesicles 116 

Anterior Tibial Artery 113 

Aorta, The 108 

Aorta, Abdominal no 

Aorta, Thoracic 109 

Apparatus, Digestive 98 

Apparatus, Respiratory 115 

Arm Bone 83 

Arrangement of the Skin 74 - 

Arteries, The 108 

Arteries, Coronary 108 

Artery, Femoral 112 

Arteries, Function of 108 

Artery, Popliteal 113 

Artery, Radial 109 

Artery, Pulmonary 113 

Artery, Ulnar 109 

Attachments, Muscle 88 

Atlas, The 80 

Auricle, Left 107 

Auricle, Right 106 

Axillary Vein 115 

Back, Muscles of 91 

Biceps, The 93 

Blood 104 

Blood, Composition of 104 

Blood, Course of 106 

Blood, Oxygenized 116 

Bodily Organs 73 

Body, Framework of 77 

Bone, Arm 83 

Bone, Compact 75 

Bone, Frontal 80 

Bone, Hyoid 82 

Bone, Sphenoid 81 

67 



Bone Structure 75 

Bone, Temporal 81 

Bone, Thigh 85 

Bones, Facial 81 

Bones, Flat 79 

Bones of Foot 86 

Bones of Leg 85 

Bones, Number of 79 

Bones, Short 78 

Bones, Side and Top of Skull 80 

Bones, Skull 80 

Bones, The 77 

Bones, Tissue of 75 

Brain, Divisions of 118 

Brain, Nerves of 119 

Brain, The 117 

Brain, Weight of 118 

Breast Muscles 93 

Breathing 116 

Calf, Muscles of 97 

Cardiacs 108 

Cells, Forms of 73 

Cells, Size of 73 

Cerebellum, The 119 

Cerebrum, The 118 

Cervical Plexus 121 

Chest, The 82 

Chewing, Muscles of 90 

Cilia of Windpipe 74 

Circulatory Apparatus 105 

Circulatory System 104 

Columnar Epithelium 74 

Column, Spinal 79 

Common Iliacs no 

Compact Bone 75 

Composition of Blood 104 

Connective Tissue 75 

Cord, Spinal 120 



68 



INDEX TO BOOK II. 



Coronary Arteries 108 

Corpuscles 105 

Course of Blood 106 

Deltoid Muscle 93 

Diaphragm, The 9 2 

Digestive Apparatus 98 

Division of the Brain 118 

Divisions, Heart 105 

Dorsalis Pedis 113 

Duodenum 100 

Endothelium 75 

Epithelium 74 

Epithelium, Columnar 74 

Epithelium, Glandular 74 

Extensors, Radial 95 

External Iliac in 

Extremity, Lower 85 

Extremity, Upper 82 

Face, Muscles of 90 

Facial Bones 81 

Femoral Artery 112 

Femoral Vein 115 

Femur, The 87 

Fibrous Tissue 76 

Fifth Nerve 119 

Flat Bones 79 

Flexors 95 

Foot Bones 86 

Foot, Sole of 98 

Forearm, The 83 

Forearm, Muscles of 94 

Forms of Cells 73 

Framework of Body 77 

Frontal Bone 80 

Function of Arteries 108 

Function of Nerves 116 

Function, Vein 113 

Gastric Juice 100 

Glandular Epithelium 74 

Gristle, Structure of 76 

Gristle, Use of 76 

Gullet, The 99 

Hand, The 84 

Heart, The 105 

Heart Division 105 

Heart Sounds 108 

Hip Socket 85 

Hyoid Bone 82 

Iliacs, Common no 

Iliacs, External in 

Inner Trunks 122 



Innominate Veins 113 

Internal Juglar 1 13 

Intestine, Small 100 

Intestine, Large 101 

Jaw, Muscles of 91 

Joints, The T 86 

Jugular, Internal 113 

Jugular Vein 113 

Juice, Gastric 100 

Knee-Pan (Knee-Cap) 85 

Lacteals 104 

Large Intestine 101 

Larynx 115 

Left Auricle 107 

Left Ventricle 107 

Leg Bones 85 

Ligaments of the Vertebrae 80 

Liver, The 102 

Lower Extremity, The 85 

Lumbar Nerves 122 

Lungs, The 115 

Lung Lobes 116 

Lung Membrane .' 116 

Median Nerve 122 

Median Vein 114 

Medulla Oblongata 119 

Membranes, Lung 116 

Mouth, The 98 

Muscle Attachments 88 

Muscle, Deltoid 93 

Muscle, The Tailor's 95 

Muscles of the Back 91 

Muscles of the Breast 93 

Muscles of the Calf 97 

Muscles of Chewing 90 

Muscles of the Face 90 

Muscles of the Forearm 94 

Muscles of the Jaw 91 

Muscles of the Lower Extremity .... 95 

Muscles, The 87 

Muscles, Thigh 95 

Muscles, Thorax 92 

Muscular Tissue 77 

Nerve, Median 122 

Nerves of Brain 1 19 

Nerves, Function of 116 

Nerves, Lumbar 122 

Nerves, Sacral 122 

Nerves, Spinal 121, 122 

Nervous System 116 

Nervous Tissue 76 



INDEX TO BOOK II. 



69 



Number of Bones 79 

Organs, Bodily jz 

Outer Trunks 122 

Oxygenized Blood 116 

Pancreas, The 102 

Pedis, Dorsalis 113 

Periosteum 75 

Peritoneum 103 

Pharynx 99 

Plantars — 113 

Plexus, Cervical 121 

Popliteal" Artery 113 

Portal Vein 115 

Posterior Tibial Artery 113 

Protoplasm 73 

Pulmonary Artery 113 

Pulmonary Veins 115 

Pulsation 108 

Radial Artery 109 

Radial Extensors 95 

Radial Vein 114 

Radius, The 84 

Respiratory Apparatus 115 

Ribs, The 82 

Right Auricle 106 

Right Ventricle 106 

Sacral Nerves 122 

Sacrum, The 80 

Saphenous Vein 115 

Scapula, The 83 

Short Bones 78 

Shoulder, Socket of 83 

Shoulders, The 82 

Side Bones of the Skull 80 

Size of Cells 73 

Skin Arrangement 74 

Skull, Bones of 80 

Skull, The 80 

Small Intestine 100 

Socket, Hip 85 

Socket of the Shoulder 83 

Sole of the Foot 98 

Sounds, Heart 108 

Sphenoid Bone 81 

Spinal Column 79 

Spinal Cord 120 

Spinal Nerves 121, 122 

Spinal Vertebrae 79 

Spine, The 79 

Stomach, The 99 

Stomach, Walls of 99 

Structure, Bone 75 



Structure of Gristle 76 

Structure of Veins 113 

Subclavian 108 

Sweetbread 102 

System, Nervous 116 

System, Circulatory 104 

Tailor's Muscle 95 

Temporal Bone 81 

Thigh Bone 85 

Thigh Muscle 95 

Thoracic Aorta 109 

Thorax, Muscles of 92 

Thorax, The 82 

Tibial Artery, Anterior 113 

Tibial Artery, Posterior 113 

Tissue of Bones 75 

Tissue, Connective 75 

Tissue, Fibrous 76 

Tissue, Muscular 77 

Tissue, Nervous 76 

Tongue, The 99 

Top Bones of the Skull 80 

Triceps, The 94 

Trunks, Inner and Outer 122 

Ulnar Artery 109 

Upper Extremity 82 

Upper Extremity, Veins of 113 

Use of Gristle 76 

Veins, The 113 

Vein, Axillary 115 

Vein, Femoral 115 

Vein Function 113 

Vein, Innominate 113 

Vein, Jugular 113 

Vein, Median ' 114 

Vein, Portal 115 

Vein, Pulmonary 115 

Vein, Radial 114 

Vein, Saphenous 115 

Vein Structure 113 

Veins of Upper Extremity 1 13 

Ventricle, Right 106 

Ventricle, Left 107 

Vertebrae, Ligaments of 80 

Vert.ebrae, Spinal 79 

Vesicles, Air 116 

Walls of the Stomach 90 

Weight of the Brain 118 

Windpipe, Cilia of 74 

Windpipe, The 1 15 

Wrist, The 84 



TO 



INDEX TO BOOK II. 



LIST OF ILLUSTRATIONS 



Acromioclavicular and Shoulder 

Joints 88 

Alimentary Canal from Throat to 

Anus 101 

Ankle Joint, Section of 88 

Arm Bones 83, 84 

Atlas, The, or First Cervical Vertebrae, 80 

Blood Corpuscles, Magnified 105 

Bone, Section of, Magnified 75 

Bones of the Hand (Carpus) 84 

Brain and Cord . . . 121 

Buttock and Back of Thigh 124 

Carpus, or Bones of the Hand 84 

Cartilage, Section of, Magnified 76 

Cervical Cord, Section of 122 

Ciliated Epithelial Tissue 74 

Corpuscles of Blood, Magnified 105 

Dorsal Vertebrae, Section of 79 

Epithelial Tissue 74 

Epithelial Tissue, Ciliated 74 

Epithelium, Columnar 74 

Face, Nerves of 118 

Fat, Section of, Magnified 76 

Femur, or Thigh Bone 87 

Fibula, or Minor Skin Bone 87 

Foot Bones (Tarsus and Metatarsus) 87 

Gland, Simple 74 

Glands, Salivary 98 

Hand, Bones of 84 

Head, Arteries of ^ . . 109 

Heart and Lungs, Sectional View . . . 106 
Heart, Showing Auricles and Ven- 
tricles 107 

Hip Joint, Socket and Ligaments .... 88 

Human Skeleton (full page) 78 

Humerus, or Large Bone of the Arm, 83 
Liver, The, Showing Lobes and Bile 

Duct 102 

Lumbar Vertebrae, Section of 79 



Lungs and Heart, Sectional View of.. 106 
Lymphatic Vessels of the Human 

Body 103 

Lymphatics 104 

Muscle, Non-striated 77 

Muscle, Striated 77 

Muscles Back of the Thigh 97 

Muscles of Back of Forearm 94 

Muscles of Front of Forearm 94 

Muscles of Front of the Leg 97 

Muscles of the Back 92 

Muscles of the Body, Back View 89 

Muscles of the Body, Front View ... 90 

Muscles of the Chest 93 

Muscles of Face, Jaw and Neck 91 

Nerve Cells, Group of, Magnified .... 76 

Nerves, Magnified and Described 77 

Nerves of the Thigh 96 

Nerves of the Thigh 123 

Nerves of the Face and Scalp 118 

Nerves — Ninth, Tenth and Eleventh, 120 

Nerve, Fifth 119 

Ninth, Tenth and Eleventh Nerves of 

Organs of Sense 120 

Non-striated Muscles 77 

Pavement Epithelial Tissue 74 

Pelvis of the Male 86 

Peritoneum, Showing all Involved Or- 
gans 102 

Racemose Gland, The 74 

Radius, or Bone of the Forearm .... 84 

Ribs, The, Showing Thorax 82 

Salivary Glands 98 

Scalp, Nerves of 118 

Scapula, or Back of the Shoulder .... 83 

Sectional View of Base of Brain 117 

Section of Bone Magnified 75 

Section of Cervical Cord 122 

Section of the Spinal Vertebrae 79 



INDEX TO BOOK II. 



71 



Semilunar Valves of the Heart 108 

Shoulder Joints 88 

Simple Glandular Epithelium 74 

Skeleton (full page) 78 

Skull, Front View of 81 

Skull, View of the Base of 81 

Spinal Column, Complete Outline of.. 79 

Spinal Cord 121 

Stomach, The 100 

Stomach Tubule, Showing Fundus and 

Muscular Coat 100 

Striated Muscle, Sections of 77 

Thigh, Arteries of 112 



Thigh, Back View of 124 

Thigh, Nerves of 96 

Thorax, Transverse Section of 116 

Thorax, View of 82 

Tibia, or Strong Bone of the Shin.. 87 
Tongue, The, Showing Mucous Mem- 
brane and Glands 99 

Transverse Section of the Thorax or 

Chest 116 

Ulna, or Bone of the Forearm 84 

Veins of the Human Leg 114 

Veins of the Upper Extremity of the 
Body 114 



Book II. 



ANATOMY AND PHYSIOLOGY. 

Necessity for This Book — A brief outline of the structure or anatomy, 
and of the function, use or physiology of the human organism must 
necessarily inaugurate any book purporting to present the prevention and 
cure of disease, for disease means disordered function, which cannot be 
understood without some knowledge of the normal or regular function, 
which in turn necessitates a study of structure. 

Plan of the Book. — As anatomy and physiology are naturally insepar- 
able we will interweave one with the other in the following pages, the 
part played by an organ being given with its description. 

Bodily Organs — Every animal is composed of organs, as the heart, 
liver, kidney, etc., and every organ consists of tissues, of which there are 
four varieties : epithelial, connective, nervous and muscular. Each tissue 
is made of numbers of cells. 

Forms of Cells. — A cell is a microscopic bag of jelly-like substance 
called protoplasm, which often contains within its substance a smaller cell 
called a nucleus, and sometimes inside the smaller cell, a tiny dot called 
the nucleolus. 

Protoplasm. — Protoplasm is formed of water, albuminous substances, 
sugary material, fat and chemical salts. The chief chemical salts enter- 
ing into its formation are carbon, hydrogen, oxygen and nitrogen. 

Size of Cells — Cells vary from ^~ to -Jj of an inch in diameter ; 
some tubes as in the hair-like blood-vessels, and some float in fluid as 
the blood corpuscles. Some have the power of moving from place to 
place, ameboid motion. 

Human Body Compared to a City. — The human body may be compared 
in its arrangement to a city, the houses being the organs ; the brick, stone, 
wood and metal the tissues, and the individual bricks, fragments of stone, 
boards or pieces of metal the cells. 

Human Body Compared to an Army. — Huxley compares it to an army, 

(73) 



74 



ANATOMY AND PHYSIOLOGY. 




Figure 8.— PAVE- 
MENT EPITHELIUM 



"each cell is a soldier, an organ a brigade, the central nervous system 
the headquarters and field telegraph, and the alimentary and circulatory 
systems the commissariat." The function of a cell is the same as that of 
a human being, they absorb food and grow, fill special offices, as protect- 
ing, secreting, etc., reproduce and die. 

Epithelium. — Epithelial tissue or epithelium means literally upon 
the nipple. It covers the entire outside of the body, as the skin, the in- 
side of the respiratory, alimentary and 
genito-urinary apparatuses as mucous 
membrane, and dips down into the va- 
rious glands which open on the skin and 
mucous membrane. 

Skin Arrangement. — On the skin it 
is arranged in layers as pavement epi- 
thelium (Fig. 8) and acts as a protec- 
tion to the delicate structures beneath. In some places, 
as in the hair and nails, it is much modified to more effect- 
ually guard against injury. 

Shape in the Stomach. — In the stomach, intestines and 
elsewhere the epithelial cell is oblong in profile (Fig. 9) 
and is called columnar epithelium. \ 

Cilia of "Windpipe — Some 
epithelium, like that in the 
windpipe, has projecting from it long waving 
filaments called cilia (Fig. 10). The cilia 
wave constantly, acting as brooms, which keep 
the windpipe 
clean. 
Glandular Epithelium. — Secretory or 
glandular epithelium (Figs. 11 and 12) is 
found in the glands, varies in shape, and 




Figure 9. — CO- 
LUMNAR EPI- 
THELIUM. 




Figure 10. — CILIATED EPI- 
THELIUM. 




Figure 11.— SIMPLE GLAND. 




Figure 12.— RACEMOSE GLAND. 



BONE STRUCTURE AND TISSUE. 



75 



is the essential portion of the gland, i. e., the portion which manufactures 
the special secretion from the blood. 

Endothelium. — Endothelium, lining serous sacs, joint cavities (syno- 
vial sacs) , and the blood and. lymphatic vessels, is analogous to epithelium. 

Connective Tissue. — Connective tissue occurs as bone, cartilage and 
fibrous connective tissue. 

Bone Structure. — Bone is fibrous tissue cemented with petrified 
cement. It consists approximately of one-third animal and two-thirds 
earthy material, the principal earthy constituents being the phosphate 
and carbonate of lime; lining bone is pinkish in color and oozes blood 
when cut. 

Periosteum. — Externally it is covered by a membrane called perios- 
teum. The shafts of long bones are hollow, the cavity being filled by the 
marrow, which consists of blood and lymph vessels, nerves and fat sup- 
ported by fibrous tissue. 

Tissue of Bones. — Bone tissue is of two kinds, spongy, which forms 
the very thin bones and the ends of long bones, and compact, which is 
found in the shafts of long 
bones and in the outside of flat 
bones. Spongy bone is made 
up of a meshwork of bony 
arches, the spaces filled with 
vessels, bone cells and connec- 
tive tissue. 

Compact Bone Compact 

bone (Eig. 5) consists of a 
series of concentric layers of 
bone disposed around a canal 
called the Haversian canal 
which affords the passage for the 
blood-vessels. The layers of 
bone are separated from each 
other by small spaces called 
lacunaB, and passing through 
the bony layers and connecting 
the lacunae are many fine chan- 
nels called canal iculi ; they 
serve to convey nourishment to 
the bone cells. The function 
of bone is to support, to protect, and to give attachment to muscles. 




Figure 5.— FACTION OF BONE, MAGNIFIED. 



76 



ANATOMY AND PHYSIOLOGY. 



Structure of Gristle.-— Cartilage or gristle (Fig. 4) is fibrous tissue 
glued together by a substance containing chondrine. It has no blood- 
vessels but is nourished by lymph which filters through it by means of 
small spaces and canals analogous to the lacunae and canaliculi of bone. 

Use of Gristle. — Cartilage forms a smooth covering for the ends of 
bones entering into a joint ; acts as a buffer between the bones of the spine, 
prevents certain tubes, like the windpipe, from collapsing, and as in the 
external ear gathers sound. 





Figure 3. 



Figure 4. 



Figure 3. — FAT. 

Figure 4.— CARTILAGE. 



Magnified. 



Fibrous Tissue. — Fibrous tissue consists ultimately of fibres which are 
developed from spindle-shaped cells. Its function is to hold the various 




Figure 57.— NERVE CELLS. 



parts of, and the organs themselves, together. Fatty tissue (Fig. 3) is 
fibrous connective tissue unfiltrated with fat. 

Nervous Tissue. — Nervous tissue is either gray, which is a mass of 
tailed cells (Fig. 57) supported by a fine connective tissue (neuroglia), or 



BONES OF THE BODT. 



It 



white, which is made of bundles of little nerve febrils, each febril is the tail 

^ n s. of a cell in the gray nervous tissue and is 

Ilk / ^*\ surrounded in some places by the white 

substance of Schwann (Fig. 58) and by a 
©1 ""'V/ primitive sheath. 





d 6 1 b £ 



Figure 6.— STRIPED MUSCLE. 1, longitu- 
dinal section; 2, 3, 4, cross section; 5, de- 
tached disk; 7, 8, fibrillse. 

Muscular Tissue. — There are two 
kinds of muscular tissue, the voluntary or 
striped, and the in- 
voluntary or non- 
striated. Volun- 
tary muscle (Fig. 
6) is composed 
microscopically of the primitive fasciculi (minute 
bundles of febrils), each febril of which consists 
of a row of disks (Fig. 6) called sarcous elements. 
Involuntary muscle is built of a number of non- 
striped, spindle-shaped cells (Fig. 7) which 
branch and join with one another. 



Figure 58. — NERVES. a, axis 
cylinder; b, inner border of white 
substance; c, c, outer border of 
same; d, d, tubular membrane; B, 
tubular fibres; e, in natural state; 
f, under pressure; g, varicose 
fibres. 



THE BONES. 




Figure 7. — NON-STRIATED 
MUSCLE. 



Framework of the Body — The body skeleton (Fig. 13) forms the 
framework of the body. Bones are divided into long, short and flat bones. 
The long bones consist of a hollow shaft of compact bone, and two broader 
extremities of cancellated bone. They are found in the extremities and 
form levers by which the trunk is moved. 



78 



ANATOMY AKD PHYSIOLOGY, 




Figure 13. — HUMAN SKELETON. 



Short Bones. — Short bones are placed where strength is more neces- 
sary than mobility, as in the hand and foot; their structure is spongy, 
covered by a thin layer of compact bone. 



THE SPINE. 



79 



Flat Bones. — The flat bones are found where 
protection of important organs is necessary, as in 
the skull, sternum and scapulae. They consist of 
two tables of compact bone filled in with cancellous 
tissue. Certain bones do not belong to one class 
alone and are called mixed bones. 

Number of Bones. — There are in the adult 
skeleton, excluding the teeth, ossicles of the ear, 
and Wormian bones, 200 separate bones. These 
are: 



lo- 



in the spinal column 26 

In the skull 8 

In the face 14 

Ribs, breast bone and hyoicl bone 26 

Upper extremity 64 

Lower extremity 62 

THE SPINE. 



Spinal Column. — The spine (Fig. 14) is a flex- 
ible column made of small bones called vertebrae, 
seven cervical, twelve dorsal, five lumbar, five 
sacral and four coccygeal vertebrae. 

Spinal Vertebrae — A vertebra (Figs. 16 and 
17) consists of a solid portion in front called the 
body, and an arch behind, so that when placed 




Figure 16. 



Figure 17. 



«2' 



Figure 14. 



Figure 14. — SPINAL COLUMN. 1, atlas; 2, axis; 3, vertebra prominens; 4, twelve dorsal; 
5, fifth lumbar; 6, 7, sacrum; 8, coccyx; 9, a spinous process; 10, 10, intervertebral foramina. 

Figure 16. — DORSAL VERTEBRA. 1, body; 2, facet for rib; 3, superior surface body; 
4, 5, intervetebral notch; 6, spinous process; 7, articular facet for tubercle of a rib; 8, 9, 
articular processes. 

Figure 17. — LUMBAR VERTEBRA. 1, body; 2, front of the body; 3, spinous process; 
4, transverse process; 5, articular process; 6, arch; 7, spinal foramen. 




80 ANATOMY AND PHYSIOLOGY. 

one above the other, as in Figure 14, the bodies of the vertebrae form a 
support for the body and the arches a canal which contains and protects 
the spinal cord. The arches are formed by a plate of bone on each side 
(lamina) joined to the body or constructed portion of bone (pedicle) and 
unite behind to form the spinous process, which is the portion one feels 
when running a finger down the back. 

The Atlas. — The first cervical verte- 
bra or atlas (Fig. 15) has neither body nor 
spinous process, but consists of an anterior 
and posterior arch and two lateral masses 
on which rests the skull. The axis, or 
cervical vertebra has a projection from 
the upper surface of its body (odontoid 
Figure 15.— atlas. i, anterior tu- process) which fits in the anterior arch of 

bercle; 2, facet for axis; 3, posterior . 

surface spinal canal; 4, 4, interverte- the atlas, permitting the head With the 

bral notch; transverse process; 5, .. , 1 _ . 1 . 1 

foramen for vertebral artery; 7, su- atlas tO be l'Otated irom Side tO Side, 

perior articular process; 8, tubercle rpu~ o n ««,«i mi • , <• 

for transverse ligament. lne »acriini. Hie sacrum Consists 01 

five vertebra? welded into one bone. It is 
triangular in shape and is wedged in between the haunch bones, forming 
the back of the pelvis. Attached to its apex is the coccyx, which consists 
of four vertebras, so joined as to form one bone. 

Ligaments. — The vertebrae are tied together by ligaments. Between 
each vertebra and its neighbor is a disk of cartilage, which acts as a 
buffer to prevent shock and allows the spine to bend in various directions. 

THE SKULL. 

Bones of the Skull. — The skull is divided into the cranium or brain 
case and the face. The cranial bones are one occipital, two parietal, one 
frontal, two temporal, one sphenoid and one ethmoid. The occipital bone 
forms the back and under part of the skull. It is perforated by a large 
opening (foramen magnum) which transmits the spinal cord to the spinal 
canal. The cerebellum rests on its inner or upper surface, the external 
surface gives attachment to muscles. 

Side and Top Bones. — The parietal bones form the sides and top of 
the cranium, joining in the median line and being placed between the 
occipital bone behind and the frontal bone in front. 

Frontal Bone. — The frontal bone forms the forehead and forms the 
roof of the orbit, on the upper surface of which rests the brain. The 



BONES OF THE FACE. 



81 



orbital plates are separated by tbe ethmoid bone, which is spongy and filled 
with perforations which transmit the nerves of smell to the nose. 

Temporal Bone — The temporal bone consists of a squamous or scale- 
like portion which overlaps the parietal bone, and a petrous or stony 
portion which helps form the floor of the cranium. The petrous portion 
lodges in the internal and middle ear. 

Sphenoid Bone. — The sphenoid resembles a butterfly in shape. It is 





Figure IS. 



Figure 19. 



Figure 18. — FRONT OF THE SKULL. 1, os frontalis; 2, globella; 3, supraorbital ridge; 
4, optic foramen; 5, sphenoidal fissure; 6, spheno-maxillary fissure; 7, lachrymal fossa; 8, an- 
terior nares; 9, infraorbital foramen; 10, malar bone; 11, symphysis menti; 12, anterior mental 
foramen; 13, ramus of the lower jaw; 14, parietal bone; 15, coronal suture; 16, temporal 
bone; 17, squamous suture; 18, great wing of the sphenoid. 

Figure 19. — BASE OF THE SKULL. 1, hard palate; 2, foramen incisivum; 3, palatine 
plate of palate bone; 4, crescenteric ridge; 5, vomer; 6, internal pterygoid' plate; 7, pterygoid 
fossa; 8, external pterygoid plate; 9, temporal fossa; 10, basilar process; 11, foramen mag- 
num; 12, foramen ovale; 13, foramen spinale; 14, glenoid fossa; 15, meatus aditorius externus; 
16, foramen lacerum anterius; 17, carotid foramen; 3 8, foramen lacerum posterius; 19, styloid 
process; 20, stylo-mastoid foramen; 21, mastoid process; 22, condyles of occipital bone; 23, 
posterior condyloid foramen. 

the keystone of cranial architecture binding the bones of the head firmly 
together. 

Facial Bones.— The facial bones are: two nasal bones, forming the 
bridge of the nose; two superior maxillary (upper jaw) ; two lachrymal, 
forming a portion of the inner wall of the orbit ; two malar or cheek bones ; 
two palate bones forming the back part of the roof of the mouth and the 
corresponding portion of the floor of the nose ; two inferior turbinated 
bones which are scrolls of bone placed in either nostril ; one vomer, form- 
ing the partition between the nostrils; and the lower jaw or inferior 
6 



82 



ANATOMY AND PHYSIOLOGY. 



maxillary bone, horseshoe in shape, joining with the temporal bone above 
and being freely movable below to permit chewing, talking, etc. 

Hyoid Bone. — The hyoid bone is U-shaped, situated in the neck just 
above the larynx and gives attachment to many muscles of the tongue 
and throat. 

THE THORAX. 



9? 7 



The Chest. — The thorax or chest is an elastic bony cage made by 
the breast bone in front, the spine behind, and the ribs and their cartilages 
at the sides. It is filled by the heart and lungs, which it protects. The 
sternum or breast bone occupies the middle line anteriorly, is flat, and is 
made of three pieces, the manubrium (handle), the gladiolus (blade), and 
the pointed extremities, the ensiform or xiphoid appendix, these names 
were given by the ancients who compared it to a sword. 

The Ribs. — There are twenty-four ribs (Fig. 20), twelve on each side. 
They are joined to the vertebra behind and to the sternum, by means of car- 
tilages, in front. They are irregularly 
semicircular in shape, flattened antero- 
posteriorly, and slightly twisted on them- 
selves. The head joins the vertebra be- 
hind, the neck is the constriction in front 
of the head and the angle, the point of 
greatest curvature. The seven upper 
ribs unite directly with the sternum, and 
are called true ribs. The other five are 
called false ribs, the upper three being 
united in front to the cartilages of the 
ribs above them, and the last two 
having no attachment in front are termed 
floating ribs. 




THE UPPER EXTREMITY. 



Figure 20.— THORAX. 1, manu- 
brium; 2, gladiolus; 3, ensiform pro- 
cess; 4, first dorsal vertebra; 5, twelfth 
dorsal vertebra; 6, first rib; 7, its 
head; 8, its neck; 9, its tubercle; 10, 
last true rib; 11, its cartilage; 12, 
angle of eleventh rib; 13, its body. 



The Shoulders. — The upper extrem- 
ity consists of the shoulder, the arm, 
the forearm, and the hand. The bones of 
the shoulder are the clavicle and scapula 
connecting the arm with the trunk. The 

clavicle, collar, or key-bone is a short bone curved like the letter f, running 

horizontally between the sternum and scapula. 



BONES OF THE FOKEAEM. 



83 



The Scapula.— The scapula (Fig. 21) forms the back of the shoulder, 
is triangular in shape, the apex pointing downward and lies on the ribs. 
On the upper part of the outer surface is a thick triangular spine, the 
outer extremity of which (the acromion) forms the point of the shoulder. 

Socket of the Shoulder. — Beneath this process tne upper angle is 
hollowed out to relieve the upper end of the arm bone. In front of this 
depression is a curved prominence, the coracoid process. 

Arm Bone — The humerus (Fig. 22) or arm bone consists of a long 
cylindrical shaft, having a rounded head above for articulation with the 




Figure 21. — SCAPULA. 1, 1, 1, oblique ridges; 2, 2, subscapular fossa; 3, superior border; 
4, superior angle; 5, supra-scapular notch; 6, coracoid process; 7, acromion process; 8, spine 
of scapula; 9, articular surface; 10, glenoid cavity; 11, head of scapula; 12, neck; 13, in- 
ferior border; 14, inferior angle; 15, posterior border; 16, origin of the spine. 

Figure 22. — HUMERUS. 1, shaft; 2, head; 3, anatomical neck; 4, greater tuberosity; 5. 
lesser tuberosity; 6, bicipital groove; 7, ridge pectoralis major; 8, internal bicipital ridge; 
9, insertion of deltoid muscle; 10, nutrient foramen; 11, facet for radius; 12, facet for ulna. 

scapula, and a broad flattened lower extremity for articulation with the 
forearm bones. 

The Forearm. — The bones of the forearm are the ulna and the radius. 
The ulna (Fig. 24) lies on the inner side of the forearm when the palm of 
the hand faces upward. The upper extremity which joins the humerus, 
has two processes, the olecranon, forming the point of the elbow and the 
coronoid process, which complete the hinge joint of the elbow in front. 



84 



ANATOMY AND PHYSIOLOGY. 



The lower end of the ulna is small and does not articulate with any bone 
of the wrist. 

The Radius. — The radius (Fig. 23) lies on the outer side of the fore- 
arm. It has a cup-shaped head for articulation with the humerus. The 
rounded edge of the head fits in a concavity of the ulna and is surrounded 



Figure 23. 




Figure 25. 



Figure 23. — PwADIUS. 1, head; 2, articulates with ulna; 3, neck; 4, tuberosity; 5, in- 
terosseus ridge; 6, articulates with ulna; 7, carpal surface; 8, styloid process; 9, insertion 
of pronator quadratus. 

Figure 24. — ULNA. 1, olecranon; 2, sigmoid cavity; 3, coronoid process; 4, lesser sig- 
moid cavity; 5, external surface; 6, interosseus ridge; 7, articulates with radius; 8, carpal 
surface. 

Figure 25. — CARPUS. 1, ulna; 2, radius; 3, interarticular cartilage; 4, metacarpal of 
thumb; 5, 6, 7, 8, metacarpal bones of fingers; S, scaphoid; L, semilunar; C, cuneiform; P, 
pisiform; T, T, trapezium and trapezoid; M, magnum; U, unciform. 

by a sling-like ligament, which allows the head to rotate. The lower 
extremity is larger and is hollowed out to fit the wrist bones. 

The Wrist — The wrist or carpus consists of eight small bones in two 
rows (Fig. 25). In the upper row, beginning at the radial side, are the 
scaphoid, semilunar, cuneiform, and pisiform bones; in the lower row, 
the trapezium, trapezoid, or magnum and unciform bones. 

The Hand. — The hand is made of fixe short cylindrical bones called 
the metacarpal bones (Fig. 25), to the lower extremity of which are 



BOXES OF THIGH AXD LEG. 85 

attached the finger bones or phalanges, there being two for the thumb and 
three for each finger. 

THE LOWER EXTREMITY. 

Parts of Lower Extremity. — The lower extremity consists of three 
parts, the thigh, the leg and the foot, and is united to the trunk by the 
os innominatum or haunch bone, which bears the same relation to the 
lower extremity that the bones of the shoulder do to the upper extremity. 

The os innominatum (Fig. 26) consists of the ilium, ischium and 
pubes, which in the adult grow together and form one single bone. It is 
irregularly oblong in shape and twisted upon itself. The ilium is the 
broad upper part of the bone and forms the prominence of the hip. The 
ischium is the V-shaped lower portion upon which we sit. ' The pubes is 
situated in front and is also V-shaped; in the adult the upper part is 
covered by hair. Between these V-shaped bones is a large opening, the 
obturator or thyroid foramen. 

Hip Socket. — At the junction of the three bones is a cup-shaped 
cavity, the acetabulum or socket of the hip, which receives the rounded 
head of the thigh bone. In front the pubic bones join and behind the 
sacrum complete the bony ring of the pelvis. The pelvis (Fig. 26) is 
basin-shaped, supports the contents of the abdomen and the trunk upon the 
limbs. 

Thigh Bone. — The femur (Fig. 27) or thigh bone is the largest and 
strongest bone in the body. It consists of a shaft and two extremities. 
The upper extremity consists of a head which is spherical and smooth, 
fitting into the acetabulum, and a neck which joins the shaft at an obtuse 
angle. The shaft supports the body, is an important lever in locomotion 
and gives attachment to muscles. The lower extremity resembles the 
lower end of the humerus ; it is smooth and joins with the main bone of 
the leg, the tibia. 

Knee Pan. — The patella or knee pan is a small flat bone situated in 
the huge tendon of the great muscles on the front of the thigh. It protects 
the knee joint and increases the leverage. 

Leg Bones. — The leg bones are the tibia er shin bone (Fig. 27a) and 
the fibula (Fig. 28). The tibia, the larger and stronger, is expanded 
above to join the femur; the shaft is triangular, the sharp edge in front 
may be readily felt beneath the skin as the shin. The lower extremity 



86 



AKATOMT AKT> PHYSIOLOGY. 



forms the inner part of the ankle joint. The fibula (Fig. 28) is a long, 
slender bone lying on the outside of the leg. Its upper end joins the ex- 




Figure 26. 

Figure 26. — MALE PELVIS. 

panded upper extremity of the tibia, strengthening it, the lower end forms 
the outer part of the ankle joint. 

Foot Bones — The foot (Fig. 29) consists of the tarsus or ankle bones, 
the metatarsus or foot bones and the phalanges or toe bones. The bones 
of the tarsus are the calcaneum, os calcis, or heel bone, the astragalus 
which joins the bones of the leg, the cuboid, the scaphoid and the three 
cuneiform bones. There are five metatarsal bones corresponding to the 
metacarpal* bones of the hand. The phalanges are similar to those of the 
hand, there being two for the great toe and three for each of the other toes. 



THE JOINTS. 

Where two bones meet a joint or articulation exists. The bones may 
be so soldered together (Fig. 30) as to form an immovable joint, as in the 
bones of the skull ; they may be slightly movable as the pelvic and ver- 
tebral joints, or they may be freely movable as in most of the articulations 
of the limbs. The freely movable joints (Fig. 31) are the hinges, as the 
elbow; the ball and socket, as the shoulder; the gliding, as the sterno, 
clavicular articulation and the ring and pivot (Fig. 32) joint, as the atlo- 
axoid articulation. The structures entering into joint formation are bones, 



THE MUSCLES. 



37 



cartilages, ligaments and synovial membrane which secretes the lubricat- 
ing fluid of the joint. (Figs. 30, 31 and 32.) 



Figure 27. 



Figure 27a. 



8^9 
Figure 21 




Figure 29 



Figure 27. — FEMUR. 1, depression for round ligament; 2, head; 3, depression for rotary 
muscles; 4, great trochanter; 5, lesser trochanter; 6, roughness for gluteus maximus; 7, linea 
aspera; 8, gastrocnemius insertion; 9, external condyle; 10, depression for anterior crucial 
ligament; 11, depression for posterior crucial ligament; 12, origin of internal lateral ligament. 

Figure 27a. — TIBIA. 1, spine; 2, articulates with femur; 3, facet for fibula; 4, head; 



shaft; 7, internal malleolus; 



attaches internal lateral ligament of ankle; 



2, articular facet; 3, insertion 
interosseus ridge; 7, facet for tibia; 



of external ligament; 4, 
8, external malleolus; 9, 



5, tubercle; 6, 

9, tarsal surface; 10, facet for fibula 

Figure 28. — FIBULA. 1, head; 
shaft; 5, 5, external face; 
tarsal surface. 

Figure 29. — FOOT BONES. 1, astragalus; 2, its anterior face; 3, os calcis; 4, scaphoid; 
5, internal cuneiform; 6, middle cuneiform; 7, external Cuneiform; 8, cuboid; 9, 9, metatarsal 
bones; 10, first phalanx of big toe; 11, second phalanx; 12, 13, 14, phalanges of other toes. 

It will be unnecessary to describe the individual joints, reference 
having already been made to them in the section on bones. 



THE MUSCLES. 



Function of Muscles. — Muscles are familiar as the flesh of animals. 
They are attached to bones, ligaments, cartilages and the skin, and by their 
contractions cause all the movements of the body. Some muscles are 
arranged in sheets (Fig. 33), some are spindle-shaped, some are disposed 



88 



ANATOMY AND PHYSIOLOGY. 





Figure 30. 



Figure 31. 



Figure 30. — ACROMIOCLAVICULAR and SHOULDER JOINTS. 1, upper acromioclav- 
icular ligament; 2, coraco-clavicular ligament; 3, coraco-acromial ligament; 4, coracoid liga- 
ment; 5, capsular ligament of shoulder; 6, coraco-humeral ligament; 7, long head of biceps. 

Figure 31. — HIP JOINT. 1, posterior sacro-iliac ligament; 2, greater sacro-sciatic liga- 
ment; 3, lesser sacro-sciatic ligament; 4, great sciatic notch; 5, lesser sciatic notch; 6, coty- 
loid ligament; 7, ligamentum teres; 8, attachment for capsular ligament; 9, obturator ligament. 




13 |* || '3 



Figure 32. 



Figure 32.— SECTION OF ANKLE JOINT. 1, tibia; 2, astragalus; 3, os calcia; 4, 
scaphoid; 5, internal cuneiform; 6, metatarsal of big toe; 7, 8, first and second phalanges of 
great toe; 9, articular cavity between tibia and astragalus; 10, synovial capsule between 
astragalus and os calcis; 11, calcaneo-astragaloid ligament; 12, synovial capsule between as- 
tragalus and scaphoid; 13, calcaneo scaphoid ligament; 14, calcaneo-cuboid ligament; 15, 
synovial capsule between scaphoid and internal cuneiform; 16, synovial capsule between 
internal cuneiform and first metatarsal; 17, metatarso-phalangeal articulation of great toe; 
18, phalangeal articulation of great toe. 



in rings like the muscle which closes the mouth, and in some the fibres 
spread out like a fan. 

Muscle Attachments. — They are attached by fibrous cord, the tendons, 
or by broad fibrous bands, the aponeuroses. The end of the muscle which 
has the firmer attachment is called its origin (Fig. 34), the other end its 



THE MUSCLES. 



89 



insertion ; this is, as a rule, merely relative, as in most cases the muscles 
act from either extremity; for instance, the sterno-cleido mastoid, the 
muscle which forms the prominent cord at either side of the neck, has its 




Figure 33. 

Figure 33. — MUSCLES, BACK VIEW. The fasciu is left upon the left limbs; removed 
from the right. 

origin from the top of the breast bone and the end of the collar bone, and 
its insertion into the bony prominence of the skull behind the ear, its 
action is to bow the head and turn the face to the opposite side ; but if the 



90 



ANATOMY AND PHYSIOLOGY. 



head be fixed it serves to raise the ribs and is thus an accessory muscle of 
respiration. 

Face Muscles. — Of the numerous small muscles of the face (Fig. 35), 
it is not necessary to speak here ; as a rule they arise from the bones of the 




Figure 34. 

Figure 34.— MUSCLES, FRONT VIEW. On the right half, superficial muscles; left 
half, deep muscles. 

face and are inserted into the skin, by their mobility giving expression 
to the countenance. 

Muscles of Chewing. — The muscles of the orbit will be taken up in 



THE MUSCLES. 



91 



connection with the eye. The muscles of mastication are the temporal, 
masseter, the two pterygoids and the buccinator. The temporal arises 
from the side of the head above the ear and is inserted into the top of the 
lower jaw. The masseter runs from the bony process external to the orbit, 
to the angle of the jaw and forms the hard mass felt in the cheek when the 
jaw is tightly closed. 

/,? 




Figure 35. — MUSCLES OF FACE, JAW AND NECK. 1, longus colli; 2, trapezius; 3, 
sterno-hyoid; 4, sterno-mastoid; 5, crico-thyroid; 6, trapezius; 7, constrictor of pharynx; 8, 
sterno-mastoid; 9, digastric; 10, attrahens aurem; 11, mylo-hyoid; 12, masseter; 13, depressor 
of lower lip; 15, orbicularis oris; 17, levator of upper lip; 19, levator of angle of mouth; 21, 
orbicularis palpebrarum. 

Muscles of the Jaw — The pterygoids run from the base of the skull 
to the lower jaw, moving it laterally. The buccinator is a broad, flat sheet 
in the cheek compressing the cheeks as when blowing or whistling, etc. 

The sterno-cleido mastoid has already been mentioned above. The 
muscles of the larnyx will be spoken of in connection with diseases of the 
throat. 

Muscles of the Back — The most important muscles of the back are 
the trapezius, which pulls the head back or the shoulder upward or back- 



92 ANATOMY AXD PHYSIOLOGY. 

ward and which runs from the occipital bone and the spine as far as the 
middle of the back, to the shoulder bones; the latissimus dorsi, which 
draws the arm downward and backward, and which arises from the 
lower ribs, the lower half of the spine and the hannch bone and is inserted 
into the arm bone near its head ; and the erector spina? which arises from 
the pelvis and lumbar vertebrae and is inserted into all the vertebrae above ; 
it maintains the spine erect. 

Muscles of Thorax. — Concerning the thorax we may mention the 




Figure 36. 



Figure 36. — MUSCLES OF BACK. 1, trapezius; 2, its origin; 3, spine of scapula; 4, latis- 
simus dorsi; 5, deltoid; 6, infra-spinatus; 7, external oblique; 8, gluteus medius; 9, gluteus 
maximus; 10, levator scapulae; 11, rhomboideus minor; 12, rhomboideus major; 13, splenitis 
capitus; 14, splenius colli; 15, origin latissimus dorsi; 16, serratus inferior posticus; 17, supra- 
spinatus; 18, infra-spinatus; 19, teres minor; 20, teres major; 21, long head triceps; 22, ser- 
ratus major anticus; 23, internal oblique. 

intercostal (between the ribs) muscles, external and internal, the external 
set raising the ribs and the internal set depressing the ribs in respiration. 
The Diaphragm. — The diaphragm is a musciilo-fibrous partition form- 
ing tlie dome of the abdomen and separating it from the thorax. It is 



MUSCLES OF THE ABDOMEN". 



93 



attached to the lower ribs and spinal column and is perforated by the 
aorta, inferior vena cava and gullet. It is a muscle of respiration and 
expulsion. 

The Abdomen. — The abdomen is completed in front and at the sides 
by a thick wall of muscles which not only aid in protecting the underlying 
structures but assist in expelling the urine, feces, etc., from the body. 
This wall is made of the external oblique muscle which runs from the 
ribs downward and inward to the pelvic bones and line a alba — the line a 
alba or white line occupies the midline of the abdomen and is formed by 
the union of the various muscular structures of the abdominal wall; the 
internal oblique muscle arises 
from the ilium and lower fibrous 
part of the external oblique (Pou- 
part's ligament), runs upward and 
inward to be inserted into the linea 
alba and lower ribs; the transver- 
salis which runs transversely be- 
tween the brain, spine, ribs and 
pelvis to the linea alba, and the 
rectus abdominalis which is situ- 
ated near the middle line of the 
body and runs from the ribs to 
the pelvis. 

Breast Muscles. — The pecto- 
ralis major and minor muscles 
form the fleshy masses of the 
breast. They run from the collar- 
bone, breast-bone and ribs to the 
caracoid process of the scapula 
and the humerus, the fibres con- 
verging from their origins to 
their insertions. They draw the 
shoulder forward and the arm 
across the chest. 

Deltoid Muscle — The deltoid 
(Fig. 37) forms the prominence 

of the shoulder. It arises from the clavicle and scapula, the fibres con- 
verging to be inserted into the humerus just above the middle. It raises 
the arm from the side. 

The Biceps. — The biceps forms the prominence on the front of the 




Figure 37. 

Figure 37.— CHEST MUSCLES. 1, sterno- 
hyoid; 2, stemo-mastoid; 3, sterno-thyroid; 4, 
sterno-mastoid; 5, trapezius; 6, clavicle; 7, 
origin pectoralis major; 8, deltoid; 9, lower 
edge pectoralis major; 10, middle pectoralis 
major; 11, fibres external oblique; 12, biceps; 
13, teres major; 14, serratus major anticus; 
15, external oblique interlocking with serratus 
major. 



94 



ANATOMY AIMD PHYSIOLOGY. 



arm when the forearm is flexed. It arises from the scapula by two heads 
and is inserted into the upper end of the radius. It flexes the forearm 
and assists in supinating or turning it over. 

The Triceps. — The triceps arises from the shoulder blade and the 
back of the humerus by three heads, and is inserted into the upper end 
of the ulna. It extends the forearm. 

Muscles of Forearm. — The muscles of the forearm are very numerous, 
and give the forearm and hand a multitude of movements. The muscles 
which turn the palm downward are called pronators, the most important 
of these is the pronator radii teres which runs from the inner part of the 
lower end of the humerus to the radius. The most important supinator 





Figure 38. 



Figure 39. 



Figure 38. —MUSCLES OF BACK FOREARM. l, biceps; 2, brachialis interims; 3, 
biceps; 4, supinator longus; 5, extensor carpi radialis longior; 6, extensor carpi radialis 
brevior; 7, insertion of these muscles; 8, extensor communis digitorum; 9, extensor communis 
digitorum; 10, extensor carpi ulnaris; 11, anconeus; 12, flexor carpi ulnaris; 13, extensor 
minor pollicis; 14, extensor major pollicis; 15, posterior annular ligament. 

Figure 39.— MUSCLES OF FRONT FOREARM. 1, biceps; 2, brachialis internus; 3, 
triceps; 4, pronator radii teres; 5, flexor carpi radialis; 6, palmaris longus; 7, flexor sublimus 
digitorum; 8, flexor carpi ulnaris; 9, palmar fascia; 10, palmaris brevis; 11, abductor pollicis; 
12, flexor brevis pollicis; 13, supinator longus; 14, extensor ossis metacarpi pollicis. 



MUSCLES OF THE LOWER BODY. 95 

or muscle which turns the palm upward (Fig. 38), is the supinator longus 
which runs from the outer part of the lower end of the humerus to the 
lower end of the radius. 

Flexors. — The radial and ulnar flexors (of the wrist) come from the 
inner part of the arm hone and are inserted into the hand hones. Beneath 
these muscles lies the flexor sublimus digitorum which divides into four 
tendons or leaders, one for each finger. These leaders are split so as to 
give passage to the leaders of the flexor profundus digitorum which are 
inserted into the ends of the fingers. The thumb is moved by special 
muscles. 

Eadial Extensors. — The muscles on the back of the forearm are the 
longer and shorter radial extensors (of the wrist), which lie behind the 
long supinator and whose tendons are inserted respectively into the 
metacarpal bones of the first and second fingers. The ulnar extensor of 
the wrist lies on the idnar side of the forearm, and is inserted into the 
metacarpal bone of the little finger. Between these muscles, in the middle 
of the forearm (Fig. 39), is the common extensor of the fingers which is 
inserted by four tendons into the backs of the last two bones of the fingers. 
The index and little fingers have special extensors. The hand is supplied 
by a number of short muscles, which give it marvelous dexterity. 

MUSCLES OF THE LOWER EXTREMITY. 

The muscles of the lower extremity consist of those of the hip, thigh, 
leg and foot. The psoas magnus and the iliacus, the former from the 
lumbar vertebrae, the latter from the inside of the ilium, are inserted 
together into the upper part of the femur. They flex the thigh and roll 
it outward. The buttocks are composed of the three glutei muscles. 
They arise from the pelvic bones and are inserted into the upper part of the 
femur. They extend the hips, raise the body from the stooping posture, 
and hold the trunk on the thigh bones. Partly beneath them lies a group 
of muscles (Fig. 41), the rotators of the hip; they are the pyriformis, 
gemelli, the internal and external obturators, and the quadratus femoris. 

Thigh Muscles. — The rectus femoris with the vastus externus and 
internus form the mass of muscle on the front of the thigh. The rectus 
arises from the ilium, the vastus from the femur ; they join to form a com- 
mon tendon which is attached to the upper end of the tibia. They extend 
the leg, flex the thigh, and raise the body from the sitting to the stand- 
ing posture. 

The Tailor's Muscle. — The sartorius, the longest muscle in the body, 
runs from the ilium downward and inward across the thisrh to the inner 



96 



ANATOMY AND PHYSIOLOGY. 



side of the shin bone below the knee. It flexes the thigh and crosses 
the legs. 

The biceps femoris arises from the ischium and is inserted into the 
head of the fibula (Fig. 40). The semimembranosus and the semitendi- 
nosus take origin from the ischium and are inserted into the inner part of 




Figure 40. 

Figure 40. — NERVES OF THIGH. 1, sympathetic ganglia; 2, third lumbar; 3, branches 
to iliacus; 4, fourth lumbar; 5, anterior crural; 6, lumbo-sacral; 7, branch to the psoas; 8, 
obturator; 9, external cutaneous; 10, nerve to pectineus; 11, branch anterior crural; 12, 
superficial division of obturator; 13, sartorius -muscles; 14, adductor longus; 15, branch to 
rectus; 16, deep division of obturator; 17, branches to vastus externus and crureus; 18, ad- 
ductor brevis; 19, branch to vastus internus; 20, adductor magnus; 21, vastus externus; 22, 
internal saphena; 23, rectus femoris; 24, patellar branch of saphena; 25, vastus internus; 
26, gracilis. 

the head of the tibia. They extend the hips, flex the knee, and raise the 
body from the stooping position. 



MUSCLES OF THE CALF. 



97 



Muscles of the Calf. — The calf of the leg is made of the soleus arising 
from the upper back part of the bones of the leg, and the gastrocnemius, 
arising from the lower end of the femur; they unite in a common tendon 
of great size, tendo-achillis, which is attached to the back of the heel bone. 
They extend the foot and raise the weight of the body in walking and 
running. Beneath them lie the popliteus and the flexors of the toes cor- 
responding to the flexors of the fingers in the forearm. The extensor 





Figure 41. 



Figure 42. 



Figure 41. — MUSCLES BACK OF THIGH. 1, fifth lumbar vertebra; 2. ilio-lumbar liga- 
ments; 3, crest of ilium; 4, anterior superior spinous process; 5, origin of fascia femoris; 6, 
gluteus medino; 7, its lower and anterior portion; 8, pyriformis; 9, gemini; 10, trochanter 
major; 11, insertion gluteus medius; 12, quadratus femoris; 13, adductor magnus; 14, inser- 
tion gluteus maximus; 15, vastus extensus; 16, long head biceps; IT, semimembranous; 
18, semitendinosus; 19, tuber ischii; 20, obturator internus; 21, point of coccyx; 22, posterior 
coccygeal ligament; 23, 24, great sacro-sciatic ligament; 25, posterior superior spinous pro- 
cess; 26, posterior sacro-iliac ligaments. 

Figure 42. — MUSCLES FRONT OF LEG. 1, tendon of quadriceps; 2, spine tibia; 3, 
tibialis anticus; 4, extensor communis digitorum; 5, extensor proprius pollicis; 6, peroneus 
tertius; 7, peroneus longus; 8, peroneus brevis; 9, soleus; 10, gastrocnemius; 11, extensor 
brevis digitorum. 

longus digitorum is attached to the leg bones and to the second and third 
phalanges (Fig. 42) of the four lesser toes by four tendons. The great 



93 



ANATOMY AXD PHYSIOLOGY. 



toe has two special flexors and a special extensor and the little toe a special 
flexor. 

On the back of the foot is one muscle only, the extensor brevis digi- 
toruni, which assists the long extensor of the toes. 

Sole of the Foot. — The sole of the foot, like the palm of the hand, is 
covered by a dense fibrous sheath, the plantar fascia, running from the 
heel bone to the metatarsal bones in front; it sustains the arch of the 
foot, and protects the vessels and nerves beneath. Immediately beneath 
it lies the flexor brevis digitorum, arising from the heel bone and being- 
inserted into the sides of the second bones of the lesser toes by four ten- 
dons which are perforated by the long flexor tendons; and just below 
this is the flexor accessorius, which is attached to and aids the tendon of 
the long flexor. There are numerous other small muscles in the foot 
which give it complicated movements. 

TEE DIGESTIVE APPABATUS. 

What it Consists of. — The digestive apparatus consists of the ali- 
mentary or food canal (Fig. 72) which extends from the mouth to the 
anus and is between twenty and thirty feet in length, and of the various 
glands which open into it. The alimentary canal is divided into the 
mouth, pharynx, oesophagus, stomach, small intestine and large intestine. 
Its function is to digest or convert the food into an assimilable form. 

The Mouth. — The mouth is an oval cavity containing the tongue and 
teeth. In it the food is ground up and mixed with saliva (Fig. 68), which 



Figure 68.— SALIVARY GLANDS 
duct; 5, sublingual. 




2, Steno's duct; 3, submaxillary; 4, its 



THE STOMACH. 



99 



not only moistens it so that it may be readily swallowed but acts on the 
starchy foods, changing them to sugar. The teeth are described in the 
chapter on teeth. The saliva is secreted by the parotid glad beloAv and in 
front of the ear, and by the submaxillary and sublingual glands, which lie 
in the floor of the mouth. 

The Tongue. — The tongue (Fig. 69) is a muscle covered by mucous 
membrane, containing many mucous glands and little projections called 
papillae in which are lodged the ends of 
the taste nerves. The tongue is the 
organ of taste, assists in articulation, 
and aids in mixing the saliva with food 
and keeping the food between the 
teeth. 

The Pharynx. — The pharynx is 
really the upper part of the oesophagus, 
expanded into a muscular bag. It 
hangs from the skull above, is four and 
a half inches long, and communicates 
with the nose, ear, mouth, oesophagus 
and larynx. 

The Gullet. — The oesophagus or 
gullet is nine inches long, of same con- 
struction as the pharynx, and empties 
into the stomach. After the food is 
chewed it is forced into the pharynx 
which contracts' and pushes it down 
into the oesophagus, which propels it 
onward to the stomach. During swal- 
lowing the opening into the larynx is 
closed by a little trap door called the 
epiglottis. 

The Stomach — The stomach (Pig. 70) is roughly pear-shaped; the 
big end, lying on the left side, measures twelve inches transversely and 
four inches vertically, is situated just below the diaphragm, receives the 
oesophagus in its upper left wall (cardiac opening), and empties into the 
small intestine at the extreme right (pylorus), the opening being guarded 
by a circular valve reinforced by muscular fibres. 

The Stomach Walls. — The stomach wall is made of four layers: ex- 
ternally the peritoneum prevents friction ; next is the muscular coat which 
churns the food, then the cellular coat which carries the blood-vessels, 




THE TONGUE. 



100 



ANATOMY AND PHYSIOLOGY. 



and internally is the mucous membrane (tripe of cow) containing thou- 
sands of little glands (Fig. 71), the peptic or gastric glands, which 
secrete the gastric juice. When food reaches the stomach, the cardiac ori- 
fice and pylorus close, the stomach contracts and mixes it 'with the gastric 
juice, which is now freely secreted. 

The Gastric Juice. — Gastric juice is made of water, salts, hydrochloric 
acid and pepsin. It changes albumen to peptone, which is readily ob- 





Figure 70. 



Figure 71. 



Figure 70.— STOMACH. 

Figure 71. — STOMACH TUBULE. 



a, neck; b, fundus; c, orifice; "m, muscular coat. 



sorbed, dissolves the cellulose of vegetable and the fibrous tissue of meats. 
Water and some of the peptones are absorbed by the stomach. The re- 
maining portion of the food, now a liquid, passes on into the intestines. 

Small Intestine. — The small intestine is about twenty feet in length, 
one inch in diameter, and extends from the stomach to the cecum, into 
which it empties. It is connected to the spine by a fold of peritoneum, the 
mensentery, and is contained in the lower and central portion of the 
abdomen. It is divided, beginning above, into the duodenum, jejunum 
and ileum. 

Duodenum — Into the duodenum empty the ducts of the liver and 
pancreas. The small intestine has four coats similar to those of the 
stomach. In the small intestine the albumens are changed to peptones, 
fat emulsified, and starches converted into sugars by the action of the bile 
from the liver, the pancreatic juice and the intestinal juices. The pep- 
tones, fat and sugar are absorbed by the intestinal walls and the remain- 
ing portion of the food passes into the large intestine, which also absorbs 
to a slight extent the nutritious portions of its contents, which are now 
sensusated and are called feces. 



THE LARGE INTESTINE. 



101 



Large Intestine.— The large intestine is five feet in length, runs from 
an enlarged pouch, the cecum, into which the small intestine empties, to 
the anus. It is about three times as large in calibre as the small intestine. 
The cecum is situated in the right lower corner of the abdomen, ending 




Figure 72. — ALIMENTARY CANAL. 1, 3, lips; 2, 4, frsenum; 5, cheek; 6, Steno's duct; 
7, roof of mouth; 8, half arches; 9, tonsils; 10, velum; 11, tongue; 12, papillae; 13, trachea; 
14, oesophagus; 15, its interior; 16, stomach; 17, its greater end; 18, its lesser end; 19, 
lesser curvature; 20, greater curvature; 21, cardiac orifice; 22, pylorus; 23, 24, 25, duodenum; 
26, valvulse conniventes; 27, gall bladder; 28, cystic duct; 29, 30, hepatic duct; 31, common 
bile duct; 32, its opening; 33, 35, jejunum; 34, opening of pancreatic duct; 36, 38, ileum; 
37, v. conniventes; 39, ileo-cecal valve; 40, 41, cecum; 42, appendix vermiformis; 43-48, colon; 
49, 50, rectum; 51, levator ani; 52, anus. 



below in the vermiform appendix, which varies from three to six inches 
in length and is about one-quarter inch in diameter. In the cecum the 
large intestine ascends to the liver (ascending colon), passes over to the 



102 



ANATOMY AND PHYSIOLOGY. 



spleen on the left side (transverse colon), descends on the left side (de- 
scending colon) to the pelvis, where it curls like an S (sigmoid flexure) 
and then ends in the rectum which reaches the surface of the hody as the 
anus. As the feces accumulate in the large intestine they are forced 
downward to the sigmoid flexure and rectum, where they remain until ex- 
pelled from the hody. 

The Sweetbread — The pancreas (sweetbread) is a long, narrow gland 
about seven inches in length lying behind the stomach. Its duct opens 
in common with the bile duct, into the duodenum. 

The Liver. — The liver (Fig. 74), the largest gland in the body, weighs 
about four pounds, and is situated in the 
upper right corner of the abdomen, 
where it is retained by the peritoneum 
which, after forming its outer coat, runs 
to the abdominal walls as ligaments. It 
is divided into five lobes, which are 
made up of lobules, each about one- 
twentieth of an inch in diameter, be- 
tween which the vessels and ducts 
ramify. The bile duct has appended to 





Figure 



Figure 75. 



Figure 74. — LIVER. R, right lobe; L, left lobe; Q, quadrate lobe; S, lobus Spigelli; 

C, lobus candatus; 1, umbilical vein; 2, gall bladder; 3, hepatic artery; 4, hepatic duct; 5, 
portal vein; 6, reflexion of peritoneum; 7, vena cava; 8, ductus venosus; 9, common bile duct. 

Figure 7 5. — PERITONEUM. D, diaphragm; L, liver; S, stomach; C, transverse colon; 

D, transverse duodenum; P, pancreas; I, small intestine; R, rectum; B, bladder. 

it a pear-shaped bag, the gall bladder, which, lying on the under surface 
of the liver, acts as a reservoir for the bile during the intervals of diges- 
tion. The bile duct unites with the pancreatic duct and empties into the 



THE EIVER AND PERITONEUM. 



103 



duodenum. The liver secretes bile, stores up sugar from the blood, helps 
make blood, destroys poison in the blood and excretes urea and allied 
products. 

Peritoneum. — The peritoneum (Fig. 75) covers all the abdominal 
organs; it is a serous sac containing a small quantity of fluid which pre- 




Figure 73. — LYMPHATICS, a, receptaculum chyli; c, thoracic duct; v, innomonate vein. 

vents friction between the organs it covers. The omentum is a double fold 
of peritoneum, which falls from the front of the stomach nearly to the 
bladder, then ascends to the transverse colon. 



104' 



ANATOMY AND PHYSIOLOGY. 



Absorption — Absorption means the passage of materials from mucous 
surfaces, serous cavities or tissues into the lymph or blood-vessels. 

The Lacteals. — The digested fat in the ' intestines is absorbed by 
lymph vessels, called lacteals, because their contents resemble milk. These 
lacteals converge from various parts of the intestine to form the thoracic 
duct which passes up and empties into a large vein in the neck. The di- 
lated lower end of the thoracic duct is called the receptaculum chyli. 
The lymph from the tissue all over the body is collected into the lymphatic 




Figure 56. 

Figure 56. — LYMPHATICS. 1, saphenous vein; 2, external iliac; 3, common iliac; 4, 
aorta; 5, ascending vena cava; 6, 7, lymphatics; 8, lower set of inguinal glands; 9, su- 
perior set of inguinal glands; 10, chain of lymphatics; 11, lymphatics with circumflex iliac 
vessels; 12, lumbar and aortic lymphatics; 13, origin thoracic duct; 14, thoracic duct. 

vessels (Fig. 56) which, finally by two big trunks, the thoracic duct and 
the right thoracic duct, into the veins of the neck. On its way to the blood 
the lymph passes through the lymph glands which frequently swell when 
any poison passes through them, the kernels felt in the neck during an 
attach of tonsilitis, for example. 



BLOOD— CIRCULATORY SYSTEM. 

'Composition of Blood. — The blood is made from the food we eat, and 
it in turn feeds all the tissues of the body and drains away all their waste 




THE HEART. 105 

products. It consists of liquor sanguinis (liquid of blood) and corpuscles 
(little bodies), the former containing water, proteids, salts, nutritive and 
excrementitious matter. The corpuscles (Fig. 54) are red, which are 
■g^-Q-g- of an inch in diameter, circular and biconcave, or white, which 
exist in the proportion of one to three of four hundred reds, are -g ^o ff 
inch in diameter and possess amoeboid 
motion. When blood is exposed to air it _ 

clots, a stringy material proteid in nature, 
fibrin, which exists in solution in the liquor 
sanguinis, entangles the corpuscles, form- 
ing a semisolid mass. 9 A 

Function of Corpuscles Blood corpus- Figure 54. -blood corpuscles. 

cles carry oxygen from the lungs to the 

tissues and the liquor sanguinis carries food; the blood drains carbon 
dioxide and other waste products from the tissues to the excretory organs : 
skin, kidney, liver and lungs. 

Circulatory Apparatus. — The blood is carried to and from the tissues 
by the circulatory apparatus, which consists of the heart, arteries, capil- 
laries and veins. The heart pumps the blood through the arteries to the 
thin-walled capillaries where the food passes out to the tissues and waste 
is given to the blood ; from the capillaries the blood drains into the veins 
which run to the heart. The heart then sends the blood to the lungs to 
be purified, to the intestines for food and again pumps it out to the tissues. 

The Heart — The heart is a hollow muscular organ of conical form, 
placed in the chest between the lungs and inclosed in a serous sac, the 
pericardium. It is placed obliquely; the base, to which is attached the 
great vessels, is directed upward and backward; the apex is directed 
downward and to the left, and corresponds to the interval between the 
fifth and sixth ribs, one inch to the inner side and two inches below the 
nipple. 

In a grown person (Fig. 51) the heart is about five inches in length, 
three and a half inches in breadth at its broadest part and two and a half 
inches thick. In the male it weighs from ten to twelve ounces and in the 
female about two ounces less. 

Heart Divisions. — The heart is divided longitudinally by a muscular 
partition into two halves and a transverse partition divides these halves 
into two cavities.. The lower cavities are called ventricles and the upper 
ones auricles. The walls of the auricles are thinner than those of the 
ventricles and the walls of the right side of the heart are thinner than 
those of the left. 
7 



106 ANATOMY AND PHYSIOLOGY. 

Right Auricle. — The right, auricle receives the blood from the two 
main veins of the body — the two vena cava. From the auricle the blood 
is forced into the right ventricle through the anriculo-ventricular orifice. 
This opening is guarded by the tricuspid valve, to prevent the reflux of 
blood into the auricle when the ventricle contracts. This valve is corn- 




Figure 51. 

Figure 51.— HEART AND LUNGS. 1, left auricle; 2, right auricle; 3, left ventricle; 4, 
right ventricle; 5, pulmonary artery; 6, arch of aorta; 7, superior vena cava; 8, innominate 
artery; 9, common carotid; 10, subclavian; 11, trachea; 12, larynx; 13, upper lobe right 
lung; 14, upper lobe left lung; 15, right pulmonary artery; 16, lower lobes of lungs. 

posed of three segments, to the free margin of which are attached ten- 
dinous cords, which, springing from the muscular ridges projecting from 
the inner surface of the ventricle, the columnse carnese, give support to 
the valves. 

Right Ventricle. — The walls of the right ventricle (Fig. 52) are 
about one-third as thick as those of the left ventricle. Beside the opening 
into the auricle there is the opening into the pulmonary artery which is 
guarded by the semilunar valves, three semicircular folds of the lining 
membrane of the heart. 

Course of the Blood — The blood is forced from the right ventricle 
through the pulmonary artery to the lungs, the semilunar valves closing 
after each contraction of the ventricle so preventing any backward flow. 



THE HEART. 



107 



Left Auricle. — The left auricle is smaller than the right, but thicker ; 
it receives the blood which returns from the lungs by the pulmonary 
veins and forces it into the left ventricle through an opening, guarded bj 




ure 52. 



Figure 52. — HEART. 1, superior vena cava; 2, inferior vena cava; 2', hepatic veins; 3, 
right auricle; 3', fossa ovalis; 3", aperture coronary vein; _|_, _|_, in auricula-ventricular 
groove; 4, 4, cavity right ventricle; 4', columnar carnse; 5', 5", tricuspid valve; 6, pulmonary 
artery; 7, concavity aortic arch; 8, ascending aorta; 9, between innominate and left carotid; 
10, auricular appendage; 11, 11, left ventricle. 



valves, similar to the right auriculo-ventricular orifice, except that the 
valve, called the mitral valve, has but two segments. 

Left Ventricle. — The left ventricle is the thickest and strongest por- 
tion of the heart. The blood received by it through the auriculo-ven- 
tricular orifice is discharged into the main artery of the body, the aorta, 
through an opening which is guarded by semilunar valves (Fig. 53) as 
in the case of the pulmonary artery. The cavities of the heart are lined 
by a delicate endothelium, which is continuous with that of the blood- 
vessels. 




10S MATOMY AND PHYSIOLOGY. 

Pulsation. — The heart pulsates from seventy-five to eighty times per 
minute in the adult; in childhood it is more rapid. The strength and 
rapidity are governed by the nerves which supply the heart with force. 

Heart Sound — Upon listening to the heart two sounds are heard. 
The first sound, dull and heavy, 
is caused by the contraction of 
the heart, the shutting of the 
auriculo-ventricular valves and 
the rush of blood. The second 
sound, sharp in character, is 
due to the snapping shut of the 
semilunar valves. Fisure ".-semilunar valves. 

ARTERIES. 

Function of Arteries. — The arteries carry the blood from the heart to 
all parts of the body. It has three coats, an outer areolar elastic coat, 
a middle muscular coat and an inner endothelial coat. 

The Aorta. — The main artery of the body is called the aorta (Fig. 
43). It springs from the left ventricle, runs up toward the neck, then 
turns and descends along the spine and divides in the lower abdomen into 
the two common iliac arteries. 

Coronary Arteries. — Just after leaving the heart it sends the two 
coronary arteries to the heart muscle. Then as it arches through the 
chest it gives on on the right side the innominate artery and on the left 
side the left common carotid and the left subclavian arteries. The in- 
nominate divides into the right common carotid and subclavian arteries. 

Cardiacs. — The carotids (Fig. 44) run up the neck to the top of the 
larynx where they divide into the external carotid which supplies the out- 
side of the head and the internal carotid which supplies the brain, ear 
and eye. 

Subclavian. — The subclavian (Fig. 45) supplies the chest, neck and 
upper extremity ; when it reaches the armpit it is called the axillary artery 
and in the arm it is called the brachial. This trunk, called subclavian axil- 
lary and brachial, according to its situation, gives off numerous branches 
to the various structures of the shoulder and arm. At the elbow it divides 
into the radial and ulnar branches. The brachial lies on the inner, pro- 
tected side of the arm just beneath the biceps muscle. It is important to 
know its location when making pressure to stop hemorrhage lower down 
the arm. 



THE ARTERIES. 



109 



Eadial Artery — The radial artery (Fig. 46) from the bend of the 
elbow down the radial side of the arm to the wrist, where it is frequently 



12 iO 




Figure 43. 



Figure 43. — ARTERIES OF HEAD. 1, common carotid; 2, internal carotid; 3, external 
carotid; 4, occipital; 5, superior thyroid; 6, trapezius; 7, lingual; 8, sterno-mastoid ; 9, facial; 
10, temporal; 11, submental; 12, transverse facial; 13, inferior labial; 15, inferior coronary; 
17, superior coronary; 19, lateral nasal; 21, angular. 



felt to determine the character of the pulse; it then winds around the 
base of the thumb, enters the palm between the thumb and metacarpal 
bone of the index finger and forms an arch (deep palmar arch), which 
sends branch to the thumb, index finger and palm. 

Ulnar Artery — The ulnar artery, larger than the radial, passes down 
the inner side of the forearm, giving off branches to the muscles. In the 
palm it also describes an arch (superficial palmar arch) which sends 
branches to the fingers. 

Thoracic Aorta. — The portion of the aorta in the thorax is called the 
thoracic aorta, that in the abdomen the abdominal aorta. The thoracic 



110 



ANATOMY AND PHYSIOLOGY. 



aorta supples the pericardium, lungs, oesophagus and intercostal structures 
with nourishment. 

Abdominal Aorta. — The abdominal aorta (Fig. 47) supplies the 
diaphragm, stomach, liver, spleen, intestines, kidneys, ovary or testicle 
and muscles of the abdominal wall by branches whose names correspond 
to the organ it supplies. 

Common Iliacs. — Opposite the fourth lumbar vertebrae the aorta 
divides into the two common iliacs, short trunks which again divide into 
the internal and external iliac arteries, giving of! no branches. 




Figure 44. 

Figure 44. — ARTERIES OF NECK. 1, occipital artery; 2, facial vein; 3, spinal acces- 
sory nerve; 4, facial artery; 5, internal jugular vein; 6, hypoglossal nerve; 7, communicans 
noni nerve; 8, lingual artery; 9, pneumogastric; .10, superior laryngeal nerve; 11, phrenio; 
12, superior thyroid artery; 13, sterno-mastoid; 14, common carotid; 15, clavicle; 16, sterno- 
hyoid; 17, subclavian; 18, omo-hyoid; 19, subclavian; 20, sympathetic ganglia; 21, apex lung. 

The internal iliac dips into the pelvic cavity and divides into two 
trunks; the anterior gives off branches to the bladder, rectum, anus, 
genital organs, buttocks and upper part of the thigh; the posterior trunk 
sends branches to the buttocks, sacrum and muscles in the pelvis. 



THE ARTERIES. 



Ill 



External Iliac. — The external iliac (Fig. 48) runs across the pelvis 
and escaping below Poupart's ligament is continued down the thigh as 





Figure 45. 



Figure 46. 



Figure 45. — ARTERIES OF ARM. 1, axillary artery; 2, thoracica acromialis; 3, si»- 
perior thoracic; 4, subscapular; 5, inferior scapular; 6, 7, branches to the teres and sub- 
scapulars; 8, anterior circumflex; 9, brachial; 10, profunda; 11, posterior circumflex; 12, 
profunda; 13, muscular branches; 14, branches to brachialis internus; 15, recurrent ulnar. 

Figure 46. — DEEP DISSECTION FRONT OF FOREARM. 1, supinator longus; 2, ulnar 
nerve; 3, brachialis anticus; 4, biceps; 5, musculo-spiral; 6, median nerve; 7, posterior inter- 
osseous nerve; 8, pronator teres and flexor carpi radialis; 9, extensor carpi radialis longior; 
10, brachial artery; 11, supinator brevis; 12, flexor sublimus digitorum; 13, 13, radial nerve; 
14, flexor carpi ulnaris; 15, extensor carpi radialis brevior; 16, ulnar artery; 17, radial origin 
of flexor sublimus digitorum; 18, flexor profundus digitorum; 19, pronator teres; 20, dorsal 
branch ulnar nerve; 21, radial artery; 22, deep branch ulnar nerve; 23, flexor longus pollicis; 
24, abductor minimi digiti; 25, anterior interosseous nerve; 26, digital branches of ulnar 
nerve; 27, supinator longus; 28, one of lumbrioales; 29, pronator quadratus; 31, flexor carpi 
radialis; 33, digital branches median nerve; 35, abductor pollicis. 



112 



ANATOMY AND PHYSIOLOGY. 



the femoral artery. It gives off two large branches to the muscles of 
the belly. 

Femoral Artery. — The femoral artery runs a straight course down the 
thigh from the middle of the groin to the lower third of the femur, where 





Figure 47. 



Figure 48. 



Figure 47. — ARTERIES OF THIGH. 1, aorta; 2, common iliac; 3, external iliac; 4, 
epigastric; 5, circumflex iliac; 6, internal iliac; 7, ilio-lumbar; 8, gluteal; 9, obturator; 10, 
lateral sacral; 11, vesical arteries; 12, middle hemorrhoidal; 13, internal pudic; 14, ischiatic; 
15, femoral; 16, foramen for femoral; 17, profunda; 18, internal circumflex. 

Figure 48. — ARTERIES OF LEG. 1, extensor proprius pollicis; 2, articular arteries; 3, 
anterior tibia; 4, 5, same artery; 6, recurrent branch; 7, 8, muscular branches; 9, dorsalis 
pedis; 10, external malleolar artery. 



it passes through an opening in the muscles and becomes the popliteal. 
After giving off several small vessels to the muscles of the thigh it sends 
out a large trunk, the profunda, which gives off two, the circumflex and 
three perforating branches, which supply the muscles. 



THE VEINS. 113 

Popliteal Artery. — The popliteal is the continuation of the femoral 
running in the hollow behind the knee joint, dividing just below the knee 
joint into the anterior and posterior tibial arteries. 

Anterior Tibial. — The anterior tibial passes forward between the 
bones of the leg at its upper part, passes down the front of the leg, and 
on the front of the foot, becomes the dorsalis pedis. 

Dorsalis Pedis. — The dorsalis pedis runs along the back of the foot 
and terminates in the artery of the great toe ; it gives off branches to the 
tarsus and metatarsus, the latter forming an arch and giving branches to 
the toes. 

Posterior Tibial. — The posterior tibial descends along the inside of 
the back of the leg to the hollow behind the inner ankle, where it divides 
into the two plantar arteries. It gives branches to the muscles of the leg, 
tibia and ankle. 

Plantars The internal and external plantar arteries crossing the 

foot form an arch, from which branches are given to the toes, in a manner 
analagous to those in the hand. 

Pulmonary Artery. — From the right ventricle of the heart arises the 
pulmonary artery, which conveys the impure blood to the lungs to be 
purified. 

THE VEINS. 

Vein Function. — After the blood flows through the capillaries it is 
collected by the veins, which are made by small branches joining to form 
larger branches and these again joining larger trunks, and so on. 

Vein Structure. — The veins have three coats, like the arteries, but 
are thinner, less elastic, and when empty collapse. They have valves 
at intervals to prevent the backward flow of blood. 

Jugular Vein. — The small veins of the exterior of the head follow the 
arteries and have similar names. They empty into the external jugular 
which runs down the neck and empties into the subclavian vein. 

Internal Jugular. — The internal jugular receives the veins from the 
interior of the cranium, passes down the neck with the carotid artery and 
unites with the subclavian vein to form the innominate vein. 

Innominate Veins. — The two innominate veins are in the chest and 
join to become the superior vena cava. 

Veins of Upper Extremity. — The veins of the upper extremity (Fig. 
49) besides those accompanying are a radial, an anterior and posterior 
ulnar and a median vein. They collect the blood from the hand and fore- 
arm, and just above the bend of the elbow the ulnar veins unite to form 
joint into the anterior and posterior tibial arteries. 
8 



11£ 



ANATOMY AND PHYSIOLOGY. 



the basilic vein, which passes up the inner side of the arm and empties 
into the axillary vein. 

Radial Vein. — The radial vein forms the cephalic, which passes up the 





Figure 49. 



Figure 50. 



Figure 49. — VEINS OF UPPER EXTREMITY. 1, axillary artery; 2, axillary veins; 
3, 4, basilic; 6, point where median basilic joins basilic; 6, posterior basilic vein; 8, anterior 
basilic vein; 9, point where cephalic enters axillary; 10. portion same vein; 11, point where 
median cephalic enters cephalic; 12, lower portion cephalic vein; 13, median cephalic vein; 
14, median vein; 15, anastomosing branch; 16, cephalica-pollicis veins; 17, veins of fingers; 
18, palmar veins. 

Figure 50. — VEINS OF LEG. 1, saphenous; 2, collateral branch; 3, anastomosis; 4, 
Internal saphenous; 5, origin of saphenous; 6, anastomosing branch; 7, branches on back 
leg; 8, internal vein of foot; 9, arch veins on metatarsal bones; 10, branch from heel; 11, 
branches on sole of foot. 

outside of the arm and winding around the shoulder- joint empties into 
the axillary vein. 

Median Vein. — Below the bend of the elbow the median and a branch 
from the deep veins empty into a large V-shaped vein; running from its 



BREATHING ORGANS. 115 

apex into which these veins empty it unites together the basilic and 
cephalic veins, one arm being called the median basilic and the other the 
median cephalic. 

Axillary Vein. — The axillary vein, in the armpit, runs up to form 
the subclavian which joins the internal jugular to form the innominate. 

The internal saphenous vein (Fig. 50) commences on the back of 
the foot, and running straight up the inner side of the leg and thigh joins 
the femoral vein just below Poupart's ligament. 

Saphenous Vein. — The external or short saphenous vein begins at the 
outer side of the foot, runs up the middle of the calf of the leg and empties 
into the popliteal vein. 

The deep veins follow the arteries and have similar names. 

Femoral Vein — The femoral vein receives all the veinous blood from 
the leg, runs with the femoral artery into the abdomen, becomes the 
external iliac which joins with the internal iliac to form the common iliac. 
The two common iliacs join to form the inferior vena cava which runs 
up the spine and empties into the right auricle, receiving in its course the 
various abdominal veins. 

Portal Vein. — The veins from the stomach, spleen and intestines are 
collected into a short trunk, the portal vein, which enters the liver. The 
blood from the liver is collected by the hepatic vein, which empties into 
the inferior vena cava. 

Pulmonary Veins. — The four pulmonary veins start as capillaries in 
the walls of the air cells of the lungs, carry pure blood and empty into the 
right auricle. 

RESPIRATORY APPARATUS. 

In order to reach the lungs air passes through the nose, pharynx, 
larynx and trachea, which warm it and filter it of impurities. 

The Larynx. — The larynx (Adam's apple) is the organ (Fig. 55) of 
voice, and will be described in connection with disease of the throat. 

Windpipe. — The trachea (windpipe) is made of rings of cartilage, 
joined by connective tissue. It is five inches long and lies' just beneath 
the skin of the neck until it enters the chest, where it divides into the two 
bronchial tubes, one going to each lung. These divide and subdivide 
into numerous branches. 

The Lungs. — The lungs are conical, slate colored in adult life and are 
separated in the middle of the thorax by the heart, gullet and great 
blood-vessels. The outer surface of the lungs is convex and smooth, the 
inner surface concave. Above it extends into the neck, below it rests 



116 



ANATOMY AND PHYSIOLOGY. 



upon the diaphragm. The right lung is the larger and is divided into 
three lobes, the left into two. 

Lung Lobes. — Each lobe is made of little lobules which consist of a 
little ramification of a bronchial tube communicating with air cells. 

Lung Membrane. — The surface of the lung is covered by a smooth 
serous membrane, the pleura, which is reflected upon the walls of the 




Figure 55. — TRANSVERSE SECTION THORAX. 1, anterior mediastinum; 2, internal 
mammary vessels; 3, triangularis sterni; 4, 5, phrenic nerves; 6, thoracic duct; 7, oesophagus; 
8, vena azygos major; 9, thoracic aorta; 10, sympathetic; R. V., right ventricle; R. A., 
right auricle; P. A., pulmonary artery; A., aorta; C, superior vena cava; V., dorsal vertebra. 

chest ; the intervening space contains a small quantity of fluid which pre- 
vents friction during the respiratory movements. 

Breathing — When the chest is enlarged by elevation of the ribs and 
descent of the diaphragm the lungs follow the chest wall and expand, air 
rushing into them. When the muscles relax the elastic and over-distended 
lungs discharge the air through the windpipe. 

Air Vesicles. — In the air vesicles the blood is separated from the air 
by a very thin partition through which oxygen passes to the blood cor- 
puscles. The expired air contains the carbon dioxide and other impur- 
ities with which it has been charged while in the air vesicles. 

Oxygenized Blood — The blood, after passing through the lungs, is 
a brighter red, richer in oxygen, cooler and is rid of its impurities. 



NERVOUS SYSTEM. 

Function of Nerves — The nervous system presides over all functions 
and harmonizes them. It permits the environs to be recognizable. It 



NERVOUS SYSTEM. 



117 



may be compared to a telegraph system, of which the brain is the central 
station, to a rider on a horse, or to the captain of a steamship. It is 
divided into the cerebro-spinal system (brain and spinal cord with their 
nerves) which presides over the animal functions, motion, sensation, etc., 
and the sympathetic system which controls the organic functions, nutri- 
tion, growth, etc. The sympathetic system is composed of a series of 
ganglia (large mass nerve cells) in the head and along the front of the 
spine, connected by nervous cords. 

The Brain. — The brain is a huge mass of white and gray nervous 
matter contained in and protected by the cranium. It is surrounded hj 




Figure 61. 



Figure 61. — BASE OF BRAIN. 1, 2, longitudinal fissure; 3, anterior lobes cerebrum; 
4, middle lobe; 5, fissure Sylvius; 6, posterior lobe; 7, infundibulum; 8, its body; 9, corporo 
albicantia; 10, cineritious matter; 11, crura cerebri; 12, pons Varolii; 13, medulla oblongata; 
14, posterior prolongation of pons; 15, middle of cerebellum; 16, anterior part of cerebellum; 
17, its posterior part and fissure; 18, medulla spinalis; 19, middle fissure medulla; 20, pyra- 
midal body; 21. retiform body; 22, olivary body; 23, olfactory nerve; 24, its bulb; 25, its 
external root; 26, middle root; 27, internal root; 28, 29, optic nerve; 30, third nerve; 31, 
fourth nerve; 32, fifth nerve; 33, sixth nerve; 34, facial nerve; 35, auditory nerve; 36, 37, 
38, eighth nerve. 



three membranes (meninges) : the dura mater, externally, dipping into 
the fissures to form the falx cerebri, tentorium cerebelli and falx cere- 
belli which separate and support portions of the brain; the arachnoid, 



118 



ANATOMY AND PHYSIOLOGY. 



the serous membrane, supplying a fluid which acts as a water cushion for 
the brain; and the pia mater, the layer carrying the blood-vessels. 

Weight of Brain. — The average weight of the brain is fifty ounces 
in males, and six ounces less in females. 

Divisions of Brain. — The brain is divided into the cerebrum, cere- 
bellum, pons varolii and medulla oblongata. 

The Cerebrum. — The cerebrum is the largest part of the brain, resting 
the roof of the orbit, base of skull, and tentorium cerebelli. It is 



on 




Figure 62. 

Figure 62. — NERVES OF FACE AND SCALP. 1, attrahena aurem; 2, anterior belly 

occipito-frontalis; 3, auriculo-temporal nerve; 4, temporal branches of facial nerve; 5, attolens 
aurem; 6, supra-trochlear; 7, posterior belly occipito-frontalis; 8, supra-orbital; 9, retrahena 
aurem; 10, temporal branch of orbital nerve; 11, small occipital nerve; 12, malar branchea 
of facial nerve; 13, posterior auricular nerve; 14, malar branch of orbital; 15, great occipital; 
16, infra-orbital branches; 17, facial nerve; 18, nasal nerve; 19, cervico-facial division of 
facial; 20, infra-orbital nerve; 21, branches to digastric and stylo-hyoid; 22, temporo-facial 
division of facial; 23, great auricular; 24, buccal branches of facial; 25, trapezius; 26, buc- 
cinator nerve; 27, splenius capitis; 28, masseter; 29, sterno-mastoid; 30, supra-maxillary 
branches of facial nerve; 31, superficial cervical nerve; 32, mental nerve; 33, platysma; 34, 
infra-maxillary branches of facial nerve. 

divided into lateral halves by the falx cerebri. The halves are joined by 
the corpus callosum. Internally it is composed of white, and externally 
of gray, nervous tissue. The gray tissue is wrinkled into convolution and 
is the active portion of the brain, the white matter conducting the nerve 
impulses to and from it. It is the seat of memory, intelligence, reason, 
will, motion and sensation. 



NERVOUS SYSTEM. 119 

The Cerebellum. — The cerebellum lies beneath the posterior portion 
of the cerebrum, is gray outside and white inside. It coordinates mus- 
cular movements. 

The pons varolii connects the various parts of the brain. It conducts 
impulses to and from the brain. 

Medulla Oblongata — The medulla oblongata is the enlarged upper 
end of the spinal cord resting in the cranium. It is made of blended 
white and gray tissue, conducts the nerves from the brain to the spinal 
cord and contains independent nervous centres which regulate the heart, 
lungs, blood-vessels, sweating, etc. 

Nerves of Brain — The brain gives off twelve nerves on each side. 
The nerves pass out through holes (foramen) in the skull and supply the 
organs of sight, smell, taste and hearing, and also motion and sensation to 
certain parts. They are: the olfactory (smell), optic (sight), motor oculi 
(motion to eye), patheticus (motion to superior oblique muscle of eye), 




Figure 63. 

Figure 63. — FIFTH NERVE. 1, orbit; 2, antrum of Highmore; 3, tongue; 4, lower jaw; 
5, Gasserian ganglion; 6, first branch of fifth; 7, second; 8, third; 9, frontal branch; 10, lac- 
rymal branch; 11, nasal branch; 12, internal nasal nerve; 13, external nasal; 14, external 
and internal frontal nerve; 15, infra-orbital; 16, posterior dental branches; 17, middle dental; 
18, anterior dental; 19, terminating branches infra-orbital nerve; 20, orbital branch; 21, 
ptyregoid nerve; 22, five anterior branches; 23, lingual branch; 24, inferior dental; 25, mental 
branches; 26, superficial temporal nerve; 27, auricular branches; 2S, mylo-hyoid. 

trifacial (sensation to face, motion to chewing muscles and nerve of taste), 
abduces (rolls eye out), facial (motion to face), auditory (hearing), 
glossopharyngeal (taste and sensation), pneumogastric (presides over 



120 



ANATOMY AND PHYSIOLOGY. 



swallowing, heart, lungs, etc.), spinal accessory (motion to muscles, neck 
and back) and the hypoglossal (motion to tongue). 

Spinal Cord. — The spinal cord is a long tail hanging from the back 




Figure 64. 

Figure 64.— NINTH, TENTH AND ELEVENTH NERVES. 1, Gasserian ganglion; 2, 
internal carotid; 3, pharyngeal branch of pneumogastric; 4, glosso-pharyngeal; 5, lingual; 
6, spinal accessory; 7, middle constrictor of pharynx; 8, internal jugular vein; 9, superior 
laryngeal nerve; 10, ganglion of pneumogastric; 11, hypoglossal; 12, ditto communicating 
with eighth and first cervical; 13, external laryngeal; 14, second cervical; 15, pharyngeal 
plexus; 16, superior cervical ganglion; 17, superior cardiac nerve; 18, third cervical; 19, 
thyroid body; 20, fourth cervical; 21, recurrent laryngeal; 22, spinal accessory; 23, trachea; 
24, middle cervical ganglion; 25, middle cardiac nerve; 26, phrenic; 27, left carotid; 28, 
brachial plexus; 29, phrenic; 30, inferior cervical ganglion; 31, pulmonary plexus; 32, aorta; 
33, oesophageal plexus; 34, vena azygos superior; 35, vena azygos minor; 36, gangliated CQrd 
q/ sympathetic. 



THE SPINAL COED. 



121 



of the brain and contained in the spinal canal. It is sixteen to eighteen 
inches long and surrounded by three membranes like the brain. 

Upper Section. — Upon section the cord 
(Fig. 59) is seen to be composed externally 
of white nervous tissue, and internally of the 
gray, which is arranged somewhat in the 
shape of the letter H. The cord is divided 
by two antero-posterior fissures into two 
equal lateral halves, which are united in the 
centre by a bridge of gray matter. 

The spinal cord is a great nerve cable 
carrying fibres to and from the brain ; it also 
coordinates motion, presides over the nutri- 
tion of certain parts and contains inde- 
pendent nervous centre. 

From the anterior horn of the gray 
matter arises the motor roots of the spinal 
nerves and from the posterior horn the 
sensory roots. 

Spinal Nerves. — Each spinal nerve, of 
which there are thirty-one pairs, consists of 
the anterior or motor and the posterior or 
sensory root. These unite within the spinal 
canal and form a single cord (Fig. 65), 
which passes through the opening between 
the vertebrae and divides into two trunks, 
one for the anterior and the other for the 
posterior surface of the body. 

Cervical Plexus. — The anterior branches 
of the four upper cervical nerves unite with 
each other to form the cervical plexus which 
gives off branches to the side of the head, 
neck, shoulder, chest and diaphragm. The 
anterior branches of the fifth, sixth and 
seventh cervical nerves unite, the fifth re- 
ceiving a branch from the fourth ; the eighth 
cervical and first dorsal nerves unite; these 

cords form the brachial plexus, and after sending nerve trunks to the 
muscles of the neck and sides of the chest below the collar bone, these two 
trunks each send off a trunk which unite to form a third or posterior trunk 



Figure 59.— BRAIN and 
CORD. 1, 1, hemispheres of 
cerebrum; 2, great middle fis- 
sure; 3, cerebellum; 4, olfactory- 
nerves; 5, optic nerves; 6, cor- 
pora albicanlia; 7, motor oculi; 
8, pons Varolii; 9, fourth nerve; 
10, medula oblongata; 11, 11, 
medula spinalis; 12, 12, spinal 
nerves; 13, cauda equina. 



122 



ANATOMY AXD PHYSIOLOGY. 



which divides into two branches, supplying the muscles and skin of the 
outside and back of the arm, forearm and hand. 

Inner and Outer Trunks. — The inner and outer trunks are continued 
down the inside of the arm, and again each sends a branch to form a 




Figure 60. 

Figure 60. — VIEWS OF SECTION OF CERVICAL CORD. A, anterior surface; B, right 
side; C, upper surface; D, nerve roots; 1, anterior median fissure; 2, posterior median fissure; 3, 
anterior lateral depression; 4, posterior lateral groove; 5, anterior roots; 6, posterior roots; 
6', ganglion; 7, spinal nerve; 7', posterior branch. 



middle cord, the median nerve. The external cord then becomes the 
musculo-cutaneous, and the internal, the ulnar. 

Median Nerve. — The median nerve (Fig. 66) gives off branches to the 
muscles and to the skin of the hand. The ulnar nerve is placed on the 
inner side of the arm and supplies the forearm and hand. The musculo- 
cutaneous supplies the skin and muscles of the forearm and wrist. 

Spinal Nerves — The twelve dorsal spinal nerves send branches along 
the ribs and supply the muscles of the back. 

Lumbar Nerves — The five lumbar nerves send posterior branches to 
the muscles of the back; the anterior branches unite to form a plexus 
which sends branches to the muscles of the belly and the genital organs; 
the largest branch, the crural nerve, is distributed to the front of the 
thigh. 

Sacral Nerves — The fifth lumbar joins the sacral nerves to form the 



SNEBVES OF SPINE AND BACK. 



123 



sacral plexus ; its largest branch is the great sciatic which passes down the 
back of the thigh, dividing at the knee into the external and internal 





Figure 65. 



Figure 66. 



Figure 65. — DEEP DISSECTION OF FRONT OF FOREARM. 1, supinator longus; 1, 
ulnar nerve; 3, brachialis anticus; 4, biceps; 5, musculo spiral; 6, median; 7, posterior in- 
terosseous; 8, pronator teres; 9, extensor carpi radialis longior; 10, brachial artery; 11, su- 
pinator brevis; 12, flexor sublimus digitorum; 13, radial nerve; 14, flexor carpi ulnaris; 15, ex- 
tensor carpi radialis brevior; 16, ulnar artery; 17, origin flexor sublimus digitorum; 18, flexor 
profundus digitorum; 19, tendon pronator teres; 20, dorsal branch of ulnar nerve; 21, radial 
artery; 22, deep branch of ulnar nerve; 23, flexor longus pollicis; 24, adductor minimi digiti; 
25, anterior interosseous nerve; 26, digital branches of ulnar nerve; 27, tendon of supinator 
longus; 28, one of the lumbricales muscles; 29, pronator quadratus; 31, tendon flexor carp 
Iradialis; 33, digital branches median nerve; 35, abductor pollicis. 

Figure 66. — NERVES OF THIGH. 1, sympathetic ganglia; 2, third lumbar; 3, branches to 
iliacus; 4, fourth lumbar; 5, anterior crural; 6, lumbo-sacral ; 7, branch of the psoas; 8, 
obturator; 9, external cutaneous; 10, nerve to pectineus; 11, branch anterior crural; 12, su- 
perficial division of obturator; 13, sartorius muscle; 14, adductor longus; 15, branch to rectus; 
16, deep division of obturator; 17, branches to vastus externus and crureus; 18, adductor 
brevis; 19, branch to vastus internus; 20, adductor magnus; 21, vastus externus; 22, internal 
saphena; 23, rectus femorio; 24, patellar branch of saphena; 25, vastus internus; 26, gracilis 



124! 



ANATOMY AND PHYSIOLOGY. 



popliteal nerves; these are continued down the leg as the anterior and 
posterior tibial nerves supplying the leg and foot. 





Figure 67. 



Figure 67a. 



Figure 67. — BUTTOCK AND BACK OF THIGH. 1, gluteus maximus; 2, gluteus medius; 
3, glutial artery; 4, gluteus minimus; 5, nerve of obturator Internus; 6, pyriformis; 7, pudic 
nerve; 8, small sciatic nerve; 9, great sacro-sciatic ligament; 10, obturator internus; 11, 
inferior gluteal nerve; 12, tendon obturator internus; 13, inferior pudendal nerve; 14, quadratus 
femoris; 15, gracilis; 16, great sciatic nerve; 17, adductor magnus; 18, insertion gluteus max- 
imus; 19, origin of semitendinosus and semimembranosus; 20, short head of biceps; 21, semi- 
membranosus; 22, tendon of biceps; 23, tendon of semitendinosus; 24, external popliteal nerve; 
25, internal popliteal nerve; 26, communicans fibrelaris; 27, popliteal artery; 29, gastrocnemius; 
31, external saphenous nerve. 

Figure 67a. — FRONT OF LEG. 1, external popliteal nerve; 2, anterior tibial artery; 3, 
musculo-cutaneous nerve; 4, anterior tibial nerve; 5, peroneus longus; 6, tibialus anticus; 7, 
extensor longus digitorum; 8, anterior annular ligament; 9, peroneus brevis; 10, tendon of ex- 
tensor proprius pollicis; 11, extensor proprius pollicis; 12, dorsal artery of foot; 13, musculo- 
cutaneous nerve; 14, tendon of tibialus anticus; 15, internal branch of musculo-cutaneous nerve; 
16, cutaneous branch of anterior tibial nerve; 17, external branch of musculo-cutaneous nerve; 
19, deep branch of anterior tibial nerve; 21, external saphenous nerve; 23, extensor brevis 
digitorum. 



INDEX TO PART I OF BOOK HI 

Preventive Medicine 

The Prevention of Disease by Elimination of 
Disease Carriers 

Part I of Book III tells of how disease is carried 
by insects and other seemingly harmless means. 

Consult the Part, Index and the Reference In- 
dex, also General Index. 

SUBJECTS OF THE TEXT 

Advice of Parents to Children in Sex- 
ual Matters 143 

Bed Bugs 138 

Bed Bugs, How to Destroy 138 

Body Lice , 139 

Breeding Places of Flies 132 

Breeding Places of Flies, How to De- 



stroy 132 

Breeding Places of Mosquitoes, How 

to Destroy 134 

Carriers of Disease 130 

Children, Advice Necessary in Sexual 

Matters 143 

Cockroaches 137 

Cockroaches, How to Destroy 138 

Common Carriers of Disease. . . / 130 

Crab Lice 140 

Destruction of Breeding Places of 

Flies 132 

Destruction of Breeding Places of 

Mosquitoes 134 

Destruction of Cockroaches 138 

Destruction of Existing Flies 133 

Destruction of Existing Mosquitoes. .135 

Destruction of Fleas 137 

Disease, Elimination of Carriers of.. 127 
Disease Prevented by Healthy Con- 
dition 128 

Drinking Cup 141 

Elimination of Breeding Places of 
Flies ..-..,,.,, 132 



Elimination of Disease Carriers 127 

Fleas 136 

Fleas, How to Get Rid of 137 

Flies, Breeding Places of 132 

Flies, Elimination of Breeding Places, 132 

Flies, Manner of Getting Rid of 133 

Fly, The 132 

Germ Laden Milk 131 

Gonorrhoea 143 

Head Lice 139 

Health as Preventive of Disease. ... 128 

Health, How to Retain 128 

Insects as Carriers of Disease 131 

Itch Mite, The 140 

Lice 139 

Lice, Body 139 

Lice, Crab 140 

Lice, Head 139 

Malaria Carried by Mosquito..' 133 

Milk, Germ-Laden 130 

Mosquitoes as Carriers of Malaria, 133 

Mosquitoes, How to Destroy 135 

Mosquitoes, How to Destroy Breeding 

Places of 134 

Mosquitoes, How They Develop 134 

Opthalmia 143 

Public Drinking Cup 141 

Public Towel 142 

Sexual Advice to be Given Children, 143 

Syphilis 143 

Towel, The Public 142 



125 



Book III. 



PREVENTIVE MEDICINE. 

PAKT I. 

THE PREVENTION OF DISEASE BY ELIMINATION 
OF DISEASE CARRIERS. 

When speaking of preventive medicine, we include the methods 
used by physicians, State and Federal Government Boards of Health, 
etc., to prevent the spread of disease, but most important is the work 
done by past and present men of science and their willing patients who 
have given their time, labor, and in many cases, their lives to discover 
the underlying causes of disease, for the latter, like everything else in 
this world, has its reasons for existence. Thus it can readily be under- 
stood that disease cannot be properly prevented when the underlying 
cause is unkown. 

Before dissection of the human body and experiments on animals 
were permitted, man's knowledge of his own body and disease, its causes 
and symptoms and treatment was mere guesswork. Thus in past centuries 
the arteries were thought to contain air instead of blood; disease was 
believed to be a curse from heaven or the king and everything lay in 
the hands of the Gods as to whether a person recovered or not. 

In the last century, man began to awaken from his sleep and by 
means of the discovery of the microscope and the permission to experiment 
upon living animals more and more the cause of disease, its transference 
from one animal to another and then from animal to man and man to 
man was tried, and always the same symptoms occurred in the animal 
or man into which the blood of the animal suffering from the original 
disease had been placed by injection into their blood, etc. By these 
methods gradually the cause of disease was found to be due to the presence 
of minute living bodies called bacilli or germs, etc., which were only 
visible when the blood, spit, urine, etc., of the sufferer was examined 

(127) 



128 PBEVENTION OF DISEASE. 

under the microscope and from this beginning are due the marvelous 
results of the present day in the prevention, treatment and cure of disease. 

Health. — Disease can be prevented by the individual doing everything 
in his power to keep in the best physical condition. Disease is a common 
enemy of all of us, waiting to destroy, but Nature is in league with us 
if we obey her laws. "With a normal body and pure blood should the 
invader arrive, the fight is on our side. But once the body is weakened 
by heredity as a result of our parent's or forefather's neglect of the 
body, through the abuse of alcohol, tobacco or immoral living, lack of 
exercise, overeating and loss of sleep, overwork or lack of work or 
improper food, then will the soil be fertile for the planting of the germs 
of disease. When exposed and once planted the fight will be in their 
favor, as the rundown body will not have sufficient vitality to overcome 
the invader and sickness and death result. 

How Can We Keep Healthy? — The best answer to that question is, 
to be the child of healthy parents and come from a sturdy stock. To be 
nursed at the mother's breast and raised out of doors in the sunshine 
and fresh air, to sleep with plenty of air in the room at night. - To have 
a natural movement of the bowels once a day. And through childhood 
to receive three meals a day consisting of pure wholesome food, plenty 
of milk, free from germs, pure water and sleep from ten to twelve hours 
a night throughout childhood, depending on the age. To play and do 
work which will be in the air and develop the muscles gradually. Every 
child should be vaccinated any time after the sixth month and repeat 
at the seventh year, to be done at once, in addition during an epidemic 
of small pox. It is not necessary or right for a child to have scarlet 
fever, measles, diphtheria, etc., as so many people think. They are often 
followed by deafness, heart disease, nervous diseases and paralysis which 
Nature never meant to inflict a child with to go through life. 

Children's teeth, eyes and throat should be examined at intervals and 
many defects corrected. The tonsils and adenoids (growths which stop 
up the nose and prevent air being breathed properly) should be removed. 
Enlarged tonsils often cause deafness by preventing air from the throat 
reaching the ear cavity due to stopping the opening of the Eustachian 
tube which leads from the throat to the ear. 

Children should not be taught too many branches at school. Every 
school should be well lighted with plenty of fresh air. Many of the 
smaller schools are now being built on open roofs of buildings in large 
cities or on platforms placed out of doors with just a roof overhead to 



HOW MAY ADULTS REMAIN HEALTHY? 129 

protect the children. All schools should he held in the open where 
possible. There is absolutely no chance of cold if the children are warmly 
dressed and experiments have proven that the children are healthier, more 
attentive and mentally efficient where they have been in school in the 
open air. 

How May Adults Remain Healthy? — In this clay and generation the 
struggle for existence is becoming more and more complex, the occupations 
are more enacting and confining, exposure to accidents more frequent, 
due to modern machinery and its difficult handling. Competition in all 
lines is great and therefore more strain is put upon the brain and nerves 
of man in all walks of life. This leads in time to state of "Overwork," 
nervous prostration or worry, if the individual has not the physical 
strength to stand the battle or fails to keep himself in a normal state 
of body and mind by careful living. 

When in the latter condition, man is a suitable soil for development 
of disease which makes short work of the rundown system, and such a 
person when exposed to disease or accident is very apt to succumb unless 
some reserve vitality comes to the aid of him or her and the physician 
or surgeon in attendance in the uneven battle for life. 

Man can keep his health and thus prevent disease by insisting on 
getting the best and purest of foods, working in factories or shops, dairies, 
barns, etc., which are well lighted and ventilated, free from dust, smoke, 
irritating vapors from paints, gases, acids, etc. By insisting upon regular 
working hours, eight hours sleep, dry and warm clothing if exposed during 
outdoor work, but not too warmly dressed for indoor work. Tea or 
coffee in moderation is not harmful. Light beers, Porter, Stout, Ale; 
wines, as Sherry, Port, Claret, without strong preservatives or alcohol, 
except in small proportions, are not harmful and refresh and cheer the 
tired nerves. Whiskey, brandy, cognac, gin, except as medicine, are 
absolutely harmful and the whiskey which the Government allows to be 
sold in this country is a disgrace and a poison. More and more corpora- 
tions and business men are insisting on their employees abstaning from 
its use. It causes a sense of stimulation or well being, which is temporary 
and is soon followed by a sense of depression which can only be relieved 
by a renewal of the dose and thus stupid man continues to be temporarily 
stimulated, while the total effect of his imbibing is to lower his vitality, 
destroy his mind, cloud his judgment and render him vicious; ruin his 
appetite by its action upon his stomach, harden his liver and destroy 
his kidneys. 
9 



130 PKEVENTIO^ OF DISEASE. 



COMMON CARRIERS OF DISEASE. 



Why is it that Disease Spreads ? — It has been found by scientists that 
certain definite living bodies (germs) are the cause of certain diseases, 
as tuberculosis, smallpox, typhoid fever, diphtheria, etc. ; and other diseases 
must be caused by other undiscovered bodies, which will some day be 
known. These minute living bodies are active and give off poisonous 
material which destroys the tissues, organs, etc., of the body. When a 
person is ill, these germs are being continually thrown off in the waste 
materials of the body, in the spittle, bowel movements, sweat, saliva, 
urine, etc. If these products of disease are allowed to remain in a vessel, 
the carpets, floor, soil, etc., they dry and in the form of dust are blown 
about in the air of the house, street or country road. If they come in 
contact with clothing or household furniture, they can be carried. Should 
a nurse or attendant upon a case be careless about disinfecting the hands 
or clothing during or after the management of a contagious disease, he or 
she can become a common carrier by touching food, dishes, clothing, etc., 
used by other members of the family. 

Water is a common carrier of disease, particularly typhoid fever, 
cholera, etc. Therefore, to prevent the spread of disease, every farmer, 
dairyman, occupant of a dwelling, factory, citizens of villages, cities and 
States, should see that they have a clean water supply free from germs 
and not contaminated by dirty water or refuse from a toilet, pig pen, 
stable, etc., which might contain germs carried from a patient or animal 
suffering from any one of the contagious diseases. One case of typhoid 
fever along the edge of a mountain stream, carelessly managed, thus 
permitting bowel movements to be thrown into or washed into the stream 
by rain, melting snow, etc., could cause an epidemic in every village which 
received its water supply from that stream or the river into which it 
emptied. 

Milk can be a common carrier of disease, such as tuberculosis, typhoid 
fever, scarlet fever, measles, diphtheria, etc. Most States, however, have 
protected the supply of milk by the enactment of laws covering the 
inspection of cattle, the erection of well lighted, clean and ventilated 
dairies, boiling and sterilization of all utensils used in its handling, even 
the wearing of sterile gowns by the milkers and attendants, cleansing of 
the cows' udders before and after milking and currying and brushing the 
cattle and covering them with light blankets. Milk should be kept at 
even temperature after being placed in sterile cans to prevent the forma- 



INSECTS AS COMMON CARRIERS. 131 

tion of germs which will develop even in transit to the consumer in the 
country or by train or in the milk bottles prior to city delivery. Rail- 
roads are compelled in some States, and should be in all States, to furnish 
refrigerator cans with ice and the dealers in the city should particularly 
during the warm weather, have a refrigerator or ice in the delivery wagons 
to maintain an even temperature for all milk delivered. 

How Can the Housewife Protect Her Children from Drinking Germ- 
Laden Milk? — First make sure that the dairy from which the milk is 
supplied is clean and up-to-date and the city dealer delivers the milk at 
her doorstep in clean bottles. Do not allow it to sit in the sun in the 
early morning in warm weather, or about the kitchen at any time of 
the year, but place it immediately on ice in a clean refrigerator until 
ready to use. When taking a certain quantity of milk out of the bottle, 
if for the baby use a Chapin dipper, and do not allow it to stand uncovered 
for flies to contaminate. Milk may also be contaminated by water from 
any source of pollution if dairy utensils are carelessly washed with a 
supply of water from an infected water supply as any dirty well or one 
contaminated by cess pool, out-house, manure pit which is infecting 
water through the soil or from drainage. 

It is absolutely vital to a country to protect its milk supply as two 
thirds of the deaths under two years of age are traceable to either germ- 
laden milk from dairies or not properly handled by dealers, nurses, 
mothers, etc., who are careless or too ignorant to appreciate the danger 
of allowing baby's milk bottle nipple being dirty, contaminated by flies 
or who allow a milk bottle to sit in the hot morning sun, — result a sick 
baby, followed by death. 

Insects as Common Carriers. — Great strides have been made in recent 
years by scientists in regard to the further prevention of disease by 
studying the life habits of insects. It has been clearly proven that the 
poison or germ of certain diseases are carried by them, such as tuberculosis, 
typhoid fever, bowel complaints of children, by the common house fly; 
malaria and yellow fever by the mosquito ; the bubonic plague by the rat 
flea, of which there are several varieties, and the squirrel flea, of which 
there are also several. 

It is easily understood that to prevent the spread of a contagious 
disease from one individual to another, the precautions are not complete 
unless he or she be protected against either the bite of a mosquito or flea 
which has received into its own blood the poison or the germ causing the 
disease, which it conveys by biting another person. Flies should be kept 



132 PKEVE1STION OF DISEASE. 

out as, by coming in contact with the spittle or discharges from a patient, 
they carry the germ or poison upon their feet, etc., to the food, milk, 
water and by direct contact to another person. 

Thus to aid in the prevention of disease, the numerous Boards of 
Health of City and State have issued regulations and instructions whereby 
these insects can be destroyed and then every person, sick or well, can 
be protected. If well, the fly is a danger by bringing disease into our 
home, if ill, it can convey our disease to another screenless home and 
start an epidemic. 

The Common Fly (Musca Domestica) — The only way to prevent the 
fly carrying disease is to destroy his breeding place, keep him out of the 
home, etc., when developed, by screens and swat or catch by fly paper, etc., 
every one seen in a room. 

House flies are a danger to human life. They are born in filth, 
feed upon garbage, sewage and waste matter of all kinds. They carry 
germs on the proboscis of their bodies, and a single fly is known to 
have carried as many as 350,000 germs and given them off into the 
liquid food in which it was floating. They also carry numerous germs 
inside their bodies which they convey to food, etc., in their vomit and 
bowel matter. 

Flies can carry disease germs of typhoid fever, consumption, diar- 
rhoea, dysentery and other diseases from a sufferer to you. They come 
in contact with your food, milk, water, etc., your sleeping child, or alight 
on an open wound, direct from the garbage can, the cuspidor, the spit 
in the street, etc., from decaying animal and vegetable matter and from 
the sick room. Thus every individual should do everything possible to 
aid the physician, city and state in destroying these known carriers of 
filth and disease and thereby prevent sickness, due to carelessness and 
indifference by permitting flies to breed and live. 

How to Eliminate the Breeding Places of Flies. — Mies breed by laying 
larvse or eggs which can be seen as Maggots in all undisturbed filth. It 
requires eight days for the millions of eggs to grow. Keep garbage 
can tightly covered, protect by screens so that flies cannot reach the 
garbage. See that garbage is collected promptly and cleanly. If 
you live in the country, burn or bury it. Allow no filth or decaying 
matter of any kind to accumulate in or near your premises. Keep stable 
clean, place manure, old straw, etc., in screened pits, vault, or in boxes 
or barrels, which should be well covered. Screen all privies, vaults and 
openings to cesspools or drainage structures. See that they do not overflow 



WHAT TO DO TO GET BID OF FLIES. 133 

and use chloride of lime freely. Pour kerosene into drains, keep drainage 
systems in good order and repair all leaks at once. Destroy sawdust 
cuspidors, they are unsanitary. Clean cuspidors daily and keep a five 
per cent, carbolic acid solution in them all the time. Permit no dirt 
to accumulate in corners, behind doors, back of radiators, under stoves, 
etc. If there is a nuisance in the neighborhood, notify the nearest health 
authority. 

What to Do to Get Rid of Flies. — Screen your windows and doors. 
Do it early in the Spring before fly time and keep it up until cold weather 
comes. Screen all food, especially milk. Do not eat food that has been 
in contact with flies. Screen the baby's bed and keep flies away from 
the baby's bottle, nipple and food, rattle, toys, etc. Keep flies away from 
the sick, especially those ill with typhoid fever, scarlet fever, diphtheria 
and tuberculosis, etc. Screen the patient's bed. Kill every fly seen to 
enter the sick-room. Disinfect all discharges, dressings, bandages, etc., 
from the patient and burn where possible. Catch all flies by use of sticky 
fly papers, traps and liquid poisons. A good poison to destroy flies is 
two teaspoonfuls formaldehyde in a pint of water sweetened with sugar 
and placed in saucers throughout the house. Be sure and have poisons 
out of reach of children and family pets. To rid an infected house of 
flies, burn in each room pyrethrum powder. Darken the room allowing 
only ray of light to enter at edge of window shades. Sprinkle pyrethrum 
powder over hot coals and carry about room. The flies will be stunned 
by the fumes and can be readily swept up. This is done because the flies 
will seek the light to escape the fumes and fall near the windows. Swat 
the fly whenever seen. A paddle can easily be made to kill the flies with 
by taking an oblong sheet of wire gauze and nailing it to a stick of 
suitable length for a handle. 

The Mosquito. — The mosquito is a common carrier of Yellow Fever 
and Malaria or "Chills and Fever" as it is sometimes spoken of by the 
public. Malaria is caused by a tiny parasite which can only be seen by the 
microscope in the blood of man and the mosquito. It lives and multiplies 
in the blood of an individual suffering from the disease. 

How is Malaria Carried by the Mosquito? — Let us imagine that a man 
has returned from some malarial country and takes up his abode in 
a healthy, yet mosquito infested village. This man may be fairly over 
his attack yet he still suffers from an occasional chill with fever. He 
has no screens in his house, nor have his neighbors, unless previously told 
to follow such precautions. A female mosquito or several attack him 



134 PREVENTION OF DISEASE. 

and suck his blood which contains these tiny parasites. The mosquito 
takes millions of these little parasites which then undergo a development 
in the body of the insect and can be seen microscopically in the stomach, 
intestine, and the small glands in its mouth, which secrete the saliva. 
!Nbw let us follow this mosquito and see what harm it can cause in a 
community. It flies through a screenless door or window and lights on 
the arm, etc., of an unsuspecting neighbor. In biting a person the 
mosquito ejects or gives off its saliva into the wound to aid in diluting 
the blood of the person which it has bitten, as the blood is too thick 
to be sucked up through the tiny tube in the bill (proboscis) of the 
mosquito. In this way the bite of the female mosquito whose body contains 
the small animal parasites which cause Malaria, pass by means of the 
saliva into the blood of the person during the act of sucking up the blood. 
Thus the mosquito sucks up the blood of the individual and in exchange 
injects into his blood the saliva containing the parasites. These parasites 
multiply in the blood of the person bitten and produce poisons which 
give rise to the chills, fever, aching limbs, etc., known as Malaria, Malaria 
Fever or "Ague," (chills and fever). It can readily be seen how malaria 
will spread when individuals in a community have millions of parasites in 
their blood, and at the same time mosquitoes are carrying around in their 
bodies, millions of the same living germs which they suck from the blood 
of the infected person, develop and inject them into the blood of every 
person they bite. 

How Mosquitoes Develop. — A female mosquito lays from 200 to 300 
eggs at a time and always in standing water, as the eggs must have still 
water and no matter how filthy the water, it will not destroy the eggs 
or prevent their development. 

How to Destroy the Breeding Places of Mosquitoes. — ;No breeding 
places, no eggs and consequently no mosquitoes. When we consider that 
one female mosquito can lay 200 to 300 eggs at a time and then figure 
the number of living pests we have seen in one evening, it can readily be 
seen how rapidly they can develop and in what numbers increase if their 
breeding places are allowed to remain about any premises. Mosquitoes 
lay their eggs in standing water, such as is found in cesspools, drains, 
open sewers, catch basins, foul street gutters, stable yard pools, tin cans, 
rain barrels or any object which holds water. In from a few hours to a 
day, depending upon the temperature and surrounding conditions, the 
eggs open and what we know and have seen as "wrigglers" come out and 
can be seen in the water in which the eggs have developed, as tiny slender 



HOW TO DESTROY MOSQUITOES. 135 

living bodies %-inch in length. In five to seven more days, the " wrig- 
glers" become "tumblers." In another five to seven days the covering 
of the head of the "tumblers" cracks and the fully developed adult winged 
mosquito comes out and, in the case of the female of the species, flies 
off ready to annoy and bite. 

Every individual should do everything possible to get rid of all 
breeding places. Examine your premises and be sure that they are free 
from any vessels, etc., which will receive and contain still water for 
one week or longer, that will afford a breeding place for mosquitoes. A 
loose brick causing a depression in the pavement, defective plumbing, 
cups, ( buckets, barrels, water pans in chicken yards, etc., a horse trough, 
a gutter on the eaves or roof of a house, bottles, barrels, tin cans, water 
spouts out of repair or clogged up and so do not drain properly. These 
collectors of water should be removed and all plumbing, drains, roofs, 
etc., repaired. 

Mosquitoes will breed indoors as well as outside. Any water left in 
clogged sinks, toilet fixtures, water pitchers in bed rooms, slop jars 
buckets, tubs, spittoons, aquariums without fish, or in fact any vessel 
which is capable of holding a few teaspoonfuls of still water, will afford 
a breeding place for the mosquito. Neglect to remove or repair the above 
structures is only allowing a large crop of mosquitoes to develop and annoy 
you and your neighbors by bites, disturbing your comfort, preventing 
rest and sleep and subjecting you to the malaria and yellow fever if 
you are in a district where these diseases are known to exist. 

Every citizen should use his influence to have every village, city 
and State corporation appropriate money to eliminate all marshes by 
filling with soil, drain all stagnant streams and have kerosene oil spread 
on the surface of lakes, ponds or any other body of standing water, no 
matter how small. The object of using oil is to prevent the "wrigglers" 
and "tumblers" from getting air, for after leaving the eggs, they require 
air to develop. A film of oil prevents the "wrigglers" from getting the 
needed air and they are destroyed by choking. One ounce of oil is 
suificient to cover 15 square feet of water. Oil should be applied and 
removed once a week during the breeding season. When standing water 
must be kept, screen the containers or keep tightly covered, so the females 
cannot deposit their eggs. Screen all doors and windows. Put screens 
up early in the spring. 

How to Destroy Existing Mosquitoes — Kill every mosquito seen about 
the house. Every mosquito killed in the winter or spring will lessen the 



136 PREVENTION OE DISEASE. 

number of mosquitoes in the summer by thousands. Use a paddle, made 
of an oblong sheet of wire gauze tacked on to a strip of wood, to serve 
as a handle, to kill both the fly and mosquito whenever seen. One of 
the best means of killing female mosquitoes (as they survive from one 
season to another) is to begin in the winter or early spring to fumigate 
the air with the following mixture : — Equal parts (by weight) of carbolic 
acid crystals and gum camphor. Liquify the carbolic acid crystals by 
gentle heat, break up gum camphor into small pieces and then pour the 
liquid acid slowly over the camphor. The acid will dissolve the camphor 
completely and the solution formed is permanent and will evaporate 
slightly at ordinary temperatures. To fumigate a tightly sealed room, 
three ounces of this liquid will suffice for 1000 cubic feet of air space. 
Place it in a tin over an alcohol or other lamp and in addition place the 
lamp on a tin waiter or old pie plate, heat and it will require about one 
half hour to evaporate these three ounces of liquid. This solution is 
death to the mosquitoes and flies. It is not poisonous to man and is not 
destructive to fabrics and materials, furniture, etc. It is not explosive, 
but is inflammable and precaution should be taken to prevent fire. 
Mosquitoes found upon the ceilings of bedrooms in the evening may be 
quickly killed by taking a shallow tin cup or lip of a tin can, tacking 
it to a stick and then fill it with kerosene. Place quietly under the resting 
mosquito which either falls into or flies against the oil and is killed. 
Burn Chinese punk and mosquitoes will be driven away temporarily. 
Equal parts of olive oil and oil of citronella applied every half hour 
or so to the skin of the face, neck, hands and ankles will keep away 
mosquitoes. This method is useful to farmers, hunters, lumbermen or 
laborers about woods, swamps, etc., where mosquitoes are an annoying 
and disease carrying pest. 

Fleas — There are one hundred varieties of this pest which live on 
dogs, cats, birds, squirrels, rats, mice, etc. It has been proven that fleas 
carry the germs of Bubonic Plague, which has caused as high as 113 
deaths in 119 cases during an epidemic. The disease was found to be 
spread by means of rats, mice and squirrels of all species and the flea 
(pulen fasciatus) in the fur of the animals was the medium by which, 
the disease was conveyed to human beings by biting them and injecting 
the germs of Plague into their blood. 

The forms which pester the American homes are the House Flea 
(Pulen Irritans), the Cat Elea (Pulen Felinius), and the Dog Flea 
(Pulen Canis). Each female flea deposits from eight to twelve whitish 



TO GET RID OF FLEAS. 137 

ovoid eggs in dust or lint, under carpets and the larger crevices of wood- 
work. In the summer they develop in about four weeks from the egg 
to the adult flea, in winter they develop in about six weeks. Four to six 
broods, as a rule are hatched out during each summer. 

The House Flea occurs in dwellings, breeding in bedding, clothing, 
carpets, window curtains, etc. They attack their victims at night. The 
Cat and Dog Flea, though they annoy only their respective victims, are 
as troublesome to human beings as the human flea. 

To Get Rid of Fleas. — Remove and clean rugs, etc. Dust Pyrethrum 
powder into all cracks and crevices where dust or dirt may be lodged to 
destroy the larva?. Scrub the floor and footboards with hot soap and 
water to kill the adult fleas. To eliminate fleas on cats or dogs, dust 
Pyrethrum powder into the hair. The fleas will fall off while stupefied 
and should be immediately swept up and burned. Sleeping places of 
dogs and cats should be cleaned and covered with a carpet or matting 
that can be shaken into an open fire and the eggs, larva? and fleas with 
which it is generally covered, destroyed. During an epidemic of Bubonic 
Plague destroy all rats, mice, stray dogs and cats, etc., and protect your 
house by killing all fleas whether in the furnishings or on your family 
pets. Flea bites are painful and if scratched may cause an abscess, 
followed by blood poisoning. The pain and itching of a flea bite can 
be counter-acted by touching the wound with ammonia water. To prevent 
infection, bathe the wound with a 5 per cent, solution of carbolic acid in 
water and bandage until healed. 

Cockroaches. — Cockroaches are brownish or black in color, broad and 
flattened in shape and smooth and hard to the touch. All cockroaches 
should be destroyed. They not only annoy, but, even though it has not 
been proven, they, no doubt, carry disease germs by coming in contact 
with discharges^ etc., from ill persons and convey filth and germs to food, 
etc. They are very numerous in pantries, kitchens and in the walls 
near a stove and fire places. They are apt to be abundant in oven rooms 
or bakeries and wherever the temperature is kept above normal. They 
usually appear at night or wherever light is absent and thus are protected 
from their common enemies. Owing to their shape they can squeeze into 
tiny cracks. They scurry away when surprised and generally escape 
capture or destruction, due to their speedy gait. They feed on animal 
matter, cereals and any food material ; also eat woolens, leather cloth and 
leather bindings of books (due to the presence of paste). They give off 
a fetid, nauseous odor, which persists even after thorough cleaning. They 



138 PREVENTION OF DISEASE. 

taint food supplies, stain shelves and dishes and when present in large 
numbers, render the air of a room unbearable. This is due not only 
to their excretion, but mostly to an oily liquid secreted in the scent gland 
and a dark colored fluid in the mouth. They will destroy bedbugs. No 
contagious disease can be said to be properly treated or isolated, if cock- 
roaches are scurrying about the walls, carpets, food, etc., of a sickroom 
and allowed to persist and possibly convey the germs of the disease to 
others in the house or to neighbors. 

How to Destroy Cockroaches. — Take a quarter of a teaspoonful of 
phosporous, two level tablespoonfuls of flour, mix and make into paste 
with well sweetened water. Phosporous is very inflammable and should 
not be allowed near fire and being poisonous must not be placed where 
children and family pets can touch or eat it. Place the paste where 
the roaches can reach it. 

Bed Bugs — The bedbug is a small but plainly visible ovoid-shaped 
bug, giving off a peculiar nauseous odor. It is of a reddish brown or 
rusty color with some discoloration on the abdomen and is furnished with 
a puncturing or sucking apparatus. The eggs are tiny white oval bodies. 
As many as 6 to 50 batches are laid in cracks of beds, furniture, picture 
frames, wall paper, crevices of woodwork, floors, etc. Each batch of eggs 
develops in from 6 to 11 weeks, and several batches may be hatched in 
a season. One generation succeeds another as long as the temperature 
remains sufficiently elevated. They hibernate during cold weather, during 
which season the insect is merely stupefied and renews its activities 
upon the return of warm surroundings. It is found in the dwellings 
of man, but other species of the same family have been found upon birds, 
as the common chimney swallow, pigeons and bats. 

The bedbug comes out at night and begins to bite and annoy. It 
conceals itself very cleverly and quickly in the day time or when surprised 
by a sudden light at night. It lives on the blood of man particularly, 
but can exist on food of other insects. It thrives best on filth and 
in old houses can keep alive without food for a year. 

Bedbugs are said to transmit smallpox. There is a possibility of 
their carrying the germs of typhoid fever and leprosy, but this fact has 
not been proven as yet. The bite is poisonous to some individuals, result- 
ing in inflammation at the seat of the bite. This is supposed to be due 
to the same secretion which gives the characteristic nauseous odor. 

How to Destroy Bed Bugs. — Spray with pure spirits or crude turpen- 
tine or benzine by using an ordinary nose and throat atomizer which 



LICE. 139 

can be bought in a drug store, all brass or wooden beds after scalding 
where possible with hot water, spray the crevices of floor, back of picture 
frames and where a house is "alive" with the pests repaper and paint 
rooms. Spirits of turpentine will kill where carbolic acid has failed. 
After each spraying, watch for the bedbugs as those which are not destroyed 
will hasten to escape and can be killed. Remember benzine and turpentine 
are inflammable and poisonous. ISTo lights should be permitted in the 
rooms during or immediately following the use of these drugs. "When 
articles cannot be sprayed, as books, etc., seal up the room and burn a 
sulphur candle. Place sulphur candle in a tin cup and place cup in a 
tin or metal pie plate containing water. 

Lice. — The body louse has been found to be a carrier of typhus fever. 
It carries the germ in its body after biting a sufferer from the disease 
and by biting a person can inject the germ into his blood. Lice belong to 
the insect family. The species which infest human beings are about 1-10 
of an inch in length and are found on the covered regions of the body and 
clothing. Lice always grow from the eggs laid by an adult louse and 
never originate from filth or other matter. They hatch out within a week 
and the young are capable of reproduction in less than two weeks. A 
single adult female will produce 5,000 lice within eight weeks. 

The annoyance of these pests biting a human being will cause, if 
sufficiently prolonged, a nervous irritation, and a condition of ill health 
follows. There are three types of lice which infest man. The Head Lice 
(Pediculus Capitis), the Body Lice (Pediculus Vestimentorum) and 
Crab Lice (Pediculus Inguinalis). 

The Head Lice. — They are grayish in color with blackish margins 
and show a reddish tinge due to the blood they have sucked from their 
victim. The eggs or nits are seen attached to the hair shafts on the scalp 
at some distance from the end of the hair and are tiny white or grayish 
pear-shaped bodies seen upon close examination. 

Tbeatment. — It is necessary to remove eggs and adults at the same 
time, so wet the hair thoroughly with crude petroleum (from any drug 
store) keep hair wet for three hours, then wash whole head with warm 
water and soap. Repeat this wash once a day for three successive days. 
The eggs can then be removed by combing the hair with a fine tooth 
comb wet with vinegar. Where possible the treatment can be made more 
thorough and permanent if the hair is cut short. 

Body Lice. — The Body Lice are larger than the head lice and are 
commonly found upon the body. This type has bands across the back. 



140 PREVENTION OF DISEASE. 

Crab Lice. — They usually develop in the seams of clothing, however 
the eggs have been found upon the hairs on the body's surface. They live in 
concealed portions of the clothing where the skin is most conveniently 
reached, where the various bites are to be found most often, as around the 
neck, across the shoulders, the upper part of the back, around the waist 
and outer side of the thighs. 

Treatment. — All clothing worn should be boiled and gone over with 
a hot iron to destroy them. A hot bath should be taken by the person 
annoyed by the parasites. Bathing suits should be carefully boiled as 
they often become infested with the eggs and body lice from a person 
who may have worn the suit and had them upon his or her clothing or 
person. 

The Crab Lice. — These are a smaller type of the former species, 
as head or body lice. They are nearly as wide as long. They have strong 
legs spread out on the sides of the body, which makes them appear like 
crabs. They are of whitish color, slightly shaded on the shoulders and legs 
with a red tinge. Crab lice are found upon the hairy regions of the 
body other than the scalp. The spread of these pests can be checked by 
washing all toilet seats with scalding water, and boiling towels and linen 
from suspected persons. Laundries should be especially careful as to the 
thorough boiling and disinfection of all clothing, as the eggs of these 
parasites can be conveyed in bed-clothing, towels, etc. 

Treatment. — Shave the hair in the region of the itching and wash 
twice a day with a lotion made of 

Tincture of Larkspur ^ ounce 

Commercial Ether 8 ounces 

The Itch Mite. — This parasite which afflicts man causes the condition 
spoken of as "Itch," "Seven Years Itch," "Army Itch," "Jackson Itch," 
etc. It has an oval body with spine-like projections.- The female is 
larger than the male and measures 1-70 of an inch in length by 1-50 
of an inch in width. The female causes the development and pain of the 
afflicted person. She burrows into the superficial skin, forming a tortuous 
or a straight dotted line, slightly elevated which varies from 1/8 to 1/2 
inch in length. This line if observed closely appears dark gray or blackish 
in color and is slightly more elevated at one end. The eggs are laid in 
this furrow and at the elevated end is usually found the female, which 
has perished, as a rule. It takes almost 13 to 20 days for the eggs to 
develop into adult mites. The young mites feed upon the tissues of the 



THE PUBLIC DRINKING CUP. 141 

body and move about causing discomfort until they reach the surface 
of the skin where they mate and females start a fresh burrow and deposit 
more eggs. 

The Itch Mite is commonly found in the skin between the fingers, 
hands, folds of the wrist, arm pits, around the stomach and about the 
neck. It is not known as a carrier of disease, but can be dangerous to 
health by causing burrows in the skin and abrasions due to scratching 
which afford an opening for germs to enter the system of the bitten 
individual. 

The Itch Mite can be conveyed from one person to another by means 
of towels, clothing, bathing suits, etc., carelessly washed, handled, or 
worn by anyone afflicted with the pests. 

Treatment. — To destroy them, have all bed linen and clothing used 
by the individual infested, thoroughly boiled or baked. Treat the region 
of the body by taking a bath, washing first with warm water and castile 
soap, using a brush to thoroughly open up the burrows and expose the 
eggs for destruction. After this, apply an ointment, 

Sublimed sulphur one drachm (teaspoonful) 

Balsam of Peru one drachm (teaspoonful) 

Vaseline one ounce (2 teaspoonfuls) 

Rub in morning and evening for from two to four days and repeat at 
end of a week if any itching continues. 

THE PUBLIC DRINKING CUP. 

The drinking cup is a common carrier of disease. It can and does 
spread consumption, syphilis and typhoid fever. Any child or adult 
suffering from tonsilitis, diphtheria, scarlet fever or other communicable 
diseases can infect another by using a public tumbler or cup, whether at 
a public railroad station, school house, ball park, pump, railroad train, 
ferry boat or steamship of any kind, etc. 

The most of the State Boards of Health have had laws passed in 
recent years to abolish the public drinking cup and those states which 
have not done so are neglecting the public health by not enforcing this 
preventive measure, which would aid in checking the spread of disease. 

The drinking cup should be replaced by a sterile paper cup which 
can be purchased in sealed packages or containers and are given away 
free of charge in trains, etc., and can be purchased for one penny from 
the slot machines in stations. They are destroyed after use and a more 



142 PREVENTION OF DISEASE. 

refreshing and sanitary drink is obtained and the danger of contracting 
disease eliminated. The Public Drinking Cup Must Go. 

THE PUBLIC TOWEL. 

The towels in toilets, bedrooms of hotels and boarding houses can 
spread disease unless they are thoroughly boiled and laundered after use, 
Most hotels, railroad stations, Pullman cars, etc., have done away with 
the public towels in toilets and use a heavy tissue paper, either as a single 
towel or in rolls and torn off as needed, which is not expensive and is 
thrown away after use. 

In Pennsylvania the State Board of Health has urged saloonkeepers, 
etc., to do away with the forks and spoons which are placed in a tumbler 
of water and are used by all comers at the free lunch counter and then 
replaced in the tumbler of dirty water for the next victim to use. 

Disease can be controlled better when our proprietors of saloons, 
restaurants, hotels, soda fountains, etc., employ only healthy employees, 
free from disease and take pains to boil or scald every public glass and 
chinaware used by not only dirty, but disease-spreading persons. The 
barroom towel which hangs in front of the bar in the cheaper saloons 
for customers to wipe their mouth and hands upon, must not be permitted. 

VENEREAL DISEASES. 

Syphilis, gonorrhoea and a host of diseases which follow in their 
train, come within the scope of Preventive Medicine. They are not spread 
by water, air, food, or insects as are so many diseases, but develop only 
from contact with a sufferer (usually by co-habitation, but possible by 
non-sexual contact), or by the germs from a sufferer being imparted to 
another by towels, clothing or other articles. They may be communicated 
to an innocent wife by a diseased husband and vice versa, and many 
serious diseases and infirmities depending on these diseases may be trans- 
mitted to the children of the diseased, as instance the disease of Opthal- 
mia or Blindness in Children, which occurs at or shortly following birth, 
and which is usually attributable to one or both of the parents suffering 
from gonorrhoea, although it may arise from other causes (see Index 
for article on Opthalmia, its cause, treatment and prevention). 

Syphilis and gonorrhoea are so largely dependent on immoral inter- 
course that their prevention is largely a matter of moral uplifting of the 



VENEREAL DISEASES. 148 

people. But, pending this moral uplifting, much is possible by the State 
and municipal governments placing these diseases on the list of contagious 
diseases which must be reported to the authorities, as is now required in 
respect of small-pox, scarlet fever and other diseases which are neither 
so loathsome nor have such far-reaching results for ill to mankind. 

All parents should carefully read the articles on Syphilis, Gonorrhoea 
and Opthalmia, to be found elsewhere in this work (see Index), and then 
they should carefully guard their children and at proper age thoroughly 
instruct them in the fearful ravages of venereal disease. There is too 
much false modesty in these matters on the part of parents. The general 
discussion of sexual matters in novels, in sensational books on eugenics 
and in ordinary conversation is to be condemned, but it is the duty of 
every mother to her daughter and of every father to his son, to not only 
keep constant guard over them in these matters, but, at the beginning of 
puberty, to instil into their minds the real truths that they may become 
imbued with the horrors of venereal disease, yet realize the nobility of 
true sexual life. Professors and teachers in resident schools and colleges 
where youth is congregated should also have regard to this vital subject 
and take means to properly impart useful knowledge, and not only adopt 
every possible precaution to prevent students from meeting lewd persons, 
but by periodical medical examination discover if any venereal disease 
is existent, and if found in any individual then suspend such student 
until the disease be eradicated beyond the possibility of contagion. 

Syphilis is a more horrible disease than small-pox and may be easily 
communicated to the innocent by a common towel, by a brother kissing 
his sister or a son his mother, and in many other ways, and yet the 
syphilitically diseased may go where they please and little or no pre- 
cautions are taken as to the spreading of the disease. It is estimated that 
in New York City alone 250,000 people are suffering from this loath- 
some disease, either inherited or acquired, and when it is borne in mind 
that large numbers of these have innocently acquired it and are now in 
turn transmitting it to others, the enormity of the evil and the imperative 
need of preventive measures, will be realized. 



INDEX TO PART II OF BOOK III 

Preventive Medicine 

Water In Its Hygenic Relations 

Part II of Book III treats of pure and impure 
water and its various effects upon the human body, 
both as respects internal and external uses. 



Air in Water 148 

Alkaline Waters, Diseases Caused by, 151 

Alluvial Waters 163 

Arsenic in Water 156 

Artesian-Well Waters 165 

Bathing Beneficial for Rheumatism ... 174 

Baths, Cold 169 

Baths, Hot 176 

Baths, Hygienic Use of Cold Baths... 169 
Baths, Hygienic Use of Warm Baths.. 174 

Baths for Old Age 173 

Baths, Temperature of 169 

Baths, Cold, Varieties of 172 

Baths, Warm 174 

Bright's Disease Caused by Water... 153 

Chalky Waters 164 

Cholera Due to Impure Water 156 

Cold Baths 169 

Detection of Contaminated Water.... 165 

Diarrhoea Due to Impure Water 159 

Distilled Water 148 

Drinking Water, Sources of 149 

Dysentery Due to Impure Water 159 

Farmhouses, Danger from Polluted 

Water 159 

Fever Germs in Ice 161 

Flesh Brush Exercise 174 

Goitre, Water as a Cause of 152 

Graveyard Waters 165 

Green Waters 166 

Hot Baths 176 

Hydropathy 173 

Hygiene of Cold Baths 169 



SUBJECTS OF THE TEXT 

Hygiene of Sea Bathing 177 

Hygiene of Warm Baths : 174 

Ice as Cause of Disease 160 

Ice from Contaminated Ponds 161 

Ice, Fever Germs in 161 

Impure Water Cause of Diarrhoea and 

Dysentery 159 

Impure Water Cause of Worms 163 

Impurity of Water 152 

Infectious Diseases from Impure 

Water 156 

Iron in Water 156 

Lead Poison in Water — 

Apply Test for 155 

Causes of 154 

Detection of 154 

Diseases from 155 

Frequency of 153 

In Rural Districts 153 

Obviation of 15s 

Palsy from 154 

Virulence of 154 

Limestone Waters 164 

Marsh Waters 165 

Mineral Springs 150 

Mountain Fever Due to Snow Water, 162 

Need of Water 147 

Precautions for Travelers 169 

Privy, Well and Stables, Proximity of, 159 

Pure Water a Sanitary Necessity 163 

Purifying Ingredients in Water.... 151 

Rain Water 1 50 

Rain Water, Purity of ; Impurities in, 149 



10 



145 



PREVENTIVE MEDICINE. 

PART II. 
WATER IN ITS HYGIENIC RELATIONS. 



THE USES OF WATER. 

Adaptation of Water to Human Needs Few people who enjoy the 

benefits of water think what a wonderful and unanswerable argument 
is afforded by them in favor of the goodness of an all-wise Creator to his 
creature, man. Of all the fluids with which we are acquainted water is 
by far the best adapted to the almost infinite variety of human wants, and 
it is the one of all others most abundant in nature, constituting as it does 
about three-fifths of the surface of our globe, and nearly seven-tenths of 
the bodies of man and of most animals. If the common fluid upon which 
we had to depend were quicksilver, or oil, its boiling-point would be so 
high that articles of food which we attempted to cook in it would be 
seriously injured in the effort to prepare them by its aid; and, on the 
other hand, nearly all the advantages of ice would fail us, in consequence 
of the exceedingly low temperature at which these substances remain fluid. 

Water in All Substances. — Water was considered by the ancient phil- 
osophers as one of the four elements out of which all visible objects were 
constructed ; and, in reality, it enters to a greater or less extent into the 
composition of nearly all natural substances. Thus, for example, some 
vegetables, like cabbage or celery, contain as much as ninety-five per cent, 
of water; and, on the other hand, close-grained marble may contain as 
much as four per cent, of water, or almost a quart to the cubic yard. On 
account of its remarkable solvent powers, which enable it to take up a 
smaller or larger quantity of nearly every substance with which it comes 
in contact, water is never found pure in a natural state; and, indeed, 
absolutely pure water for chemical purposes can only be obtained by 
repeated careful distillations. 

(147) 



148 WATER IN ITS HYGIENIC RELATIONS. 

Air and Gases in Water. — A considerable amount of air generally 
exists in water, and is taken up by the gills of fishes, assisting them to 
accomplish the proper aeration, or rather oxygenation, of their blood. 
The air usually mingled with water may be expelled by boiling, but is 
absorbed again if t'he boiled water is agitated with access of the atmos- 
phere. 

Boiled Water. — The insipid taste of water which has been boiled is 
due to the absence of air. Many gases besides air may be artificially or 
naturally mingled with water, and some, like ammonia or nitric acid, are 
freely soluble in it. In sea-water, the presence of common salt, with small 
quantities of sulphate of soda or Glauber's salt, and, of the compound of 
magnesia and chlorine, called chloride of magnesium, render it entirely 
unfit for drinking, as many a hapless shipwrecked sailor has found to his 
cost. 

Distilled Water — At the present day, most sea-going vessels are 
provided with apparatus for distilling the water of the ocean, and so pro- 
ducing a pure and wholesome but insipid water, which can be rendered, 
however, more palatable by agitation with plenty of fresh air. Hence, the 
horrible agony of death by thirst among sailors is now much less frequent 
than formerly, although mariners in open boats, or cast upon small un- 
inhabited islands, still sometimes scan with anxious eyes the briny waste 
around them, beholding — 

" Water, water everywhere, but not a drop to drink.' ' 

Sea-Water. — Sea-water varies considerably in composition, being, of 
course, more concentrated, as a rule, in the tropical regions, where evap- 
oration is most active, such, for example, as in the Mediterranean Sea and 
the Atlantic Ocean near the equator. According to analysis, the water 
in the English Channel contains in 1000 parts — 

Chloride of Sodium. 28.05 

Chloride of Magnesium 3.66 

Sulphate of Magnesia 2.29 

Sulphate of Lime 1.40 

Other Saline Materials. . 76 

Total Solid Matter 36.16 

Besides these, and perhaps contributing largely to the healthful 
qualities of sea-vater, there exist in the ocean small quantities of iodine 



SOURCES OF DRINKING WATER. 149 

and bromide, and extremely minute amounts of some of the common 
metals. It has been found that, by dissolving a little common salt and 
carbonate of soda, lime and magnesia in distilled sea-water, its taste is 
rendered much more agreeable ; and this plan, it is said, is adopted in the 
Russian navy. 

Purity of Rain-Water. — The water, which rises in vapor into the 
atmosphere from all the oceans, seas, lakes and rivers of the globe is 
condensed after a longer or shorter time, and falls to the earth again as 
rain. Rain-water, being in reality a distilled fluid, is the nearest approach 
to a pure water which we find in nature, and when caught in clean vessels 
placed upon elevated objects is almost free from contamination. 

Impurities in Rain-Water. — It contains, however, small quantities of 
organic matter, nitric acid and ammonia, all of which are washed out of 
the air through which it descends as rain. The source of the nitric acid 
is believed to be the nitrogen of the atmosphere, which combines with 
oxygen under the influence of the electric spark during thunder-storms. 
Nitric acid in rain-water exists in such insignificant amount as to be 
entirely unimportant in itself; but it adds very seriously to the danger of 
impregnation with lead from lead pipes, roofs and cisterns by rapidly 
dissolving that metal and forming the very soluble and highly poisonous 
salt, nitrate of lead. 

SOURCES OF DRINKING WATER. 

Evaporation. — Our supplies of drinking water are, of course, derived 
originally entirely from the rainfall. We need not consider now how the 
water found its way into the air. Without entering into the details of the 
process of evaporation, all that the present object requires is, that we 
clearly recognize the fact that spring, fountain, river and lake are all 
alike fed from the clouds which float over our heads and send their rain 
upon the just and upon the unjust. Hence, then, man is wholly dependent 
for his supply of this vital element upon the rain which comes down from 
heaven. He may dwell upon the most arid plains, but he drinks from 
the stream which flows beside or underneath his feet — which stream is 
itself fed by floods that fell perhaps a thousand miles away — and what- 
ever mystery attaches to subterranean waters, we may be sure that, by a 
long enough circuit, we can trace every drop back to the clouds. 



150 WATEB IN ITS HYGIENIC RELATIONS. 

VARIETIES OF WATER. 

Rain-Water. — In classifying waters, we have first to consider them 
as regards their sources. Rain-water, as already mentioned, is sweet and 
soft, and when filtered is perfectly adapted to all the purposes of life ; the 
one difficulty about its use being the impossibility of collecting it pure 
and preserving it without contamination for the long periods of time 
and in the large quantities which would often be necessary. 

Spring- and Well- Waters. — Spring- and well-waters are almost always 
more or less impregnated with the soluble ingredients of the earth and 
rocks through which they pass, and are therefore sometimes very unsuit- 
able for the ordinary wants of life. As a general rule, they are colder than 
other waters, although hot springs are found in various parts of the world, 
some with a temperature as high as the boiling point. 

Mineral Springs. — Mineral springs, notwithstanding they are much 
used for drinking, are properly medicinal agents. They comprise all those 
waters which contain sufficient quantities of dissolved matters, such, for 
example, as iron or sulphur, as to produce thereby a positive effect upon 
the systems of persons partaking of them. The mineral springs of this 
country are frequently valuable remedial agents in some chronic diseases. 

River-Water. — River-water is, to a certain extent, similar to spring- 
water, but is much more apt to be contaminated with sand and clay, 
organic material from decomposing vegetable or animal remains, the 
refuse of manufactories, and especially with the sewage of cities and 
towns, to which it is probable immense amounts of sickness and death are 
annually due in all civilized countries. Unfortunately, river-water is that 
which is chiefly supplied to towns and cities, and therefore finds its way 
into the systems of vast numbers of our fellow-beings. 

Stagnant Water. — Stagnant water is, from the large quantity ot 
organic matter in a decomposing state which it holds in suspension or 
solution, exceedingly unfitted for drinking and culinary purposes, no 
matter how transparent it may appear ; and it shoudd, in consequence, be 
carefully avoided whenever running water can possibly be procured. 
Pond-water, canal-water, ditch-water and marsh-water all come under this 
category, and should be scrupulously shunned, under penalty of suffering 
from fever and ague, dysentery, typhoid fever, and many other dangerous 
maladies. 

Quantity of Water Needed — The quantity of water needed by man 
and animals must therefore be very carefully calculated. Repeated ex- 



VARIOUS WATERS. 151 

periments upon a very extended scale in England have shown that a 
healthy man requires daily as drink from two to four pints of water, this 
amount being in addition to that which is swallowed as moisture in food. 
The amount required for cooking is estimated at from half a gallon to a 
gallon or more. To this quantity, Dr. Parkes considers should be added 
for daily ablution, including a sponge bath, five gallons; daily share of 
kitchen and other utensils, and house washing, three gallons ; and share 
of clothes washing, another three gallons; making up a total of a little 
over twelve gallons for each individual daily. In the poorer districts of 
the city of London, the amount used is stated to be only about five gallons 
daily. A shower-bath will require about four gallons extra, and a plunge- 
bath from forty to sixty gallons. Where water-closets are used an addi- 
tional quantity of from four to six gallons daily for each person must be 
provided. 

DISEASES FROM MINERAL IMPURITIES IN WATER. 

Purifying Ingredients. — Since all rivers, spring- and well-waters con- 
tain a certain amount of dissolved matters, taken up from the soil through 
and over which they pass, it becomes a very important consideration to 
determine what these ingredients are in any particular sample of water, 
and also the kind and degree of such impurity which will not prove 
injurious to health. Dr. Letheby, from investigations made in sixty-five 
English and Scotch towns, arrived at the conclusion that from five to 
twenty grains to the gallon of the compounds of lime and magnesia are 
necessary to render drinking water in the highest degree wholesome. 

Saline Impurity. — But any quantity of saline impurity exceeding 
thirty-five grains to the gallon renders a water unfitted for the freest 
domestic use. Such water would be popularly designated as a very "hard" 
water, but a good deal of indifference is caused by the nature of the hard- 
ness, that due to sulphate of lime, and called the permanent hardness be- 
cause it is not removable by boiling, being decidedly most prejudicial to 
health. 

Diseases Caused by Alkaline Waters. — The symptoms referable to an 
excess of alkalinity, arising from the presence of these earthy salts in a 
drinking water, are mainly those of a dyspeptic nature. At first the 
employment of hard water by persons who are unaccustomed to it pro- 
duces diarrhoea, which is occasionally serious or even dangerous in its 



152 WATER IX ITS HYGIENIC RELATIONS. 

character. But the long-continued use of such a drinking fluid is thought 
to cause habitual constipation, with the heavy train of evils, including 
piles and liver complaint, which depend upon it. Calculus, or stone in 
the kidney or in the bladder, which gives rise sometimes to the most 
horrible agony human beings are ever called upon to endure, is believed 
to be due, in many instances, to an excess of lime and magnesian salts in 
the drinking water. 

Cause of Goitre. — The swelling of the thyroid gland in the neck, 
producing the repulsive deformity of Goitre, or Derbyshire neck, seems 
to be intimately connected with mineral impurities in water. In ISTotting- 
ham, England, where this disease is not unfrequently met with, the com- 
mon people attribute it to the hardness of the water, and in other parts 
of Great Britain it is found to prevail only, or at least especially, in those 
districts where the magnesian limestone formation abounds. 

Goitre in Switzerland. — Dr. Coindet, of Geneva, Switzerland, asserts 
(that Goitre is speedily produced in persons who drink the hard pump- 
water in the lower part of that town, whilst in other parts of Switzerland 
the use of spring-water has been followed by the development or augmen- 
tation of Goitre in a very few days. In India also it has been shown 
conclusively to prevail, to any marked extent, only where the magnesian 
limestone rocks underlie the soil ; but whether it is the lime and magnesian 
salts, or whether, as has been suggested, it is the presence of sulphide of 
iron in the bed-rock formation, which is the direct cause of the develop- 
ment of Goitre, has not yet been positively determined. It appears cer- 
tain, however, that Goitre is originated by some water impurity, and that 
this contamination is of an inorganic and not of an animal or vegetable 
nature. 

Organic Impurities in Water. — A small quantity of organic matter of 
vegetable origin, that is to say, an amount not exceeding three grains to 
the gallon, is not generally found to be injurious, but even very minute 
quantities of organic material of animal origin, especially if this material 
is composed of the waste matters, such as urine or excrement, from man 
or animals, is the great cause of unwholesomeness of water. Probably 
one-fourth of the sickness and death in civilized communities arises di- 
rectly or indirectly from this one cause, and, unfortunately, even when we 
are fully forewarned of this imminent danger to health, it is exceedingly 
difficult, in most thickly populated places, to secure a source of water 
supply with which sewage has not been mingled. 



DISEASES FROM IMPURE WATERS. 153 

Effect of Metallic Impurities. — The effects of minute traces of metallic 
substances in drinking water have not yet been ascertained with sufficient 
accuracy, but it is quite possible that the entire sanitary condition of a 
district may depend in some measure upon impurities of this description. 
Mr. Wanklyn suggests that the well-known salutary effect of what is 
called change of air may be, in reality, partly due to the escape from some 
extremely small metallic impurity in the water of the section of country 
from which removal takes place. 

Cause for Bright's Disease. — It has long seemed probable that the 
increasing prevalence of that terribly fatal malady, "Bright's disease," 
especially in cities and large towns, may be due to the poisonous effects of 
exceeding minute quantities of lead, dissolved from the lead pipes so 
generally employed as service-conduits, notwithstanding the protective 
coating which usually forms so promptly upon them. 

Lead Poison in Water — These are probably very common throughout 
our whole country, and, contrary to what at first sight might be imagined, 
it is likely that lead much more frequently and seriously affects the health 
of people inhabiting small villages and country houses, than that of resi- 
dents in cities, notwithstanding the latter constantly use water which is 
brought into their houses through long lines of lead service-pipes. The 
explanation of this seeming paradox is that river-water, which is that 
usually supplied to citizens, contains in almost all cases a small amount of 
the sulphate of lime, sulphate of magnesia, or some other compound of 
sulphuric acid, which, when brought in contact with the lead pipes, is 
decomposed, and the resulting sulphate of lead which is formed has the 
happy faculty of clinging to the inside of the pipes where it is produced, 
and thus constituting an insoluble lining, which not only protects the tube 
from further corrosion, but also, what is of far greater importance from a 
sanitary point of view, prevents any further contamination of the drinking 
water which flows through the conduit. 

Lead Poison in Rural Districts. — In rural districts, on the other hand, 
wherever rain-water is used for drinking purposes, it is exceedingly liable 
to be contaminated with lead from lead-lined cisterns, lead service- or 
collection-pipes, lead roofs, or from the solder of tin roofs. As a rule, 
the purer the rain-water, the greater is its action on lead with which it 
stands in contact; hence, therefore, the presence of a minute quantity of 
some salt of sulphuric acid in water is of very great importance, and 
serves as an invaluable protection against lead-poisoning to the human 
beings and animals who may employ it for drinking purposes. 



154 WATER IN ITS HYGIENIC RELATIONS. 

How Lead Poisons Water. — When pure water recently boiled is placed 
in, or run over, lead, no action takes place ; but if the water, after being 
boiled, is exposed for a short time to the air, from which it absorbs oxygen 
and carbonic acid, and is then brought in contact with lead, we soon find 
that a whitish film, which on chemical examination is found to be com- 
posed of the carbonate of lead, is formed upon the metallic surface. This 
whitish film, which easily separates from the lead on which it appears, 
and becomes mechanically mixed with the water, is very poisonous. Since, 
as already mentioned, rain-water contains usually some nitric acid, in 
addition to the oxygen and carbonic acid which it absorbs from the air, 
and this nitric acid combines with lead to form a very soluble and poison- 
ous nitrate of lead, it is much more dangerous than even pure aerated 
water, after standing for a short time in contact with a leaden surface. 
Rain-water intended for drinking or cooking purposes ought, therefore, 
never to be collected from lead or tin roofs, transmitted through lead 
pipes, nor under any circumstances stored in lead-lined cisterns of any 
kind. 

Virulence of Lead Poison. — In the celebrated case of the accidental 
poisoning of the ex-royal family of France, at Claremont, by lead which 
was taken up in the drinking water, the amount was found not to exceed 
one grain of metal to the gallon of water. From cases which have 
since been observed, it would appear that the habitual use of water con- 
taining one-tenth or even one-twentieth of a grain per gallon, is some- 
times attended with danger. In his investigation into the cause of that 
curious disease, as it was formerly considered, the Devonshire colic, Sir 
George Baker, who discovered that it was only a form of lead-poisoning 
due to the drinking of cider fermented in lead-lined vats and troughs, 
found that eighteen bottles of cider he examined contained four and a 
half grains of lead, or a quarter of a grain to each bottle. 

Lead Palsy. — Under some special circumstances, not at present well 
understood, extremely minute amounts of lead in water may prove in- 
jurious. Thus, for example, Dr. Angus Smith speaks of cases in which 
lead-paralysis, or palsy, was apparently produced by water containing 
only one one-hundredth of a grain of lead to the gallon. 

Detection of Lead in Water — The method of detecting the probable 
presence of lead in a sample of drinking water is so simple that every 
reader is advised to take the first opportunity of examining their own 
water-supplies, and so making sure that, they or their families are not 
liable to the insidious dangers of lead-poisoning. In order to determine 
whether a water is contaminated with lead, all one has to do is to drop 



LEAD POISOX IX WATER. 155 

two or three drops of the solution of sulphide of ammonium into the 
suspected fluid, contained in a white howl or large cup, and observe 
whether a brownish or yellowish coloration is produced. If the liquid 
remains perfectly clear and colorless you may he sure that it either con- 
tains no lead, or that such a metallic impurity is present in a quantity of 
less than one-tenth of a grain to the gallon, an amount which is not gen- 
erally injurious to health. If, however, a slight brownish tint is produced 
in the water which is being tested, it must not be too hastily condemned 
as poisoned, since either copper or iron might give rise to the same 
coloration with the reagent. Such a suspicious water ought, however, to 
be promptly analyzed by some good analytical chemist before being em- 
ployed for either cooking or drinking purposes any further. 

Applying the Test for Lead. — The sulphide of ammonium may be 
purchased at a small cost, say for twenty-five cents an ounce, of most 
dealers in chemicals ; and, as its odor is extremely disagreeable, it should 
be kept carefully corked until the moment it is used. The experiment 
should be made upon half a pint of the suspected water; and, if the 
contamination is supposed to be caused by lead pipes, it is a good plan to 
test a portion of the liquid which has stood over night in the conduits. 
The mode of discriminating the precipitate caused by iron from those 
due to the dangerous metals, lead and copper, is to let fall a few drop 
of hydrochloric acid, called also muriatic acid, into the fluid. If the 
brownish or yellowish-brown tint disappears, we may know that innocent 
iron is the only metallic impurity ; whilst if, on the contrary, no change is 
effected by the addition of the acid, one of the poisonous metals, lead or 
copper, is present. No water, however, in which the slightest tinge is 
produced by adding the sulphide, of ammonium, should be swallowed by 
man or beast until a rigid investigation by a competent water-analyist 
has proved it to be harmless. 

Difficulty of Obviating Lead Poisoning. — Attempts have been made to 
obviate the danger of water contamination from lead pipes in various 
ways, but not as yet with complete success. In some instances 'the pipes 
have been lined with other metals, such as tin or zinc; but, at least in 
some instances, a galvanic action has thus been set up, which corroded 
the conduits with great rapidity, and probably led, therefore, to still more 
dangerous pollution of the water supply. Coating the pipes on the inside 
with coal-tar. bituminous varnish, solution of gutta-percha and of India- 
rubber, have also been experimented with, as yet with but partial success. 

Lead Diseases. — The injurious effects of lead upou the human system 



15 G WATER IN ITS HYGIENIC RELATIONS. 

are displayed first, in the production of dyspepsia; later, obstinate con- 
stipation and a peculiar kind of colic, so common among painters from the 
influence of lead that it has received the name of "painter's colic;" and 
finally, disturbance of the nervous system, especially that peculiar form 
of lead-palsy called wrist-drop, in which the power to lift up the hand is 
more or less completely lost. 

Iron in Water. — The presence of iron in a water, rendering it what 
is called Chalybeate, from the old Greek name for iron, renders it to many 
persons only a useful tonic, but in some people it causes severe headache 
and serious disturbance of the digestive organs. 

Arsenic in Water. — Arsenic, copper and mercury are rarely found 
in drinking waters in America, except in streams flowing near chemical 
works, or unless they are introduced designedly with some murderous 
intention. These metals may, therefore, be practically ignored in the 
consideration of water from a hygienic point of view. 

Infectious Diseases from Impure Water. — The principal acute diseases 
which are due to impure water are Cholera, Typhoid Fever, Diarrhoea and 
Dysentery ; and, although it is only within a comparatively recent period 
that mankind has begun to realize its dangers from this source' of these 
maladies, the accumulated evidence is already very conclusive. 

Cholera Due to Impure Water. — Among the remarkable outbreaks 
which go to prove that this mode of cholera propagation is not at all un- 
common, may be mentioned the following, condensed from Mr. Simons' 
eighth report as medical officer of the English privy council, during the 
prevalence of cholera in England in 1865 : A gentleman and his wife 
from the village of Theydon-Bois, in Essex, had been lodging at the town 
of Weymouth for two or three weeks, and returned home towards the end 
of September. On their way home they passed through Dorchester, 
where the gentleman was seized with diarrhoea, vomiting and cramps, 
which continued more or less during the next day and the day following, 
when he reached his own home. During the journey the wife also began 
to complain of pains in the abdomen, which was followed by diarrhoea and 
eventually by cholera, from which she died. 

Cholera Infection. — A few days after their return the same terrible 
disease rapidly attacked other members of the household, so that, within 
a fortnight, in that one little circle, eleven persons had been seized with 
cholera, including the mother, father, grandmother, two daughters, son, 
doctor, serving-lad, serving-mlaid, laborer and country-woman, and of 
these eleven only three survived, namely, the son, a daughter and the 



TEST FOR LEAD POISON. 157 

serving-lad. Later, in the country-woman's family, there was another 
fatal case. It cannot well be doubted, concluded Mr. Simon, but that the 
exciting cause of this succession of events was in some way or other the 
return of the parents from Weymouth — of the father with the remains 
of choleraic diarrhoea upon him, of the mother with apparently the begin- 
nings of the same complaint. But this is only part of the case, and the 
remainder teaches a mpst impressive lesson. All the drinking water used 
in the house came from a well beneath the floor of the scullery, and into 
that well there was habitual soakage from the water-closet. 

Another Case of Infection. — Another famous illustration is found in 
the history of the "tea-water pump" of Broad street, near Golden 
Square, London, which during the cholera visitation of 1854, killed 
nearly 500 persons in a single week, in one of the fashionable localities of 
the city. It has long been known that water containing five or six grains 
of lime and magnesia to the gallon is much to be preferred for making tea 
to water of any other quality. This is because the lime precipitates the 
astringement matter of the leaf, yet does not interfere with the solution 
of the desirable constituents; and hence certain wells which have this 
proper proportion of mineral matter come to be valued very highly by 
persons of nice taste. 

The Famous London Pump — At any rate, the Broad street pump had 
in London the reputation of furnishing, in its cold sparkling waters, 
a better medium for "the cup which cheers but does not inebriate," than 
was elsewhere to be found. When the cholera invaded this neighborhood 
the wealthy resident retired to the fashionable suburbs which were still 
uninfected; but, to the surprise of many, the cholera broke out among 
them with terrible severity. The health officers soon discovered, however, 
that those who were attacked had sent in every day to their favorite Broad 
street pump for their water-supply, and, by removing the pump-handle, 
they quickly put an end to the epidemic. 

Avoiding Cholera. — A first and highly important warning, therefore, 
which these and mfany other similar occurrences give us is never to drink 
any water which, by any possibility, could have become contaminated 
with the smallest particle of discharge from the bowels of a person suffer- 
ing from cholera or choleraic diarrhoea. 

Typhoid Fever from Polluted Water. — The remarks which have been 
already made with regard to the influence of impure water on the spread 
of cholera, apply still with greater force to the causation of typhoid fever. 
So common is this mode of propagation that the assertion may be ventured 



158 WATER IN ITS HYGIENIC RELATIONS. 

that few readers of these pages have not lost some near relative or beloved 
friend from this dreaded disease arising in this way, although the true 
source of the infection was perhaps, at the time it occurred, quite un- 
suspected. 

Spread of Typhoid. — Sir William Jenner, than whom no higher medi- 
cal authority could well be quoted, in commenting upon this point, says : 
The spread of typhoid fever is, if possible, less disputable than the spread 
of cholera by the same means ; solitary cases, outbreaks confined to single 
houses, to small villages and to parts of large towns, cases isolated it seems 
from all sources of fallacy, and epidemics affecting the inhabitants of 
large though limited localities, have all united to support, by their testi- 
mony, the truth of the opinion that the admixture of a trace of excrement, 
but especially of excrement from a typhoid-fever patient, with the water 
supplied for drinking purposes, is the most efficient cause of the spread 
of the disease, and that the diffusion of the malady in any given locality 
is limited or otherwise, and limited just in proportion as the dwellers 
in that locality derive their supply of drinking water from polluted 
sources. 

Deadly Effect of Water Impurity. — According to the late Dr. William 
Budd, it also appears to be highly probable that, when the poison of 
typhoid fever enters the system by drinking water, infection is much more 
certain than when it is disseminated by the air and is breathed into the 
lungs. In support of this statement, he instances an outbreak which 
occurred in Wales, where out of ninety or a hundred person^ who attended 
a ball, fully one-third was shortly afterward laid up with fever. Although 
the water was not examined, there was satisfactory reason to believe that 
it was polluted with sewage. 

Typhoid Poison from a Well.— In a report of the American Public 
Health Association, Dr. Austin Flint gives an account of an outbreak 
of typhoid fever in Vermont which it was possible to trace, in the 
most circumstantial way, to the poisoning of a well in some such 
method as has been described. A young man traveling through that region 
by stage-coach was taken ill, and, when he could go no further, was 
left at a tavern in a little hamlet to be. cared for, his illness soon proved 
to be typhoid fever. A small watercourse, in a shallow valley, divided 
the village into two portions, each of which consisted of half a dozen 
houses or less. In a few days new cases of the fever made their appear- 
ance in that part of the hamlet to which the tavern belonged — every house, 



INFECTIONS FROM WATER. 159 

in fact, but one was invaded with this disease — whilst on the other side 
of the stream not a case occurred. It appears that the tavern well, which 
was the only one upon that side of the village, furnished the water-supply 
to all the families belonging there but one. That one family had had a 
quarrel with the landlord of the hotel, had consequently deserted the 
tavern well for a more distant supply of drinking water, and so escaped 
swallowing the specific poison of typhoid fever in the water by which all 
their neighbors were stricken down. 

Typhoid from Milk. — It has also been proven in late years that 
typhoid is transmitted from infected milk, cows have been allowed to 
drink from streams that have had the discharges from typhoid patients 
thrown into them. The germs have been taken into the cows and finally 
into the milk. This milk was distributed to families and in many cases 
caused typhoid. 

Proximity of Privy and Well — Unless privy and well be located at 
considerable distance from each other, and further unless the nature of 
the ground be such that the flow from the privy will be away from the 
sources of the well, there is always grave danger of the pollution of the 
well water with germs from the privy. This also applies to nearby 
stable yards. There are many authenticated cases of typhoid which have 
been directly traced to the proximity of wells to privies and stables, and 
the danger should not be underestimated. 

Danger in Farm-houses from Polluted Water. — Of course, the same 
conclusion holds good for country farm-houses or dwellings when, from 
motives of convenience, although there is space enough and to spare, 
but a short distance is interposed between the sides of the hole which is 
called the well, and which furnishes the drinking water, and the other 
hole nearby which is called the cess-pit, and used as a receptacle for filthy, 
often poisonous, excrement. Moreover, there are no doubt many instances 
where, owing to the inclination of beds of sand or gravel, strata of rock 
and so forth, impurities of these and other dangerous varieties may be 
carried, by underground currents, much further than the distances which 
have been mentioned as measured upon the surface of the earth. In 
other words, a cess-pool on a hill-side, 500 feet or more away from a well, 
may infect the water of the latter, if underground currents favor such 
contamination. 

Diarrhoea and Dysentery from Impure Water. — The instances of out- 
breaks of these two diseases from contaminated water-supply are very 



160 WATER m ITS HYGIENIC RELATIONS. 

numerous, and probably most persons can recall examples of this kind. 
The impurities which produce diarrhoea and dysentery are suspended 
earthy matters, such as are found in most river-waters after a rain; sus- 
pended animal and vegetable material; sulphates and chlorides of lime 
and magnesia, and nitrates of ammonia and of lime. Besides the nu- 
merous outbreaks traceable to direct sewage contamination, there are 
several instances recorded of indirect poisoning of a water-supply from 
this source, as in the following curious case. 

Outbreak at Salford Jail. — In the Salford, England, jail there was 
a sudden outbreak of diarrhoea of a choleraic type, which affected more 
than half of the prisoners; while of the officers and their families, who 
were distributed throughout the building, not one was attacked. The 
food of the convicts was examined and found to be good ; it was evident, 
also, that the air did not contain the cause of the disease, because both 
classes above mentioned were under the same conditions in that respect. 
Suspicion was therefore directed to the drinking-water. It was then dis- 
covered that, though ' the water supplying all parts of the prison was 
derived from the same source, there was one cistern for the use of the 
officers, and another covered cistern for furnishing to the prisoners their 
allowance, and that the untrapped overflow-pipe of the latter com- 
municated with an open sewer. On the day of the outbreak of diarrhoea 
in the jail, the water from this cistern was observed to be colored and to 
taste unpleasantly. 

Sewer-Gas Poison — It had obviously absorbed sewer gas, which had 
ascended through the overflow-pipe, and that this had been the real cause 
of the disease was indicated by the fact that the diarrhoea disappeared 
almost as rapidly as it had broken out, when the cistern was emptied and 
the pipe efficiently trapped. 

Diarrhoea in Country Districts. — Dr. Wilson declares that, according 
to his experience, much of the diarrhoea which prevails in country districts 
during the summer and autumn amongst children is due to polluted water, 
drank either as it is drawn from the well or when mixed with milk, fraud- 
ulently or by accident. 

Impure Ice as a Cause of Diarrhoea. — The fact that ice is now used by 
almost all classes to an extent which entitles it to rank rather as a necessity 
than, as formerly, as a luxury of life, renders it important that its purity 
should be as jealously guarded as the water-supply. It is popularly be- 
lieved that water frees itself from dangerous organic matter, as it does to 
a great degree from certain saline contaminations during the process of 



TYPHOID FROM IMPURE WATER. 161 

freezing, and also that the vegetable or animal germs of typhoid and other 
fevers are killed, or at least rendered sterile, by congelation of the water 
in which they exist. Both these ideas are, however, unquestionably er- 
roneous, as has been repeatedly proved by the various experiments which 
ignorant hotel-keepers try without the least intending it, upon their guests, 
on a scale which would make the boldest vivisector stand aghast before 
the suffering inflicted, even if it were only upon the brutes which form 
the subjects of his researches. 

A Case of Impure Ice Poison. — Such was notably the case in an epi- 
demic of intestinal disorder which occurred at the watering-place of 
Eye Beach, N. H. From the account of Dr. Mchols, who attended 
most of the patients, it seems that, early in the season, a mild form of 
disturbance of the stomach and bowels made its appearance among the 
guests of a particular hotel at this favorite summer resort. The symptoms 
were in general giddiness, nausea or vomiting, diarrhoea and severe ab- 
dominal pain, accompanied by fever, loss of appetite and mental depres- 
sion. The well and drainage system of the establishment, which had re- 
cently been put in complete order, was found almost faultless, and the 
milk-supply of unquestionable purity; but on the attention of the phy- 
sician being directed to the stock of ice provided for the guests, conclu- 
sive proof of its dangerous quality was promptly obtained. 

The Contaminated Ice Pond. — Both the house in which the ice was 
stored and the water from the melted ice gave off a decidedly disagreeable 
or even offensive odor. Finally, a visit to the pond from which the ice 
had been gathered disclosed the fact that much of the water in it was 
dark-colored, foul and highly contaminated with filthy marsh-mud and 
decomposing saw-dust. Chemical analysis showed that both it and the 
suspected ice contained a large excess of organic and volatile impurities, 
including four one-hundredths of a grain per gallon of albuminoid am- 
monia. 

Fever Germs in Ice — In Connecticut, the Board of Health informs 
us that, in several instances, attention has been drawn to sewage-con- 
taminated ponds with ice-houses upon their borders, and that several 
isolated cases of typhoid fever, and one death, from the free use of 
ice polluted by sewage, had been recorded in that State. The curious 
natural experiment of the United States steamship Plymouth, elsewhere 
detailed, shows conclusively that fever germs are not infallibly destroyed 
by a freezing, probably not by a zero temperature, and contributes 
11 



162 WATER IN ITS HYGIENIC RELATIONS. 

its share of proof that impure ice, especially when gathered from ponds 
polluted by sewage, may constitute a prolific cause of disease. 

Dangers in Snow-Water — Snow-water, pure and fresh as it seems 
whilst flowing in the sparkling streams which descend snow-capped moun- 
tains in our Western States, may be very dangerous to health in conse- 
quence of organic impurities contained in it. Mountaineers, to whose 
long observation and experience in the wilds some attention is due, at- 
tribute the origin of the so-called mountain fever to the melting of snows 
and the drinking of snow-water. 

Mountain Fever Due to Snow-Water — This disease is apt to prevail 
in the Rocky Mountains in the spring, that is, during May and June, 
when the ice in the streams breaks up and the snow commences melting. 
In one instance, out of a party of 367 officers and men, 110 were affected 
with mountain fever in a few weeks after commencing to drink snow- 
water, which is described by the medical officer attached to the expedition 
as being cold, clear and perfectly free from the alkaline taste generally 
found in waters of that region. 

Ague from Impure Water. — Although the poison of fever and ague 
is probably, as a general rule, conveyed into the human system by the 
bite of mosquitoes, some cases seem to show that it may also enter the 
body by drinking water. 

Diarrhoea Outbreak from Impure Water As general conclusions in 

regard to contaminated water, it may be stated that: 1st. An outbreak 
of diarrhoea arising in a community is almost always owing to impure air, 
impure water, or bad food. If it affects a number of persons suddenly it 
is probably due to one of the last two causes, and if it extends over many 
families, almost certainly to water. But, as the cause of impurity may be 
transient, it is not always easy to find experimental proof. 

Dysentery Outbreaks from Impure Water. — 2d. Diarrhoea or dys- 
entery constantly affecting a community, or returning periodically at 
certain times of the year, is far more likely to be produced by bad water 
than by any other cause. 

Cholera Outbreaks from Impure Water.— 3d. A very sudden and 
localized outbreak of either typhoid fever or cholera is almost certainly 
owing to the introduction of the poison by water. 

Malarial Outbreaks from Impure Water, — 4th. The same statement 
is true in cases of ague or malarious fever; and, especially if the attacks 
are serious, a possible introduction by foul water should be carefully 
inquired into. 



DISEASES DUE TO IMPUKE WATEB. 163 

Worms from Impure Water. — 5th. The introduction of the eggs of 
some of the intestinal worms, by means of drinking water, is proved in 
some instances and rendered highly probable in many others. People 
residing in districts where shallow-dip- and draw-wells are in common use, 
seem to be particularly subject to parasitic worms in the bowels. 

Pure Water a Sanitary Necessity. — 6th. Although it is not possible 
at present to assign to every impurity in water its exact share in the 
production of disease, or to prove the precise evil influence on the public 
health of water which is not extremely impure, it appears certain, says 
Dr. Parkes, that the health of a community always improves when an 
abundant and pure water-supply is given; and, apart from this actual 
evidence, we are entitled to conclude from other considerations, that 
abundant and good water is a primary sanitary necessity. 

.Bocks Yielding Pure Water. — As a general guide to the water im- 
purities that may be expected in waters from the various geological forma- 
tions enumerated, the following condensed summary of the best known 
facts, as given by Dr. Parkes, will prove useful. The granitic, meta- 
morphic, trap-rock and clay-slate waters are generally very pure, often 
not containing more than from two to six grains per gallon of solid matter, 
which is chiefly made up, of carbonate and chloride of sodium, with a little 
lime and magnesia. The organic matter is very small in amount usually, 
but shallow wells in disintegrated trap-rock may, of course, be fouled by 
surface washings or soakage. The water from millstone grit and hard 
oolite is also very pure, sometimes containing only four grains per gallon 
of mineral matters, which comprise the same saline materials as are found 
in granitic waters, with the addition of sulphates and a- trace of iron. 

Kocks Yielding Impure Water. — Soft sand-rock waters, on the con- 
trary, are often impure, containing much sodium chloride or common 
salt, sodium carbonate, sodium sulphate, iron and a little lime and mag- 
nesia, amounting altogether to from thirty to eighty grains per gallon. 
The organic matter may also be abundant ; that is, to the extent of from 
four to eight grains to the gallon, or even more. Occasionally, however, 
these waters are quite pure. 

Sand and Gravel Waters — The loose sand and gravel waters also vary 
much in their composition, and in tolerably pure gravels, not near towns, 
the water is often very free from contamination. In many sands, which 
are rich in salts, the water percolating through them is, of course, much 
affected, the dissolved solids amounting sometimes to seventy grains per 
gallon, and consisting of sodium chloride, sodium carbonate, sodium sul- 



164 WATER IN ITS HYGIENIC RELATIONS. 

phate, with calcium and magnesium salts, and a good deal of organic 
matter. The water from the sandy plains of southern France is said to 
contain enough organic matter to produce ague in those who drink it. 

Chalky Waters. — The typical "hard" water, from chalk formations, 
is very sparkling and clear, highly charged with carbonic acid, and con- 
tains from seven to twenty grains of calcium carbonate, a little magnesium 
carbonate and sodium chloride, with small and immaterial quantities of 
iron, silica, potassa, nitric, sulphuric and phosphuric acids in combination ; 
organic matter is usually in small amount, and is therefore a good, com- 
paratively wholesome and pleasant water, which, though hard, softens 
greatly by boiling. 

Limestone Waters. — The waters from limestone and magnesian lime- 
stone regions are also clear, sparkling liquids, of agreeable taste, but they 
differ from the chalk waters in that they contain usually more calcium 
sulphate, the sulphate of lime or gypsum, sometimes to the amount of 
twelve grains per gallon, and in dolomitic districts much magnesium sul- 
phate and carbonate. They are not so wholesome as the chalk waters, are 
hard and soften less on boiling. 

Clay Waters. — The water of clayey districts is chiefly surface, and 
soon runs into converging streams. They often contain much suspended 
matter in the form of mud, but few dissolved constituents. Waters from 
the mixture of sand and clay brought down by the rivers, perhaps of 
former ages, and called Alluvium, are generally impure. 

Alluvial Waters — The alluvial waters contain calcium carbonate and 
sulphate, magnesium sulphate, sodium chloride and carbonate, iron, silica, 
and often much organic matter, the total amount of solids reaching 120 
grains or more. Occasionally the organic matter oxidizes rapidly into 
nitrites, and, if the quantity of chloride of sodium is large, it might be 
incorrectly supposed, from analysis, that it was contaminated with sewage. 

Surface Waters. — Surface and subsoil waters are often highly impure, 
and, although very variable in composition, are always to be regarded 
with suspicion until proved to be safe. 

Soil Waters. — Some soils contain potassium, sodium and magnesium 
nitrates, and give up these salts in abundance to water which soaks through 
them. In towns, and among human habitations, the surface and shallow- 
well water is often very unsafe, as already explained. It may contain 
large quantities of calcium and sodium nitrates, nitrites, sulphates, phos- 
phates and chlorides. Organic matter exists often in large amount and 
slowly oxidizes, forming nitric acid and ammonia. 



QUALITY OF VARIOUS WATERS. 165 

Marsh Waters. — Marsh-water always contains a large quantity of 
vegetable organic matter, it being not unusual to find f roni twelve to forty 
grains per gallon, and sometimes even more. Suspended organic matter 
is also common, but the amount of saline impurity is very variable. 

Poisoned Waters from Graveyards. — In water from graveyards, am- 
monium and calcium nitrites, and sometimes fatty acids, with much 
organic matter of animal origin, are met with. The water of a well at St. 
Didier, France, more than 300 feet from a cemetery, was found to be 
largely contaminated with ammoniacal salts and organic matter, which 
was left on evaporation. The water was clear at first, but had a vapid 
taste ad speedily became putrid. 

Artesian-Well Waters. — Artesian-well water varies greatly in com- 
position, being so highly charged with saline matter sometimes that it is 
quite undrinkable. The artesian Avell at Grenelle, France, contains 
enough sodium and potassium carbonates to render it alkaline to the taste, 
although it is used for the water-supply of the town. In some cases 
artesian-well water contains an appreciable amount of iron; in other 
instances, when drawn from the lower part of the chalk formation, or the 
green sand below it, it is tolerably pure. The temperature of the water 
is usually high in proportion to the depth of the well. Thus, for example, 
a well at Louisville, Kentucky, bored to the, depth of over 2000 feet, 
discharges an immense volume of water, the temperature of which is 
75 degrees Fahrenheit. The amount of air in the water of deep artesian 
wells is often small, and this circumstance, with the frequently elevated 
temperature and high degree of saline impregnation, is apt to make such 
wells very unsatisfactory as sources of water-supply. 

Seashore-Well Waters. — Lastly, water from wells near the seashore 
is apt to be brackish and objectionable on that account, even though it 
does not contain much organic matter. Dr. Parkes mentions one instance 
where a bored well, 150 feet deep, near the sea, yielded water impregnated 
with 500 grains of solids, including 380 grains of chlorides, per gallon. 

THE DETECTION OF CONTAMINATED WATER. 

Vigilance Over Drinking- Water. — As a general rule, the examination 
of drinking water, in order to determine its purity, and consequent safety 
as a beverage, involves a chemical and microscopical analysis, which should 
always be made when circumstances permit. Moreover, it must not be 
forgotten that water which is usually pure and wholesome, may be at any 



166 WATER IX ITS HYGIENIC RELATIONS. 

time polluted by the fouling of its source during heavy rains, the occur- 
rence of floods, the alteration in the customary course and flow of sewage, 
manufacturing refuse, and so forth, above or below ground. Constant 
vigilance over the condition of the water-supply is, therefore, exceedingly 
necessary to health ; but as complete investigation requires the, skill of a 
professed analytical chemist, those methods of examination need only 
be described in detail which are especially used as giving us warning of 
danger, with a few of the simpler tests. 

Character of Water Tests. — For hygienic purposes, then, we examine 
water in order to discover whether it contains any suspended or dissolved 
ingredients which are likely to be hurtful. Some saline materials often 
found in water, as already mentioned, are not injurious when present in 
small quantities only, whilst others, consisting of or resulting from putre- 
fying animal matter, are at once recognized as very dangerous to health. 
In any instance, reliance must not be placed upon the results of single 
tests, but all the circumstances of the case must be searched out and care- 
fully considered. 

Green Waters. — Green waters generally owe their color to vegetable 
matters, chiefly microscopic plants, and are usually harmless, although 
certain bluish-green plants of this kind give rise to the disagreeable smell 
popularly denominated the pig-pen odor, and probably render the fluid 
unwholesome as well as disgusting. 

Yellow Waters. — Yellow or brown waters are the most to be feared, 
as their color is often due to animal organic matter, such as sewage. It 
is sometimes the case, however, that a yellow or brown tint is due to de- m 
composed vegetable material, such as peat, or decayed wood, and the fluid 
is then merely unpleasant and not hurtful. Water is also occasionally 
colored in this way by some salt of iron, although in most instances the 
metal is precipitated as oxide of iron in the sediment. 

Microscopic Tests. — The lustre or brilliancy of a water, which is 
recommended as a good test as to the amount of air which a specimen 
contains, can readily be judged by the eye; but the only satisfactory 
examination of the sediment must be made with the microscope, which 
ought to have a power of about two hundred and fifty diameters, although 
even an instrument of half that capacity will often reveal much of interest 
and importance in the deposit of a suspected drinking water. 

Taste Not a Good Water Test.— The taste of a water is a very uncer- 
tain indication in regard to wholesomeness. Of course, any badly-tasting 
water ought at once to be rejected, but some very agreeable waters, as far as 



COLOR TEST OF WATER. 167 

their tastes are concerned, have proved to be dangerously contaminated 
with sewage of the vilest character. And yet many people are to be 
found all over the country who think that if a water is bright and clear it 
must be good ; nay, if it is the drinking fluid of their own wells which is 
called in question, they will often indignantly resent the faintest sugges- 
tion that it can possibly be in the least degree injurious to health. As 
remarked by Dr. Fox, however, such cases as that of the servant who, 
coming from an obscure village near the Dartmoor, in the southwest part 
of England, objected to the pure water of a distant town where she was in 
service, because it was devoid of both taste and smell, are becoming rare. 

Where Taste Test Fails — As regards dissolved mineral matters, taste 
is of little use, and differs in different persons. On an average, 
common salt is not recognized until it reaches the quantity of seventy-five 
grains per gallon, whilst carbonate of lime is perceptible when dissolved 
in a water to the amount of ten grains per gallon ; iron, however, can be 
recognized by its astringent flavor in very small quantities, occasionally 
as minute an impregnation as two-tenths of a grain per gallon may be thus 
detected. A permanently-hard water has sometimes a peculiarly insipid 
or slightly saline taste, if the total salts amount to thirty-five or forty 
grains per gallon and the sulphate of lime or gypsum to six or eight grains. 

What Taste of Water is Due to. — The taste of good drinking water is 
due entirely to the gases dissolved ; water nearly free from the hardness 
of carbonate of lime, held in solution by carbonic acid, such as distilled 
water, is not so pleasant as the brisk, highly-carbonated waters ; it may 
be called flat, but it is difficult to define the kind of taste or the absence 
of it. 

Rules for Pure Water. — Although the general characters of a water, 
when examined as directed above, give only an imperfect idea of its value. 
they are yet important when no other investigation can be made. If the 
water be colorless, clear, free from suspended materials, of a good lustre, 
yet not too brilliant, devoid of smell and taste, except such as are recog- 
nized as characteristic of a safe and usable water, we shall in a majority 
of cases be justified in pronouncing it a wholesome drinking fluid ; whilst, 
according to the degree in Avhich it deviates from these characteristics, 
will we proportionately be sustained in regarding it with grave suspicion. 

Chemical Tests the Best. — Visible suspended matter is probably often 
the most dangerous, although there is little doubt that the microscopic 
germs of various diseases may exist in small aggregations without being 
recognizable at all by the naked eye of even the most practised observer ; 



l(3g WATEE IN ITS HYGIENIC RELATIONS. 

and, of course, the metallic impurities, such as lead and copper, for de- 
tecting which rules have already been given, must often escape discovery 
bv any examination which does not include the application of chemical 

tests. 

Nessler Test of Water. — The one of these chemical reagents which 
it would be well to apply in every instance where it is possible to do so, 
is the "Xessler's test," an ounce of which may be procured from almost 
any good chemist for twenty or twenty-five cents. It constitutes a test 
for the products of decomposing animal matters, especially sewage ma- 
terials, including human and animal excrement, and is, therefore, capable 
of giving timely warning against the most dangerous of the common 
pollutions of drinking waters. 

The Ammonia Test. — In the whole round of chemical analysis there 
is no determination which surpasses that of ammonia from putrefying 
animal matter by this method in point of delicacy. It is questionable 
whether any other approaches it. The ISTessler reagent is said to be capable 
of indicating one part of ammonia in twenty million parts of water, and 
even this assertion, surprising as it may seem, is given as an understate- 
ment of the delicacy of the test. Such being the characteristic of this 
way of calculating the ammonia, the great advantage of causing deter- 
minations of organic matter to depend on measurements of ammonia will 
be manifest to every one. 

Form of the Nessler Test. — In order to make use of this reagent, fill 
an ordinary wine-glass or small goblet which will hold from two to four 
ounces, nearly full of the water it is wished to examine, and add three 
or four drops of the Nessler's solution. If a yellow or brown color, or a 
brownish precipitate, be produced, the water contains ammoniacal salts. 
As a rule, this should be regarded as a very suspicious circumstance, and 
should the coloration be well marked, it is almost sufficient of itself to 
condemn the water for drinking purposes. If a milky or curdy precipitate 
is also formed, it shows that the fluid is a hard water, and more or less 
unfit for washing. Should this whitish precipitate be excessive, it hides 
to a certain extent the yellowish color indicative of ammonia, so that it is 
necessary to take a fresh sample of the water, add to it a few drops of 
strong solution of caustic potash or soda, and after the precipitate of lime 
which is thus caused to fall has subsided, test for ammoniacal compounds 
with the Xessler's reagent. 

The Soap-Test of Impure Water. — Clark's soap-test for determining 
the hardness of water is prepared by dissolving a small quantity of soap, 



CHEMICAL TEST OF WATER. 169 

say one ounce in half a pint of a mixture of equal parts of alcohol and 
water. It is used by dropping it into a measured quantity, such, for 
example, as an ounce of the water to be tested, until the fluid when shaken 
begins to form a beady lather — the relative number of drops required to 
produce this effect nearly indicating the comparative degrees of hardness 
of the waters undergoing examination. 

Water Test Should Always be Made — This soap-test may be used to 
decided advantage in all "hard-water" districts, and every one should test 
his water-supply at the earliest opportunity, with it, with the Nessler s 
reagent for organic ammonia indicating pollution by sewage, and with 
the sulphide of ammonium for contamination with lead. And the appli- 
cation of these two latter tests is important, even although the drinking 
water in question has been in use for a long time by various members of 
a family without apparent injury, for many instances are on record in 
medical books where chronic derangements of health have been due to 
impurity of the water taken into the stomach, and yet this source of injury 
has been entirely unsuspected until a chemical examination of the water- 
supply has revealed the insidious origin of the trouble. 

Water Precautions for Travelers. — A wise precaution when traveling, 
especially in unhealthy districts or during an epidemic of any kind, is to 
drink none but boiled rain-water, which you can make sure has not been 
exposed to contamination by lead pipes, roofs or cisterns. To be effectual, 
the boiling ought to be continued briskly for half an hour or longer. 
Rain-water is preferable in limestone regions, because the hard water con- 
taining lime is partially or not at all improved in this respect by boiling, 
and gives rise to serious diarrhoea in many of those unaccustomed to its 
employment. Such hard water is also probably one great cause of the 
very painful calculous disorders. 

HYGIENIC USE OF BATHS. 

Temperature of Baths. — Coming now to the detailed consideration 
of water as applied to the human skin in the form of a bath, in order to 
accomplish the important hygienic purposes described, it is obvious, in 
the first place, that temperature has a powerful influence in this respect. 

Cold Baths. — The range of the cold bath varies more than that of 
any other kind, extending, as it does, from 84 degrees Fahrenheit down 
to 33 degrees of the same scale. The lower temperatures included be- 
tween these limits would, of course, test the endurance of even the 



170 WATER IN ITS HYGIENIC RELATIONS. 

strongest to encounter safely the severe shock which is generally produced 
by the sudden application, and still more the prolonged immersion of the 
body in a water so near its freezing-point; but from 84 degrees to 74 
degrees the reaction required is so slight that few persons who are not 
actually invalids are too feeble to manifest it. 

First Effect of the Cold Bath. — A shock is experienced throughout 
the whole nervous system, more or less severe, according to the lower 
or higher temperature of the fluid, and the contracting effect of the cold 
aids the spasmodic contraction occurring in the small blood-vessels to 
drive the blood to the inner portions of the body, and allow the surface to 
become quickly chilled. 

Second Effect of the Cold Bath. — But if the cold is not too severe, or 
the individual is not exhausted by fatigue, or enfeebled by disease, a 
change in these conditions promptly manifests itself soon after leaving 
the bath, especially if the skin is rapidly dried by friction with some 
absorbent substance. The heart and pulse return to their normal rate 
of movement, the nervous system recovers from the shock which it has 
undergone, the blood flows back to the surface of the skin, and a glow 
of renewed warmth is felt throughout the entire body. 

A Guide to Cold Bathing 1 . — This agreeable change in the condition 
of the circulation and the sensations is called the reaction, and constitutes 
our very best guide to the employment of cool or cold bathing. If the 
water of a bath has been colder than is adapted to the strength of an in- 
dividual's constitution, reaction comes on but slowly, and several hours 
may elapse before the natural balance of the circulation is fully restored. 
In such a case, the hands, feet and nose remain chilly, and also cold to the 
touch of another person. The fingers, lips and indeed the whole face, 
has a bluish tint, and a more or less shrunken appearance. The pulse 
continues weak and slow, and languor and feebleness characterize all the 
movements. Of course, the method of deriving the greatest amount of 
benefit from these indications is for each person to cautiously test the 
power of his system to establish reaction, commencing with a bath of 70 
degrees or 65 degrees, and gradually descending the scale of the ther- 
mometer, as he finds he is able to fully react from the depression produced 
by venturing among its lower depths. 

Time for Cold Bathing. — It is recommended by some authors to resort 
to cold bathing either about an hour before breakfast in the early morning, 
or else late in the evening just before retiring for the night. The early 
morning bath of this kind may do very well for some few people of un- 



HYGIENIC USE OF BATHS. 171 

usually vigorous constitutions, but as a general rule the evening is a better 
time for such a test of strength ; and for many persons the middle of the 
morning, that is to say, about three hours after breakfast, when the first 
meal of the day has been nearly all digested, and the system is fortified 
thereby to bear the shock and establish the necessary reaction after it, 
is decidedly preferable to any other period of the twenty-four hours. 

When to Avoid Cold Baths. — Under no circumstances should a cold 
bath be indulged in either immediately before or immediately after a 
meal, on account of the tendency which its inevitable shock will have to 
produce more or less disturbance in the process of digestion by congesting 
the stomach and intestines. ISTor are cold baths suitable for individuals in 
either extreme of life, because both in infancy and in old age the power 
of developing animal heat is least efficient in its operations, and the 
reaction is accomplished slowly or not at all. 

No Cold Bath After Fatigue. — Protracted labor or exercise, whether 
mental or physical, if so long continued as to leave the body suffering from 
feelings of great weariness or exhaustion, absolutely forbid the use of the 
cold bath. It was under these circumstances that Alexander the Great, 
of Macedon, nearly perished, from plunging after a long and fatiguing 
march into the icy current of the river Cydnus ; an imprudence which, , 
it is said, did actually prove fatal to the German emperor, the aged Fred- 
erick Barbarossa, at the head of his crusading army, seventeen hundred 
years later. In adverting to this latter event an ancient author quaintly 
observes : "No wonder if the cold water quickly quenched those few sparks 
of heat left in him at seventy years of age." 

Duration of the Cold Bath. — The duration of a cool or cold bath must 
vary very much with the temperature of the water. When very cold the 
period of immersion should not exceed one or two minutes, whilst with 
water between 60 and 70 degrees, the duration of the bath may extend 
to a quarter or even half an hour; in every instance, however, we must 
be guided by the completeness of the reaction on coming out of the water. 

Friction After Cold Bath. — Energetic friction of the whole surface 
of the body after bathing is highly beneficial as tending to produce the 
necessary degree of reaction. Active physical exercise, as well as warm 
and stimulating drinks, likewise aid in accomplishing the same desirable 
result. Even when a person is accustomed to the daily use of the cold 
bath, any sudden reduction of strength, such as may result from intem- 
perance in eating, an evening debauch, or excess of any kind, particularly 



172 WATEK, IN ITS HYGIENIC RELATIONS. 

of the sexual powers, or even over-exertion in walking or in field-sports, 
will forbid recourse to it the following morning. 

River-Bathing. — Bathing in rivers is even more to be recommended 
than that in ordinary bath-rooms during the summer season, as the gentle 
exercise of walking to and from the river-side, and if swimming whilst 
immersed in the water, promote the reaction which is so conducive to 
health. Evil consequences are, however, apt to result from river-bathing, 
if the baths are too prolonged, if too violent exertion is indulged in, or if 
the rays of the sun overheat the head of the bather. Dr. Bell states that 
he has seen continued fever, of some days' duration, and violent headache, 
with slight delirium, arise in boys who had thus imprudently exposed 
themselves. 

VARIETIES OF COLD BATHS. 

Cold Sponge-Bath. — There are various ways of employing water in 
cold bathing, according to the force of the current of fluid, the amount 
of surface to which it is applied, and so forth. Affusion and sponging are 
the mildest ways of using cold water as a bath, and there are few persons, 
not actually invalids, who cannot thus employ water, of moderately low 
temperature, with benefit. After the slight depression of the bodily 
warmth, produced by sponging with fluid of 60 or 65 degrees, of course 
but a mild reaction follows, but this is suitably proportioned to the feeble 
energies of debilitated persons. By a repetition of the process a greater 
endurance is developed, and colder water may ultimately be resorted to, 
with correspondingly increased advantage. The cool or cold sponge-bath 
is sometimes of great service in treating typhoid fever, and others of the 
eruptive diseases, as will be explained in the second part of this work. 

The Shower-Bath. — In a shower-bath the water falls in divided 
streams, and thus, being generally distributed over the whole body, gives 
a severe shock to the system ; such a one, should the fluid be of a low tem- 
perature, as only the most vigorous persons can endure. 

The Cold Douche.— The cold douche differs from the shower-bath in 
that the water of a douche is poured upon the surface of the body in a 
solid column, instead of a number of small streams. It is sometimes 
highly efficacious in reducing the violent excitement of delirious or insane 
patients, but, being a very powerful agent, should be used only with cau- 
tion and close watching, never in the indiscriminate way cutomary in 
some so-called hydropathic establishments, from which it is said that more 
than one sudden death has been the lamentable result. 



COLD BATHING. 173 

The Bath for Old Age. — The advance into old age of those who, in 
the vigor of youth and maturity, have accustomed themselves to the regu- 
lar use of the cold bath, does not necessarily interpose an obstacle to the 
continuance of the practice of bathing, provided the general health re- 
mains good. But if there be evidence of feebleness of the functions, or 
disorder in any one of the great systems of the body, such as the digestive 
apparatus, or the muscular system, so as to prevent the customary allow- 
ance of nutritious food or of exercise being taken, the cold plunge or 
shower-bath should be given up, and simple washing with cold water, 
followed by active friction, substituted in its place. Should even this 
prove rather too great a shock for the enfeebled powers of life, as may be 
evinced by want of prompt reaction subsequently, recourse to anything 
but the tepid or warm bath must be strictly prohibited. 

The Water-Cure. — The evidence in favor of great benefit being de- 
rived in suitable cases from the so-called water-cure, in the numerous 
hydropathic establishments of Europe and this country, is very convinc- 
ing ; and, in fact, it is probable that persons generally of great mobility of 
temperament, who are readily excited and readily depressed, and whose 
nervous system is soon exhausted by either bodily or mental efforts, will 
often find relief in the systematic use of a moderately cool or cold bath. 

Objection to Hydropathy — The difficulty is with establishments of 
this kind that, being carried on as business enterprises, their proprietors 
are not withheld, by any philanthropic considerations, from looking at 
every case which applies to them with an eye to business, and recommend- 
ing their particular cure to all possible patients, except where they are 
very sure that positive injury will result from the treatment. It is there- 
fore advisable, in every instance, to consult some reputable physician, who 
is not devoted to any exclusive system or dogma of medical practice, 
before submitting oneself to the powerful agencies of water as applied by 
hydropathic practitioners. 

Cold Bathing Removes Heat.— Dr. Bell judiciously remarks that there 
is a class of people, who suffer from a sedentary life, devotion to the desk 
in business, or to study, and complain of troublesome heat and dryness 
of the hands, and sometimes of the feet, with accelerated pulse and thirst ; 
their appetite is not good, nor their sleep sound or refreshing. Though 
their systems be actually weaker than usual, yet is there morbid activity 
of the skin, owing, in part, to the vessels of the integument not relieving 
themselves by free and regular perspiration. Cold bathing, by mod- 
erating cutaneous excitement, and relieving the perspiratory organs, re- 



174 WATEB IS ITS HYGIENIC RELATIONS. 

moves the unpleasant feeling of heat and dryness ; and, by sympathy, pro- 
duces nearly correspondent effects on the stomach. 

The Flesh-Brush and Exercise. — The use of the flesh-brush and exer- 
cise in the open air are, it may be supposed, powerful auxiliaries to the 
measures just recommended. 

Cold Bathing for Rheumatism. — There are many persons who, though 
enjoying what is often called full health, are liable to colds, rheumatic 
pains and stitches from any slight exposure to cold or moist air. Their 
vascular and nervous systems are both tolerably excitable, and they are 
readily thrown into perspiration from even moderate exercise or warm 
apartments. In them it is desirable so far to regulate the functions of the 
skin as to moderate its stimulation, and prevent the consequent debility 
which follows this state. Cold bathing accomplishes this purpose, and 
keeps the skin in a less constant condition of excitement, renders it less 
liable to sweat so freely from exposure to external warmth or by active 
exercise, and, of course, prevents the subsequent languor and suscepti- 
bility to morbid and enfeebling agencies. It would be a great mistake, 
in such a case, to talk of the tonic action of cold bathing. Its beneficial 
operation is evinced here at a time when no stimulus or tonic is admissible, 
and in habits sanguine and plethoric, on which nearly similar effects with 
those from cold bathing would be produced by a moderate bleeding, re- 
duction of the usual quantity of food and diluent drinks. 

HYGIENIC APPLICATION OF WABM BATHS. 

Temperature of Warm Bath — When the water used for bathing has 
a temperature of from 92 degrees to 98 degrees Fahrenheit, it produces 
upon the skins of most people the sensation of warmth, and although water 
of this degree of heat is usually employed chiefly for cleansing- purposes, 
yet it has hygienic properties of a sufficiently marked character to render 
it worthy of especial notice. Since water is a much better conductor of 
heat than air, and especially than confined air, as much caloric is extracted 
from the human body when immersed in water which is only a few degrees 
lower than the average human temperature, as by air of much greater 
relative coldness. 

Effect of Warm Bath — The warm bath diminishes the frequency of 
the pulse, especially when it has been greater than natural, and this effect 
is almost exactly in proportion to the duration of immersion. It also 
renders the respiration slower, and diminishes the temperature of the 



THE WATER-CURE. 175 

body, relaxes the muscular fibre, increases the bulk of the fluids by absorp- 
tion, or perhaps only by restricting evaporation from the skin, removes 
impurities from the surface, promotes desquamation and renewal of the 
cuticle, lessening the hardness of the nails and indurations of the epi- 
dermis. 

Separation of Outer Skin — The separation of the outer layers of the 
nearf-skin or epidermis, which may often be seen floating in small, whitish 
fragments upon the bath water, is due to two causes. In the first place, 
it is softened by the water, and so rendered more easily removable by 
slight friction; and secondly, it is in part pushed off by the increased 
fullness of the blood-vessels underneath. A humorous writer has com- 
pared the epidermis which covers the whole surface of the body to a tight 
shirt, and a dirty cuticle, therefore, to a dirty shirt which is gotten rid of 
by the aid of a bath. 

Take Short Warm Baths. — A prolonged daily use of the warm bath 
is apt to cause eruptions on the skin similar to those which managers of 
water-cure establishments pronounce critical, and of the greatest advan- 
tage in certain diseases of the nervous system. 

Warm Baths Soothe the Nerves. — An immediate and very agreeable 
effect of the warm bath is to soothe a nervously excited condition and 
promote sleep, which to many people is peculiarly refreshing when pro- 
cured by this means. 

Time to Take Warm Baths — The best period for taking a warm bath 
is about an hour previous to the mid-day meal, because then the disturb- 
ance of the circulation will have time to pass off before food is introduced 
into the stomach, and the secretion of the gastric juice and other fluids 
necessary for digestion will not be thereby interfered with. 

Duration of Warm Baths. — The duration of a warm bath ought not 
to exceed in ordinary cases half an hour, although in the warm water-cure 
of Leuk, in Switzerland, patients sometimes remain in the tepid fluid five 
hours in the morning and three hours in the afternoon, with alleged bene- 
fit. In the Leuk bath, persons breakfast from little floating tables, which 
afterwards serve to support books and newspapers for their amusement, 
and it is said that the Emperor Charlemange used to hold prolonged levees 
whilst immersed in his warm bath at Aix-la-Chapelle, which was supplied 
by one of the numerous thermal springs of that famous city. 

Warm Baths in Acute Diseases. — The relaxing and soothing influence 
of the warm bath is an invaluable aid to the treatment of many acute 
diseases, and being, as a general rule, devoid of danger in its application, 



176 WATER IX ITS HYGIENIC RELATIONS. 

is a remedy peculiarly adapted to domestic practice, particularly among 
children, before the skilled physician, who should always be sent for im- 
mediately when a person it attacked with any acute disease, has time to 
arrive. Its prompt remedial effects may often be observed in bilious 
colic, in painter's colic induced by the poisonous influence of lead, in spas- 
modic croup, in infantile convulsions, in mental excitement bordering on 
delirium or even violent maniacal frenzy, and in many other diseases, as 
will be more fully explained in the second part of this book. 

HOT BATHS. 

Temperature of the Hot Bath. — The hot bath is so designated if the 
water employed is above the natural blood-heat of about 98 degrees 
Fahrenheit, and may range as high as 110 degrees, above which it is 
seldom safe to use water over the whole surface of the body. Of course, 
habit will often enable a person to endure the local application of water 
having a much higher temperature than this without injury. 

Effect of Hot Baths. — Hot baths are decidedly stimulating, and rap- 
idly produce redness of the skin with quickening of the pulse and respira- 
tion. Perspiration is poured out upon the face in great abundance, the 
mind becomes dull and inattentive, and, if the immersion is unduly pro- 
longed, vertigo and apoplexy may supervene. One experimenter lost, dur- 
ing the short space of eight minutes, in a bath of the temperature of 
113 degrees, about a pound and a half of his weight. Even a hot foot- 
bath of 110 degrees is stated in one case to have quickened the pulse from 
seventy-seven to ninety-two, and to have caused some headache in about 
half an hour. In another instance a foot-bath of 113 degrees raised the 
pulse from sixty to one hundred and five beats per minute in five minutes, 
and flushed the face, but without bringing on headache. 

Where Danger Lies. — The hot bath ought therefore to be employed 
cautiously or not at all by persons of sanguine temperament, and those of 
robust or plethoric habit of body, especially if there is any hereditary 
tendency to apoplexy in their families. 

Where Good is Derived. — This powerful remedy is, however, capable 
of doing good service in conditions of torpid, sluggish circulation, dry and 
cold skin, feebleness of muscular movement, and a low grade of sensi- 
bility ; but great care must be used not to mistake this state of the system 
in an individual naturally weak and phlegmatic, or enfeebled by old age 
or chronic disease, for the languor of the vital processes which is pro- 



HOT BATHS. 177 

duced by acute inflammation, or pressure of the blood upon the brain 
or upon the lungs. 

When to Avoid Hot Baths. — In suspended animation from sunstroke, 
apoplexy, insensibility from inhaling noxious gases, or from swallowing 
narcotic poisons, disastrous results might be, and probably would be, pro- 
duced by the application of a hot bath. 

When to Use Hot Baths. — In exhaustion and torpor from exposure to 
intense cold, the hot bath, contrary to popular opinion on the subject, is 
a most valuable remedy. Some recent experiments performed in Eussia, 
in order to determine what is the best way to resuscitate animals which 
have been subjected to such severe cold as to be almost fatal in its effects, 
gave the following results: Of twenty dogs treated by the customary 
gradual method of bringing them into a cold room which was slowly 
warmed, fourteen died; of twenty similar animals introduced at once 
into a warm room, only eight died ; whilst of twenty in an analogous con- 
dition, which were placed at once in a hot bath, all recovered. 

Local Hot Baths. — Hot baths applied locally to small portions of the 
body only, have often proved beneficial in gout and in acute as well as 
chronic rheumatism, and are highly recommended by some authorities for 
the relief of piles, in certain affections of the kidneys, and in some female 
disorders. Sundry modifications of the hot bath, such as the Turkish 
bath, the vapor bath, and so forth, have, under certain circumstances, con- 
siderable value. 

THE HYGIENE OF SEA-BATHING. 

When to Refrain from Sea-Bathing. — The long line of seacoast belong- 
ing to the United States, and the large proportion of our population which 
resides within a day's journey of the ocean, by placing a salt bath within 
the reach of many readers, render the subject of sufficient importance 
to be separately discussed. On paying a visit to the seaside, it is well to 
refrain from bathing, and indeed from exposure to the rays of the sun 
on dry land also, for a day or two if possible after arrival, or until the 
system becomes a little accustomed to the effect of the salt air and the 
surroundings. The rules already given in regard to the time of bathing, 
and especially as to not entering the water for an hour or so before or 
after a meal, ought to be strictly adhered to. 

Duration of Sea-Baths. — The time spent in the water cannot be pre- 
scribed with the same exactitude, since the proper length of a dip in the 
ocean varies very greatly with the temperature of the water and air, the 
12 



178 WATER IN ITS HYGIENIC RELATIONS. 

vigor of the individual's constitution, his temporary condition of health, 
and sc forth. But in the state of the circulation we fortunately have a 
general guide, which every one can readily consult for himself, and quickly 
determine when nature decides that the bath should promptly terminate. 
After the first shuddering inspiration, which is generally produced by the 
application of cold water to the bare surface of the body, with the quick- 
ened pulse and breathing which for a few moments accompany it, the 
pulse, the action of the heart, and the respiration all become slower for a 
short time, and then are again accelerated. 

Signs to Stop a Sea-Bath. — But if immersion in the cold sea-water is 
too long continued, the pulse and the breathing are again reduced in 
frequency, a sense of chilliness comes on, and with this a slight blueness 
of the lips, and of the fingers underneath the nails, makes its appearance. 
The moment this is perceived it should be accepted as an imperative order 
to quit the water at once and restore the lost activity of the circulation, 
which it indicates, by energetic friction of the surface with warm, dry 
towels as speedily as possible. As a general rule, from -Q.Ye to fifteen 
minutes is amply sufficient time to spend in the surf, and it is far better 
to err on the prudent side by coming out needlessly soon, than to prolong 
the bath until the teeth begin to chatter and the fingers have the shriv- 
elled, bluish-white appearance of a washerwoman's hand, thereby risking 
some serious internal congestion afterwards. When the water is unusually 
cold, and especially when the air is also chilly, a bath in the ocean, if 
taken at all, should be correspondingly brief. 

What Sea-Bathers Should Do. — In order to obtain the best results, a 
bather should enter the water whilst he is comfortably warm, and yet 
not in a free state of perspiration. It is a good plan to wet the head and. 
breast first, or after wading only a short distance from the edge, for the 
purpose of avoiding the temporary fullness of the brain, which leaves 
some persons with a dull headache for several hours ; also, if the sun is 
shining brightly, a bathing hat, or other protection for the head and nape 
of the neck, ought always to be worn. 

Adjuncts of Sea-Bathing. — Floating, diving and swimming are ex- 
cellent ways of adding to the pleasure of the sea-bath, but the latter should 
not be indulged in when the surf is very heavy, when the tide is running 
out, or when there is a strong current nearly in a line with the margin of 
the beach, as the latter may diverge a little from the coast, and carry the 
bather too far out to sea before he is aware of his danger, 



INDEX TO PART III OF BOOK HI 

Preventive Medicine 
Pure Air Necessary for Health 

Part III of Book III deals with effects of air 
upon health and shows the necessity of taking every 
possible precaution to secure pure air in the home. 

SUBJECTS OF THE TEXT 



Air, Action of Impurities of 186 

Air, Bacteria in 187 

Air a Blood Purifier 181 

Air Changes, Frequency of 196, 197 

Air, Composition of Pure Air 182 

Air and Consumption 198 

Air, Contamination by Sewer-Gases, 198 
Air, Fatal Results from Impure Air, 181 

Air, Impurities of 186 

Air, Localities of Pure Air 183 

Air, Necessity of Pure Air 181 

Air Poisoning ' 186, 187 

Air, Qualities of Pure Air 182 

Air, Quantity for a Room 195 

Air, Residual 185 

Airs, Relative Weight of 196 

Anatomy of the Respiratory Tract. . . .183 

Apartments, Size of 195 

Asthma, Grinders' 201 

Bacteria in the Air 187 

Blood Purifier, Air as 181 

Breathing, Frequency of 185 

Change of Air, Necessity of Frequent 

Change 196, 197 

Clothing 187 

Coal Dust as a Cause of Consumption, 200 

Cold Air 187 

Composition of Pure Air 182 

Consumption and Air 198 

Consumption, Coal Dust as a Cause of, 200 

Consumption, Saw-Grinders' 201 

Contamination of Air by Sewer-Gases, 198 

Danger of Saliva-Loaded Dust 200 

Dangers of Neglected Ventilation 198 

Dangers from Wet-Grinding 202 



Diphtheria from Sewer-Gas 199 

Diseases, Match-Makers' 203 

Dust- 
As a Cause of Disease 200 

Coal Dust as a Cause of Consump- 
tion 200 

Danger of Saliva-Loaded Dust 200 

Fume Poison 203 

Grinders' Asthma 201 

Magnetic Plate, The 202 

Match-Makers' Diseases 203 

Mechanical Fan, The 202 

Metal Fumes 203 

Pottery Dust 202 

Saw-Grinders' Consumption 201 

Tobacco Dust 203 

Wall-Paper Poisons 203 

Wet-Grinding, Dangers from 202 

White-Lead Poison 203 

Effects of Temperature 197 

Examples of Sewer-Gas Poison 199 

Fan, Mechanical, for Dust 202 

Fatal Results from Impure Air 181 

Frequency of Air Changes 196, 197 

Fumes, Metal 203 

Fume Poison 203 

Gas Poison, Examples of Sewer-Gas 

Poison 199 

Grinders' Asthma 201 

Grinders' Consumption 201 

Health, Influence of Winds on Health, 192 
Heart Function in the Respiratory 

Tract 184 

Importance of Ozone 194 

Importance of Ventilation 194 



179 



180 



INDEX TO PART III OF BOOK III. 



Impure Air, Fatal Results from 181 

Impurities of Air 186 

Impurities of Air, Action of 186 

Influence of Winds on Health 192 

Larynx, The 183 

Localities of Pure Air 183 

Lungs, The 183 

Magnetic Plate for Metal Dust 202 

Match-Makers' Diseases 203 

Mechanical Fan for Dust 202 

Metal Dust, Magnetic Plate for 202 

Metal Fumes 202 

Natural Ventilation 196 

Necessity of Pure Air 181 

Neglected Ventilation, Dangers of 198 

Origin of Ozone 194 

Ozone — 

Importance of 194 

In Pine Woods 194 

Origin of 194 

Property of Turpentine 194 

Physiology of the Respiratory Tract, 184 

Pine Woods, Ozone in 194 

Plate, Magnetic, for Metal Dust 202 

Poison, Examples of Sewer-Gas 

Poison 199 

Poison, Fume 203 

Poison from Sewer-Gas 199 

Poison, White-Lead 203 

Poisoning, Air 186, 187 

Poisons in Sewer-Gas 199 

Poisons, Wall-Paper 203 

Pottery Dust 202 

Process, Hardening 188 

Property of Turpentine 194 

Providing Against Weather 189 

Pure Air, Composition of 182 

Pure Air, Locality of 183 

Pure Air, Qualities of 182 

Quantity of Air for a Room 195 

Relative Weight of Airs 196 

Residual Air 185 

Respiration 185 

Respiratory Tract — 

Anatomy of 183 

Heart Functions 184 

Larynx, The 183 



Lungs, The 183 

Physiology of 184 

Trachea, The 183 

Room, Quantity of Air for 195 

Room, Sleeping 196 

Saliva-Loaded Dust, Danger from.... 200 

Saw-Grinders' Consumption 201 

Sewer-Gas — 

Avoiding Poison from 200 

Contamination of Air by 198 

Diphtheria from 199 

Examples of Sewer-Gas Poisoning, 199 

Poisons in 199 

Proof of Poisons in 199 

Typhoid from 199 

Vomiting from 199 

Size of Apartments 195 

Sleeping Room, The 196, 197 

Ventilation in 197 

System of Ventilation 194 

Temperature, Effects of 197 

Trachea, The ,. 183 

Tract, Respiratory. See Respiratory 
Tract. 

Turpentine, Property of 194 

Typhoid from Sewer-Gas 199 

Ventilation — 

Dangers of Neglected Ventilation, 198 

Effects of Temperature 197 

Frequency of Air Changes 196, 197 

Importance of 194 

In Sleeping Rooms 197 

Natural Ventilation 196 

Quantity of Air for a Room 195 

Size of Apartments 195 

Sleeping Room, The. 196 

System of 194 

Weight of Airs 196 

Vomiting from Sewer-Gas 199 

Wall-Paper Poisons 203 

Weather Observations 189 

Weather, Providing Against 189 

Weight of Airs. Relative 196 

Wet-Grinding, Dangers from 202 

White-Lead Poison 203 

Winds, Influence on Health 192 



Lungs, The 



LIST OF ILLUSTRATIONS 

...183 J Lungs, Air Passages of. 



184 



PREVENTIVE MEDICINE 



PART III. 
PURE AIR NECESSARY FOR HEALTH 



THE VITAL NECESSITY OF AIR. 

Value of Pure Air. — There are some things in nature of which we 
take but little cognizance, probably from the fact of their apparent sim- 
plicity. Pure air, pure water, pure food are essential and fundamental to 
good health and health to happiness, so we see that our very lives depend 
upon the exercise of principles which we neglect to study and understand, 
possibly on account of other and manifold duties. But nature's laws are 
invariable, and the time comes when dire results follow a disregard of 
first principles. Any one will admit that pure, unadulterated food is 
necessary to health. Pood is converted into blood, which having circu- 
lated through the body is unfit for further use until purified. 

Air a Blood Purifier. — It is through the medium of the air, with its 
life-giving oxygen, that the blood is purified. It therefore follows, logic- 
ally, that air and pure air is necessary to health and, other things being 
equal, the health will be imperfect in proportion to the impurity of the 
air we breathe. It should be our aim to learn much of so important a con- 
dition of health in order that we might, so far as is possible, avoid disease. 

Necessity of Pure Air. — Not only is pure air of value to preserve a 
state of health, it is an absolute necessity. It is true that some persons 
with strong wills and capacious lungs can perform the feat of holding the 
breath, but if they endeavor to prolong the experiment from a minute 
and a half to two minutes the need of breathing becomes so intense that 
control over the muscles of the chest is lost and a deep inspiration must 
be drawn in spite of resolutions to the contrary. If the access of fresh 
air to the lungs is absolutely prevented by external force death speedily 
takes place, the fatal result occurring in from five to fifteen minutes. 
This latter condition is present in hanging and drowning and in some 
forms of croup in children. Pour minutes is the limit of time a person 
can be deprived of oxygen and live. 

Fatal Results from Impure Air. — No better illustration of the fatal 
effects of impure air upon the human svstem can be brought forward than 

(181) 



!£•> PUKE AIR AS A CONDITION OF HEALTH. 

the lamentable history of the Black Hole of Calcutta, a prison in India, 
the horrors of which have rendered it memorable even in that land of 
ferocious cruelty. According to the account of a survivor, 146 persons 
were shut up on a sultry night in June in a prison eighteen feet square, 
furnished with only two small windows, both strongly barred with iron. 
The thirst and oppression of breathing felt by the unhappy prisoners soon 
became intense, and the scanty supply of water brought in compliance 
with their entreaties only made the confusion more terrible, and caused 
several to be trampled to death. This scene of misery proved entertain- 
ing to the brutal guards outside, who supplied them with water that they 
might have the satisfaction of seeing them fight for it, as they phrased it, 
and held up lights to the bars in order that they might lose no part of the 
inhuman diversion. 

Frantic Pleas for Air. — Before eleven o'clock most of the gentlemen, 
who formed about one-third of the whole, were dead, and "air ! air !" be- 
came the general cry. Renewed insults were devised for the purpose of 
provoking the guards to shoot them, and every man had eager hopes of 
meeting the first bullet. About two o'clock in the morning the survivors 
crowded so much to the windows that many of them £ died standing, unable 
to fall on account of the throng. About six in the morning an order came 
for their release ; but at that time, out of the 146 who went into the dun- 
geon ten hours before, only 23 remained alive, and all these miserable 
survivors were in a highly feverish condition, several dying from putrid 
or typhus fever soon afterward. 

We Breathe Out Poison. — Such, then, are the frightful consequences 
of overcrowding together a large number of human beings, and thus 
depriving them of fresh air in such a way that they are exposed to the 
poisons of their own contamination, comprising carbonic acid and the 
secretions from the lungs and skin. Wholesale poisonings by very impure 
air of this kind are fortunately seldom met with, but the gradual injury 
to health and destruction of life-force, produced by breathing an atmos- 
phere slightly contaminated with noxious ingredients, are exceedingly 
common, and probably give rise to or aggravate a large part of the diseases 
to which our flesh is heir. 

QUALITIES OF PURE AIR. 

Composition. — In speaking of pure air we refer to a standard con- 
dition of air. The air is a mechanical mixture of elements. As ordinarily 
met with at the surface of our earth, pure air, when analyzed, is found to 
be composed of seventy-nine parts of nitrogen and twenty-one parts of 



QUALITIES OF PUKE AIR. 



183 



oxygen to every one hundred parts of air. It contains also a considerable 
quantity of watery vapor, a trace of ammonia, and from three to six parts 
in ten thousand of that deleterious gas carbonic acid. Oxygen is the 
active element. If a candle be held in oxygen it would burn more 
brightly than in ordinary air, and so our own lives, if lived in an atmos- 
phere of oxygen, would be more quickly spent. Our tissues would be 
quickly used up. Nitrogen, which forms so large a proportion, acts simply 
as a diluent ; of itself it cannot support life, and a lighted candle held in 
nitrogen gas is quickly extinguished. Carbonic acid gas, or, as it is called, 
carbon dioxide, is normal to the extent of .04 per cent., and though it is 
useless to animals, it is quite as necessary to plant life as is oxygen to us. 

Localities of Pure Air. — As air is rendered impure by respiration, the 
purest air is found in those localities farthest removed from human 
habitation, i. e., on the mountain tops and upon the ocean. When there 
is a tendency to disease or during recovery from a disease residence in 
the mountains or at the seashore is of distinct benefit. 

In order to understand how it is that the breathing in and out of the 
air of a room in time vitiates it, it will be necessary to explain some points 
of the anatomy and physiology of the respiratory tract — and the act of 
respiration. 

RESPIRATORY TRACT. 

Anatomy. — The respiratory tract is made up of the lungs and the air 
passages leading to them. The air passages comprise the larynx or voice 
box, the trachea or windpipe and the bronchial tubes — two in number — 
which are branches of the trachea. 

The Larynx. — The larynx is situated at the 
upper part of the trachea and presents in front 
the prominence known as Adam's Apple. 

The Trachea. — The trachea or windpipe is 
four and a half inches long, and extends from 
the larynx to about the middle of the breast-bone 
or sternum, where it divides into the two bron- 
chial tubes. 

The Lungs. — The lungs, two in number, are 
situated in the cavity of the thorax or chest, one 
on either side of the heart. The lungs are made 
up of lobes, and the lobes are made up of still 
smaller divisions called lobules or little lobes. 
These latter are quite small, one one-hundred 
and twentieth of an inch in diameter, and they The Lungs. 




18-4 



PURE AIR AS A CONDITION OF HEALTH. 



represent the ultimate divisions of the bronchial tubes, which have rami- 
fied and subdivided like the branches of a tree. Surrounding each lung 
and lining the cavity of the chest is the pleura, an inflammation of which 
constitutes the disease known as pleurisy. 

Physiology. — The larynx, trachea and bronchial tubes admit the air 
to the lungs. The larynx, in addition to this function, is the organ of 
voice, being supplied with the vocal cords. Voice is produced by the out- 
going air setting these cords into vibration. The air cells, of which the 

lungs are composed are the 
meeting places of the air and 
the blood for the purpose of the 
exchange of oxygen and car- 
bonic acid. 

Heart Functions The 

heart, which is a thick, strong 
muscular bag ? pumps the blood 
through the lungs as it goes 
round and round through the 
circulation, at the rate of about 
sixteen hundred pints of the 
vital fluid every hour. These 
sixteen hundred pints of blood, 
by being spread out in the fine 
network of delicate tubes in the 
walls of the air : cells, get rid of 
nearly sixty pints of carbonic 
acid, and absorb rather more 
than sixty pints of oxygen in 
that length of time. Upon 
this gaining of fresh oxygen 
and getting rid of stale carbonic 
arid unceasingly, our very lives depend, for, as demonstrated in hanging 
and drowning, if this interchange of the gases in the blood is interrupted 
for even the space of a few minutes death is the effect. 

Unceasing Heart Pumping—Whilst life continues, night and day, our 
hearts must go on pumping dark, purple, venous blood into the lungs, to 
1)0 there purified and changed into red arterial blood by losing its carbonic 
acid and gaining fresh oxygen, which is carried to every part of our bodies, 
as has been just explained, conveying everywhere its own new and vigor- 
ous life. Night and day, too, quite as unceasingly, must the lungs do 




The Air Passages of the Lungs. 



RESIDUAL AIR. 185 

their part, by pumping in fresh air to furnish this requisite supply of 
revivifying oxygen; and, what is almost equally important, they must 
pump out the air which has been partly deprived of its oxygen, and has 
received in its place the worn-out and now deleterious substances got rid 
of by venous blood. This constitutes the pulmonary circulation in dis- 
tinction to the circulation of the blood through various parts of the body 
for purposes of its nutrition which constitutes the systematic circulation. 

Respiration. — The lungs, which contain the air, are not active in the 
act of respiration. The chest cavity enlarges by the contraction of the 
diaphragm and the elevation of the ribs and sternum, so that the chest 
is enlarged in its vertical, its transverse and its antero-posterior dimen- 
sions. With this enlargement the pressure from without is greater than 
the pressure from within, and the air rushes in, thereby distending the air 
vesicles. In expiration the chest-cavity diminishes in the diameters in 
which it has been increased, and, as a result, the air in the lungs is sub- 
jected to pressure, and consequently rushes out. The air that passes in 
and out with each respiration is called tidal air, and is equal to twenty 
cubic inches of air. But, after an ordinary inhalation, it is possible, by 
the exercise of a little effort, to breathe in still more air, to the extent of 
one hundred cubic inches. This is called the complemental air. After 
an ordinary expiration it is still possible to breathe out air to the ex- 
tent of one hundred cubic inches. This is called the supplemental or 
reserve air. 

Residual Air. — After all effort to expel air from the lungs there 
still remains about one hundred cubic inches, called the residual air, from 
the fact that it resides in the lungs. But we must not get the idea that 
this residual air is unchanged, for it is ever being purified. 

Frequency of Breathing — The respirations vary from fourteen to 
eighteen per minute. They are greater during infancy and childhood. It 
is then during respiration that the fresh air, laden with oxygen, is carried 
to the blood to give to the blood its oxygen, and to receive in its place 
carbonic acid. But the air does not meet the blood directly. On the 
outer side of the air cells we have the air, while distributed on its inner 
side we have the small blood-vessels or capillaries which have carried the 
blood to the lungs. So that separating the air from the blood we have, 
first, the walls of the air cells, and second, the walls of the capillaries. 
But these two are so thin and delicate that the exchange can readily take 
place through them. 



186 PURE AIR AS A CONDITION OF HEALTH. 

IMPURE AIE. 

The Impurities of the Air. — The light of modern research has enabled 
ns to know mnch of atmospheric . conditions conducive to disease and 
health, the latter particularly engaging onr attention at this time. The 
impurities of the air are, first, suspended substances and, second, gaseous 
substances. The suspended substances are particles of almost every 
known substance, the most important being sand, dust, soot, pollen, micro- 
organisms of all kinds, particles of food and clothing. The gaseous im- 
purities are carbonic acid, whenever it exceeds .05 per cent. ; carbon 
monoxide; sulphur dioxide; sulphuric, hydrochloric and nitric acids; hy- 
drogen sulphide, ammonia and its compounds, and organic vapors from 
decomposing animal and vegetable matters. 

Action of Impurities of the Air. — The solid impurities act by clogging 
up the air vesicles, thereby interfering with their function. They may 
of themselves be causes of disease, as in the case of micro-organisms. The 
gaseous impurities act, first, by virtue of their own toxic or poisonous 
properties and, second, by the fact that they take the place of the neces- 
sary element, oxygen. Carbonic acid is normal to the extent of .04 per 
cent. As before mentioned, air that we inhale contains twenty-one parts 
of oxygen and seventy-nine parts of nitrogen to every one hundred parts 
of air. On the other hand, expired air contains sixteen parts of oxygen, 
five parts of carbonic acid and seventy-nine parts of nitrogen. If, now, 
we should be placed in a room where the air is unchanged, the air inhaled 
contains a greater percentage than .04 per cent., and is consequently im- 
pure. 

Carbonic Acid. — Carbonic acid is the most common impurity of air, 
and, with its associated organic matters from human or animal breathing, 
pollutes the atmosphere of closed or badly-ventilated apartments in the 
manner already described. Acute poisoning from contaminated air, such 
as took place in the Black Hole of Calcutta, is very uncommon, because 
people who are long shut up in over-crowded rooms always feel such an 
overpowering need of fresh air that they can be prevented only by main 
force from hurrying away from the danger to which they are exposed. 
Nature warns them so emphatically and imperatively to seek a purer 
atmosphere that they become ready to sacrifice everything to obey her 
commands. 

Symptoms of Air Poisoning. — The early symptoms of oppression from 
breathing impure air are too well known to require any lengthened de- 
scription, although the direct connection of many uncomfortable sensations 



EFFECTS OF EXPOSURE TO DRAUGHTS. 187 

experienced in crowded rooms, with the aerial contamination, is not so 
generally understood and appreciated. Among the primary indications 
of physical injury to the blood from inhaling vitiated or "second-hand" air, 
are a disposition to draw long, full breaths, as a result of the stifled or 
almost suffocated feeling which early makes itself apparent. This is 
accompanied, or soon followed, by flushing of the face, throbbing of the 
temples, headache and sickness at the stomach, which may even proceed 
so far as faintness or an actual fainting-fit, as we often see in delicate 
ladies accidentally wedged in crowded lecture-rooms, concert-halls or 
theatres. 

Chronic Effects of Air Poisoning. — The chronic effects of long-con- 
tinued breathing an air which is but moderately polluted are seen in 
a general deterioration of the strength, appetite and digestion, a pallid 
dyspeptic appearance, from want of renewal of the blood. 

Bacteria in the Air. — Bacteriology has explained the cause of many 
diseases., The air is everywhere laden with them. They enter our bodies 
through the respiratory and digestive tracts. If our vitality or resistance 
is sufficient to withstand their invasion we remain in a state of health ; but, 
when the vitality is lowered for any reason, the bacteria invade the system 
and disease results. The bacteria present in the atmosphere are not, as 
a rule, actively disease producing. Those that do produce disease are 
found particularly where the discharges of diseased animals have been 
allowed to collect and dry. These excretions become pulverized and are 
subsequently carried about in the air we breathe. The dried expectora- 
tion of cases of tuberculosis, of influenza, and occasionally of pneumonia, 
produce these diseases in this manner. The boards of health in various 
parts of the country are fast coming to the conclusion that expectoration 
upon the sidewalks, in the street cars, in public halls, and so forth, is a 
menace to the public well-being. In hospitals patients suffering with 
tuberculous disease are obliged to expectorate in special cups or paste- 
board boxes, which are kept covered and subsequently destroyed. Similar 
measures might be adopted in private practice. 

EVIL EFFECTS OF EXPOSURE TO DRAUGHTS. 

Cold Air. — Cold air, and especially cold, moist air, is so often a factor 
in the production of disease that the consideration of this constantly im- 
pending danger to health and its hygienic treatment by the means of 
suitable clothing is very important. 

Clothing. — Contrary to the popular notion, clothing gives no heat 



188 PURE AIR AS A CONDITION OF HEALTH. 

in itself, but only saves the heat of our bodies from escaping into the 
surrounding air, and it does this just in proportion as it is a bad conductor 
of heat. The rate at which our raiment carries off the bodily heat varies 
from that of a thin linen coat, for example, which conveys it away rapidly, 
to. that of a thick fur coat, through which the loss of heat into the sur- 
rounding air is very gradual. Upon this difference in conducting power 
for heat the relative value of different articles of dress depends. 

Why Clothing Comforts. — Much of the comfort that clothes afford is 
due to the fact that they give what is called an "artificial surface" to our 
bodies, on which the cold air can act without our feeling it so much. It 
is the absence of this artificial surface on the bare hands and face which 
makes the fingers, forehead and ears ache so with the cold, sometimes in 
wintry weather, and the reason that people's toes, after a while, often 
ache in the same way, is that the foot-coverings frequently become chilled 
through, so that they no longer do their duty as protectors against loss, of 
heat. 

Hardening Process. — The process of "hardening oneself" consists in 
rendering the skin so used to changes from a warm to a cold air, that its 
blood-vessels and nerves are comparatively little affected by the contract- 
ing influence of the cold. "Making oneself tender," on the contrary, is 
establishing the habit of staying in warm air, and venturing out only when 
well wrapped up, to such an extent that any accidental exposure to even 
moderately cold blasts has a powerful, or even dangerous, effect. Harden- 
ing the skin against the weather is just like hardening the eyes to a bright 
light, or the ears to loud noises. All three may occasionally prove valuable 
accomplishments after they are acquired, but a certain per cent, of the 
people who try to be thus accomplished will lose their lives, or their eyes, 
or their ears, in the process. ~Ko doubt thousands of young girls have 
died of consumption caught in the attempt to harden themselves to going 
with bare arms and bare necks, in the costume absurdly called "full dress" 
by fashionable society. 

Dangers to be Avoided. — In every effort to harden oneself agairrt 
the influence of changes of the air, and likewise in the practice of that 
accomplishment after it is acquired, any saving of clothes is often more 
than compensated for by a waste of extra food used up in maintaining the 
animal heat, through the process of burning up the fatty and starchy 
articles of our diet. Besides this, a great and frequently an unnecessary 
strain is imposed upon the digestive organs, in preparing this extra supply 
of nutriment, and the nervous system is also severely taxed in regard to 
both the digestive and the hoat-regnlating operations, so that study or 



WEATHER OBSERVATIONS. 189 

other mental efforts may be seriously interfered with. Hence the harden- 
ing process should only be applied to our bodies in the most carefully 
considered way, by people who are, at the time the experiment is tried, in 
good health, and those especially who are free from any tendency, in- 
herited or otherwise, to disease. 

When to Venture Out of Doors — As a substitute for hardening oneself 
by exposure to all sorts of atmospheric changes, without carefully regu- 
lated protection, attention to the weather indications, or "probabilities," 
as published every day in the newspapers, has of late years become of 
great importance from a hygienic point of view. In fact, the study of 
sanitary meteorology, as this branch of the science might be called, for 
the purpose of determining what hygienic precautions in regard to cloth- 
ing, ought to be instituted against hot, moist, or cold air, what days or 
what hours convalescent patients, and especially children, may venture out 
of doors, when is the best time for invalids to bear removal, and at what 
periods neuralgic and rheumatic patients must exercise particular care 
against exposure, has a highly practical, and sometimes an almost incal- 
culable value. 

Providing Against Weather. — Any one, by consulting the daily "indi- 
cations" in the public prints, can provide against the weather correctly 
about eight times out of ten, but in order to avoid most of the remaining 
20 per cent, of blunders, it is only necessary to combine the knowledge 
obtained from the signal office predictions with that derived from ob- 
servations upon an aneroid or mercurial barometer, as described in the 
following pages. 

WEATHER OBSERVATIONS. 

Signal Service Bureau. — From the time the great Dr. Johnson uttered 
his famous sarcasm upon observers of the weather, to wit, "A certain set 
of men pass their lives in watching the changes of the weather, and die at 
a good old age with the conviction that the weather is changeable," little 
has been accomplished in rendering us more truly weather-wise, until the 
splendid results attained by our own Signal Service bureau gave a new 
impetus to the study of meteorology. 

Value of Weather Observations. — Few can dispute that not only the 
hygienists of America, but also those of the Old World, are under great 
obligations to our National Government, which, taking timely advantage 
of opportunities never before presented in the history of mankind, has 
utilized them with marvelous success. 

Weather Reports. — These opportunities consist, of course, in the cir 



190 PURE AIR AS A CONDITION OF HEALTH. 

cunistanees, first, that in our American Union there is a larger compact 
portion of the earth's surface inhabited by civilized man, now under the 
same jurisdiction, and controlled by one central authority, than in any 
antecedent epoch; and second, that by the most extended system of tele- 
graphic communication ever organized, it has been possible, during the 
last decade, for the first time in the history of the world, to obtain in- 
stantaneous and simultaneous weather reports from an area of the earth's 
surface occupying the whole breadth of our continent, stretching from the 
thirtieth almost to the fiftieth parallel of latitude, and comprising more 
than three millions of square miles. 

Methods of Observing* Weather. — Over this vast section of country 
signal stations have been established, under the direction of the Weather 
Bureau, at least wherever practicable, and to such extent as the yearly 
appropriation would permit. At these stations three observations are 
taken daily, at the same moment, the hours selected being 7 o'clock a. m. ? 
3 p. m. and 11 p. m., Washington time. 

Weather Maps. — By this plan the changes from hour to hour and day 
to day, as well as the effects which are produced by these alterations, are 
noted, and after these records are forwarded to the central office, they are 
reproduced in a permanent form upon the daily weather map, which is 
transmitted as far as practicable over the country. Here these daily 
maps may justly be entitled "the geography of our atmosphere." With- 
out examining them, we can no more secure an accurate conception of the 
general state of the weather than we could gain a correct idea of the real 
arrangement of seas, continents and islands, as represented upon geo- 
graphical maps, by walking a few miles along the coast, or climbing over 
a range of mountains. 

Storms. — By means of the extensive series of observations, carried 
on through several years by the United States Signal Office, it has been 
discovered that storms occur in areas of low barometer, rounded or oval 
in form, and two or three hundred miles in diameter, which travel across 
our country, from west to east, exactly opposite to the apparent movement 
of the sun in the heavens. The storm therefore is an immense ring or 
oval of wind, cloud and rain, which speeds across the country about as 
rapidly as a fast express train; that is, from about 300 to 600 miles in 
twenty-four hours. 

Direction of Storms. — Such storms usually come to us from the Pacific 
coast, and by having telegraphic messages sent to Washington from several 
of the western stations on the Pacific Railroad, announcing at what time 
the storm reached each one respectively, the observers of the signal office 



WEATHER OBSERVATIONS. 191 

can, of course, tell just how fast that particular tempest is advancing, and 
calculate when it is due in Washington, exactly as the railroad officials 
can tell, if they are informed by telegraph, precisely what time their train 
will arrive from the west. Evidently, after being thus notified, it is an 
easy matter for the Washington authorities to send word to the people in 
the neighborhood to get ready to meet the rain in one instance, or their 
friends at the depot in the other. 

Storm Paths. — The path of an area of low barometer across the con- 
tinent has been aptly compared to the track of an immense water-cart, the 
centre of which is, as a general rule, the line of most violent storm. The; 
average rate of motion for such a storm-centre is 350 miles a day, although 
it may vary from 100 to 1200 miles in twenty-four hours. The winds 
commonly blow from all quarters towards the area of low. barometer, the 
many apparent exceptions being caused by mountain-ranges, valleys, and 
so forth, turning aside the currents of air. 

Barometric Effects. — From this it follows that, when the area of low 
barometer is running on a line of high latitude, the winds felt in places 
on its southern margin will be from the south, and vice versa. That is to 
say, if at any time an area of low barometer is passing through New York 
and New England, the winds in Philadelphia will, in a general way, be 
towards it and from the south; while, on the contrary, at any time when 
a similar area is traveling through Virginia and Maryland, the winds in 
Philadelphia will be from the north, and usually cooler. The exceptions 
to the rule of north winds being cooler and south winds warmer, are 
obviously due to large volumes of cold air or of warm air, respectively, 
having previously been blown to the north or south of a particular position. 

Direction of Barometric Areas — Although the general direction of the 
areas of low barometer seems to be round the earth towards the rising sun, 
their course is sometimes very irregular, as is demonstrated by the daily 
weather maps, which occasionally exhibit them traveling almost due north 
for three or four days, during which excursion they may pass over a dis- 
tance of a thousand or fifteen hundred miles, before they resume their 
usual easterly tendency. The storm, as before remarked, is where the 
area of low barometer is, and as this almost always approaches us from 
the west or southwest, most of our storms really come from that direction. 
Kesarce there is seldom or never a true northeast storm, much as we hear 
$>eeple talk about "northeasters ;" and a northeast wind, with rain, results 
from an area of low barometer situated southwest of us, and, as a rule, 
traveling eastward on a parallel of latitude one or two hundred miles south 
of our position. 



192 PURE AIR AS A CONDITION OF HEALTH. 

Uses of the Barometer. — The use of the barometer is especially seen 
in determining, by its steady and gradual rise, that the edge of an oval 
of low barometric pressure has passed over a particular place. It also 
indicates, by its gradual fall, the oncoming of an area of low barometer, 
although when, as frequently happens, a storm lags behind this area a 
little, rain and wind may be most severe with a rising barometer. The 
indications afforded by barometric observations must therefore be specially 
studied for each particular place, and judicially combined with the daily 
report of probabilities from the Weather Bureau, in order to gain the 
greatest advantage in sanitary meteorology. 

INFLUENCE OF WINDS ON HEALTH. 

Variety of Influences. — Wind or air in movement exercises upon 
human health an influence which depends partly upon its rapidity, partly 
upon the properties which it may have acquired from the land and water 
over which it has passed, and lastly upon its variations. Its influence from 
these various causes may be either accidental or temporary, or durable 
and more profound. Thus, the effect of a cold or damp wind upon an 
individual who is in a free perspiration, as a consequence of active exer- 
cise just engaged in, may be to produce a cold, a sore throat, a bronchitis, 
or an attack of rheumatism, according to the predisposition or weak point 
of the person. Hence, as already insisted upon, every man ought to study 
out carefully his own special aptitudes, under the agency of certain ex- 
citing causes, to the development of particular diseases. This is indis- 
putably the part of wisdom, because it is far easier to avoid these exciting 
causes, which may so readily bring into action the dangerous maladies to 
which we are predisposed, if we are well informed concerning the exact 
defect in our armor against their power. 

Deleterious Influences — A wind, if charged with injurious substances, 
such as the pestilential effluvia of marshes, for example, may carry with 
it the causes of serious alterations in the health. Some such winds pro- 
duce, in countries where they blow, diseases terrible both on account of 
their severity and their persistence, and which cease only with the wind 
which has brought them. Difference in the rapidity of the movement of 
the air gives rise to great variations in its effects. A moderate agitation of 
the air, such, for instance, as a wind moving ten miles per hour, is 
decidedly favorable to the proper performance of the functions of the 
skin, to the energetic exercise of the muscular syptem, and to the main- 
tenance of an agreeable temperature. Nothing, for example, can be 



INFLUENCE OF WINDS ON HEALTH. 193 

pleasanter, nor in their way more healthful, during the exhausting heats 
of summer, than the sea breezes of maritime coasts. 

Sea Breezes. — When cool air is in rapid motion, however, and just in 
proportion to that activity, a great and speedy abstraction of heat from 
the surface of our bodies is perceptible. Air which in repose gave merely 
the sensation of agreeable freshness, becomes cold when in movement, and 
cold air under a similar change of circumstances becomes frigid. 

Hygienic Effects of Air in Motion. — Physiologists have calculated that, 
with dry air in rapid motion, the loss of moisture from the surface of the 
skin is ten times as great as when the air is still and moist. This fact 
explains the necessity of avoiding, as far as possible, exposure of the body 
particularly when perspiring to air in rapid motion, because the dangers 
of chill are thereby greatly increased. On the other hand, a very dry 
wind rapidly parches the skin, checks its secretions, which are so important 
to the maintenance of health, and produces a general feeling of discomfort. 
The exaggerated condition of this prejudicial influence is seen in persons 
exposed to the celebrated sirocco of the Great Desert of Sahara. The 
influence of winds depends not only upon their humidity and their 
rapidity, but also upon the nature of the countries which they traverse. 
The wind which crosses the icy peaks of snow-clad mountain-ranges carries 
with it for a long distance the cold with which it is charged. The town 
of Nice, such a favorite resort for consumptives in the south of Europe, 
would have an almost perfect climate were it not for the fierce and frigid 
wind called the mistral, which occasionally visits it, blowing from the 
summits of the Alps down the valley of the Rhone. 

Effects of Cold Air. — Cold encountered without forewarning may be 
the cause of disease. Too often it is a predisposing cause of disease. Cold 
air may of itself cause disease, as is seen in frost bite, or it may produce 
its results by simply making the system more vulnerable. To illustrate — - 
it was formerly thought that cold was the cause of pneumonia. We now 
know that pneumonia, like many other diseases, is due to a germ. Many 
healthy persons have the germ of pneumonia in^the secretions of the 
mouth. If the vitality or power of resistance is good no evil effects follow. 
Should the same individual be "run down" for any reason and the added 
influence of cold be present the germs are no longer resisted and pneu- 
monia results. 

Benefits of Winds. — But no cloud is without its silver lining, and if 
we but look for it, it may be found. If we examine the subject more 
closely we see that winds are responsible for conditions of health, that 
upon winds or air in motion depends the whole subject of ventilation to be 



194 PURE AIR AS A COSTDITIOK OF HEALTH. 

discussed later. It is by the motion of the air that respiration is possible. 
Impure air is diluted by pure air, and then rendered purer. 

OZONE. 

Among the invisible ingredients of air sometimes found in consider- 
able quantity, but not always present in any appreciable amount, is ozone. 

Origin of Ozone. — Ozone is made up of three atoms of oxygen, whereas 
free oxygen is made of but two atoms. It is therefore concentrated 
oxygen, and by loss of one of its atoms it is converted into free oxygen 
of two atoms. 

Importance of Ozone. — As yet, the researches of medical chemists 
only enable us to state that the test of Shoenbein indicates that ozone is 
more abundant in pure than in impure air; in greater quantity at the 
seashore than in the interior, and in mountain air than in that of plains ; 
absent in the centre of large towns, yet present -in their suburbs ; deficient 
in the air of a hospital ward, yet plentiful in the atmosphere outside. 

Ozone in Pine Woods. — Dr. Xicholson, of Michigan, found in a long 
series of observations that ozone was more abundant in a pine forest than 
in the open country during the summer, but less abundant during the 
winter; less abundant in coal-pits and over swamps than in the open 
country, and less abundant in the night than in the day. 

Property of Turpentine. — The results of these investigations in regard 
to the air of pine woods are in accord with the statements of Dr. Schreiber, 
of Vienna, who declares that the turpentine exhaled from pine forests 
possesses to a very high degree the property of converting the oxygen 
of the air into ozone, and this fact perhaps explains why a continued resi- 
dence among the balsamic odors of the pines has long been credited with 
a favorable influence in cases of consumption. The test for the presence 
of ozone in the air, consisting of paper which has been soaked in starch 
and iodide of potassium, or iodide of calcium, is not reliable. 

VENTILATION. 

Importance of Ventilation. — Having reviewed the serious derange- 
ments to health that impure air might occasion, it behooves us to consider 
some preventive measures to ward off disease. The great remedy against 
impure air is, of course, proper ventilation. 

System of Ventilation. — In arranging any system of ventilation, we 
may assume that the greatest amount of carbonic acid (and its associated 
organic material from the breath) which may be allowed in an inhabited 



VENTILATION. 195 

room, without injurious results, is six-tenths of a gallon in every 1000 
gallons of air, as already mentioned. The first question then is, how much 
fresh air must be supplied every hour for each person in a room, in order 
that this proportion of impurity may not be exceeded % 

Quantity of Air for a Room. — By experiment and calculation it is 
found that, in order to keep up this admitted standard of purity, it is 
requisite that 3000 cubic feet of perfectly pure air should flow into a room 
hourly for every grown person occupying it. Of course, an equal bulk 
of more or less vitiated air must escape to give place to the pure air, and 
this bulk, which must be poured in and likewise emptied out hourly for 
each individual, would be equal to the contents of an apartment thirty 
feet long, ten feet wide, and ten feet high. 

When Increase of Air is Needed. — Such a quantity, large as it seems, 
must sometimes be considerably increased, in order to maintain the requi- 
site standard of purity. For example, when lights are used, and no pro- 
vision is made for carrying away the products of combustion, much addi- 
tional pure air is needed. An ordinary gas-burner consumes the oxygen of 
about twenty-five cubic feet of air hourly, and produces nearly as much 
carbonic acid as ten men would do in the same space of time. Sick people, 
especially those with diseases of the lungs, and those affected with low or 
putrid fevers, should have a larger quantity of pure air; and it has been 
found thai*, unless 3500 or 4000 cubic feet are supplied hourly for each 
patient, hospital wards, for instance, are more or less haunted by offensive 
odors. 

Size of Apartments. — The size of apartments for human habitation 
should be directly dependent, within certain limits, upon the perfection 
of the ventilating and warming apparatus, because, if the room is small, 
it is only by securing a proper delivery of warm air that the occupants 
can receive their allotted 3000 cubic feet per head per hour, without 
suffering from dangerous or unpleasant draughts. For instance, in a 
room containing but 100 cubic feet, the air must be changed thirty times 
hourly, or every two minutes, in order to maintain the atmosphere at its 
standard purity. This would involve the necessity of such rapid currents 
of air flowing through the narrow space that it would be almost unin- 
habitable. 

Objection to Small Rooms. — Besides, when the room is small, it is not 
possible to diffuse equally the air which enters it, because, between the 
inlet and the outlet, a direct current is apt to be established, so that a good 
deal of the fresh air passes right through, without being of any use in 
reducing the amount of impurity. 



196 PURE AIR AS A CONDITION OF HEALTH. 

The Sleeping-Room. — The best authorities assert that, with ordinary 
means of ventilation, the space for every grown person should be not less 
than 1000 cubic feet, and that in this space the entire air should be 
changed three times each hour. According to this rule, a sleeping-room of 
ten feet wide, ten feet high, and twenty feet long, might be allotted to 
two people; and four persons, but no more, should sit, eat or sleep in a 
room twenty feet square and ten feet high, provided it was well ventilated 
in the ordinary way. 

Frequency of Air Changes — If the best ventilating apparatus is em- 
ployed, and the air is warmed to the temperature of about 65 degrees 
Fahrenheit, the air in a room may be changed six times hourly without 
causing annoyance, so that, under such exceptional conditions, an apart- 
ment of less than half the size above mentioned, or twelve feet wide, four- 
teen feet long and ten feet high, would answer for four people. 

Death Rate in Small Lodgings. — The dimensions given above are, 
unfortunately, very much larger than are generally provided in our 
dwelling-houses, and in the crowded lodgings of the poorer classes the 
allowance of space for each person often falls as low as 250 or even 200 
cubic feet. Under the latter circumstances, the increased sick : rate and 
death-rate, and the general aspect of what a celebrated French physician 
graphically describes as "physiological destitution," bear witness to the 
disastrous effects of breathing impure air in confined apartments. 

Natural Ventilation.— A certain amount of natural ventilation, as 
distinguished from artificial ventilation, effected by contrivances especially 
arranged for that purpose, goes on all the time through the many crevices, 
holes and pores of our dwellings, although this supply of air is, as a rule, 
but a small part of what is necessary for our health. It contributes, 
however, to the change which does progress, whilst we sit quietly within 
our four walls without feeling the least draught. 

Relative Weight of Airs. — Since air, like other gases, expands or con- 
tracts according as it is heated or cooled, warm air is, of course, lighter 
than cold air, and tends to escape at the upper part of a room, whilst its 
place is supplied by cold air, which flows in through every aperture in 
the lower portion. The familiar experiment of opening a door leading 
to a cold entry an inch or two, and then holding a lighted candle first near 
the bottom and then at the top of the crack, shows very clearly, by the 
way the flame is blown inward in the first instance, and outward in the 
second, how strong are the currents of air in these two positions. 

Effects of Second-Hand Air — Many persons, especially ladies, are so 
sensitive to the effects of second-hand air in a room, that they can tell 



SLEEPING APARTMENTS. 197 

in a very few minutes, by the sensations in the head and lungs, whether 
an agreeable- amount of ventilation has been provided, by leaving the 
door a little way open, or whether it has been shut tight. 

Effects of Differing Temperatures. — The rapidity with which the neces j 
sary interchange of air goes on through the crevices of our doors and 
windows depends very much upon the difference between the inside and 
outside temperature. This important fact is well illustrated by the fob 
lowing observations of Pettenkofer. He found that, in a room ten feet 
high, ten feet wide and twenty-six feet long, containing 2600 cubic feet, 
when the difference in temperature within and without was 34 degrees, 
the contents of the apartment changed once in an hour, through the ordi- 
nary crevices of the doors and windows. In the same room, with the same 
difference in temperature, but with a roaring hot fire in the stove, the 
change in the air increased about one-fourth. When, however, in the 
same room the thermometer stood at 71 degrees, whilst outside it registered 
64 degrees, leaving a difference of only 7 degrees, ventilation went on 
only at the rate of 780 feet per hour, and even opening a window, the 
aperture of which equalled eight square feet, only increased the ventila- 
tion about one-half, or to 1060 cubic feet. This experiment was very 
instructive, showing, as it does, that a difference in temperature of 34 
degrees, with carefully shut doors, windows and crevices, has as great an 
influence in securing a pure atmosphere as much larger and quite unob- 
structed communications with the outer air, when this latter is of nearly 
the same temperature as that inside. 

Getting Rid of Foul Air. — The quickest way of getting rid of foul 
air in a room is by cross ventilation, or "perflation," as it is sometimes 
called. This is obtained by opening windows on opposite sides of the 
apartment when a moderate breeze is blowing; but it is a method which 
cannot be relied upon, because, if the outside air is stagnant, no ventilation 
is secured ; whilst, on the other hand, if there is a strong wind, the violent 
current of air produced might be unendurable. 

SLEEPING APARTMENTS. 

Ventilating. — In all rooms which are occupied most of the day, and 
in all sleeping rooms, proper ventilation should be secured by artificial 
apparatus specially designed for the purpose, as will be described in the 
section of this book upon Sanitary Architecture. In old houses, until 
proper alterations can be made, the exit of foul air ought to be provided 
for by lowering the windows a1 the top, and the entrance of fresh air per- 
mitted by raising them at the bottom. 



198 PUKE AIR AS A CONDITION OF HEALTH. 

Preventing Unwholesome Draughts — Unwholesome draughts may be 
prevented in the latter instance by the simple device of fastening a board 
across the window-frame on the inside, in snch a way as to direct the 
incoming current air upward toward the ceiling of the room. Dr. 
Keen's arrangement, which is still simpler and equally efficient, is to fasten 
with tacks or pins a piece of cloth, or even strong paper, across the lower 
ten or twelve inches of the window-frame, and then raise the lower sash 
more or less, according to the weather. The convenience of this con- 
trivance is increased if the cloth, instead of being permanently fastened to 
the window-frame, is held in its place by loops of tape, which allow of its 
easy removal as occasion requires. 

Dangers of Neglected Ventilation — If we but stop a moment to con- 
sider we cannot fail to see the necessity of properly ventilating the sleep- 
ing apartments. \Ye are oftentimes surprised at the neglect of these all- 
important matters by intelligent people. If the air of any room becomes 
impure during the day we are at liberty to remove to another, and our 
sense of smell or perhaps a headache indicates when such a change is 
desirable. But during the night the senses are at rest and the individual 
must breathe again and again the foul air of an unventilated room. 

Consumption and Air. — Speaking on the subject of patients suffering 
with tuberculosis or consumption under treatment, Tyson states the more 
nearly the temperature of the sleeping-room approaches that of the out- 
doors the more likely is the patient to improve. The same truth holds in 
cases of health. 

Remove Plants at Night. — Plants should not be kept in a sleeping 
apartment. During the night they do not give off oxygen, hence their 
presence is not needed. It is only under the influence of sunlight that 
the carbonic acid of the air is changed to carbon, which becomes a part of 
the plant, and oxygen which supports animal life. 

CONTAMINATION OF AIR BY SEWER-GASES. 
Dangers from Cess-Pool Germs. — A second great danger of impure 
air arises from its pollution by emanations from sewers and cess-pools, 
which frequently contain the germs of typhoid fever, diphtheria and per- 
haps other complaints, as will be more fully explained under the head of 
Contagion as a Cause of Disease. Dr. Letheby found that sewage-water 
excluded from the air and containing 128 grains of organic matter to the 
gallon, gave off over a cubic inch of foul-smelling gases per hour for a 
period of nine weeks. 



CONTAMINATION OF AIR BY GASES. 199 

Poisons in Sewer-Gas. — Of course, the danger to persons who inhale 
sewer-air, or "sewer-gas," as it is often called, depends very much upon 
whether it is loaded with disease-poisons as well as with foul odors, and 
the instances adduced by well-meaning but ignorant persons, for the pur- 
pose of showing that the emanations from sewers have proved harmless, 
are chiefly cases in which ill-smelling gases happened to be unmixed with 
the poisons of disease. 

Proof of Sewer-Gas Poisons. — It would be just as well to argue that 
because hundreds of ships cross the Atlantic in safety every year, there- 
fore no shipwrecks ever occur, as to contend that, because many people 
breathe sewer-gas with impunity, therefore it is never injurious to human 
health. That some sewer-gas is highly deleterious in its nature is proved 
by the following stubborn facts; and since we have as yet no tests for 
determining accurately the degree to which any particular sewer is in- 
fected with the germs of disease, our safest plan is to cut off all connection 
between the air of our houses and that of those dangerous channels for 
filth and disease-poisons. 

Diphtheria from Sewer-Gas. — Dr. William rT. Thursfield, of Birming- 
ham, England, reports that he traced an isolated case of diphtheria to 
temporary exposure to sewer-gas in a house on a short line of sewer which 
he knew to be specifically contaminated by diphtheria. This sewer, when 
opened and examined by a surveyor, produced in him a severe diphtheric 
attack. 

Typhoid from Sewer-Gas.— Dr. William V. Keating, of Philadelphia, 
has detailed at length four cases of typhoid fever attributed to sewer- 
gas from untrapped drain-pipes, and refers to cases of measles, scarlet 
fever and diphtheria in two other families apparently from the same 
cause. 

Dr. C. W. Chamberlain, of Hartford, relates a remarkable case of 
fatal erysipelas which was seemingly due to sewer-gas from a waste-pipe 
carelessly left open beneath the bed of the patient. 

Vomiting from Sewer-Gas. — Dr. George Wilson quotes the account 
of twenty out of twenty-two boys of Clapham, England, who were attacked, 
and two of them died, with violent vomiting, purging and fever within 
three hours after standing over a choked-up drain, watching the workmen 
cleaning it out. 

Other Examples of Gas Poisons — Nor are these isolated instances, for 
the medical journals of America and Europe record numerous similar 



200 PURE AIK AS A CONDITION OF HEALTH. 

examples of dangerous or fatal effects from disease-poisons in sewer-air 
when inhaled by human beings. 

Avoiding 1 Sewer Poisons. — In view of this great body of evidence, 
showing the direct conveyance of disease by air from sewers, it behooves 
us all to avoid the access of such noxious effluvia into our houses, or into 
any inhabited place whence they can penetrate into the lungs, which are 
the usual avenue of entrance into human systems. 

DUST IN THE AIR AS A CAUSE OF DISEASE. 

Solid Particles. — Dust of various kinds floating in the air, and often 
occurring in such minute particles that it can only be recognized in a 
bright sunshine, or by the aid of a beam of electric light, as Professor 
Tyndall has shown, is far more potent a cause of disease than is generally 
supposed. 

Danger of Saliva-Loaded Dust. — Although affections of the stomach 
and bowels are often induced by the introduction of particles of injurious 
dust swallowed with the saliva, diseases of the lungs are chiefly to be 
dreaded when air loaded with substances which are mechanically or chemi- 
cally noxious find their way to the delicate mucous membrane which lines 
the recesses of our pulmonary organs. Bronchitis, catarrh and acute or 
chronic pneumonia, the latter often running on into one form of con- 
sumption, are especially to be guarded against in persons who are liable 
to be forced to inhale dust of various kinds. 

Unhealthy Trades — The effects of dust are chiefly dependent for 
their severity on the large amount of the offending material, and the 
angular, rough and hard character of its particles. A large number of 
the unhealthy trades are insalubrious especially from this cause. Thus, 
for example, it is stated by Mr. Simon that, excepting in one locality, 
300,000 miners break down in England prematurely from bronchitis and 
pneumonia caused by the atmosphere in which they live. The one excep- 
tion is most important, because it occurs among the colliers of Durham 
and Northumberland, where the mines are well ventilated. 

Coal Dust and Consumption.— The sharply-angular fragments of coal 
which may be seen under a microscope to constitute coal dust, mechani- 
cally irritate the lungs of those who inhale them, and often give rise to 
the kind of consumption which is so peculiar that it is called miners' con- 
sumption or miners' phthisis. This malady alone cuts short the days of 
an immense number of laborers among coal dust, and after death their 



DUST AS A CAUSE OF DISEASE. 201 

pulmonary organs are found filled with sharp particles oi coal, which 
being inhaled with the breath, become imbedded in the substance of the 
lung, and then acting like a vast quantity of tiny splinters in the flesh, 
give rise to innumerable minute boils or abscesses, by which the breathing 
apparatus is actually riddled with holes, and so much of it destroyed that 
the poor sufferers die for want of lung-substance enough to supply prop- 
erly their blood with air. 

Saw Grinders' Consumption. — The fine particles of steel and of sand 
thrown off in grinding saws and other tools, give rise to saw-grinders' con- 
sumption, particularly when dry-grinding is resorted to, and unless the 
dust is carried away from the workmen. 

Particles of Deadly Dust — In manufacturing these various steel and 
iron implements, the rough articles are firmly pressed against grindstones, 
which are revolving sometimes at the rate of three thousand times in a 
minute. Practically it is found that the degree of danger to the workmen 
thus employed depends partly upon the amount of dust inhaled, partly 
upon the character of the particles composing this dust, and partly upon 
the constrained attitude which the workmen are frequently compelled to 
assume. 

What Dust Most Dangerous. — The grinding of needles and forks is 
the most dangerous, because it must be done upon dry grindstones, in 
order to reduce the chance of the fabricated utensil becoming rusty. 
Scissors, razors and table-knives can be ground partly upon wet grind- 
stones, so that the men employed in such work run less risk of injury from 
it, whilst the coarser implements generally are now, as a rule, finished 
upon wet stones entirely, so that still less danger is incurred. 

Grinders' Asthma. — The grinders' consumption, called also the 
grinders' asthma from the difficulty of breathing, which is one of the 
prominent symptoms, comes on very gradually, and often lasts four or 
five years before it proves fatal. At first there is only a little dry cough, 
with scanty expectoration ; later on the mucus, which is coughed up, 
begins to be reddish from a minute quantity of blood mingled with it ; and, 
although there is no fever, and the strength and appetite remain good, 
an examination of the chest with the stethoscope reveals serious trouble 
in one or both lungs. 

How Recovery is Possible — Still, recovery is not only possible, but 
probable, at this stage of the complaint, if the workman can be persuaded 
to abandon his occupation ; but if he persists in exposing himself to the 
perils incurred by breathing these dangerous dusts into the lungs, the 



202 PUKE AIR AS A CONDITION OF HEALTH. 

pulmonary structure soon begins to ulcerate away, and painful, lingering 
death by consumption follows. 

Average Life of Grinders. — Until recent improvements in regard to 
grinding, the fatality of these particles of dust, when inhaled into the 
lungs, was very great. According to Dr. Holland, the average age at 
death of twelve workmen at the trade of needle-grinding was only thirty 
years and eight months, and other authorities give the duration of life as 
from thirty-one to thirty-five years. 

Use of the Magnetic Plate. — In factories where steel-grinding goes 
on to a very great extent, the use of a large magnetic plate, for drawing 
to itself the metallic particles, is very useful; but, of course, it has no 
power to purify the air from any injurious dust, except that made up of 
iron or steel, and perhaps on this account it has never been popular 
among the workmen. 

Use of the Mechanical Fan — Another very efficient method is to draw 
away the dust in the strong current of air created by a powerful me- 
chanical fan. A single fan may be made to extract the dust from several 
grinding stones, care being taken to have the opening in the boxes which 
surround the stones and in which the draught is set up underneath, so as to 
extract both the heavier and lighter particles. This plan adds materially 
to the expense of manufacture, and is therefore not very popular among the 
mill owners, but it so greatly diminishes the dangers to the workmen, 
when properly adapted, that its employment should be enforced by law, 
in order to protect the health of the operatives. 

Danger from Wet-Grinding. — Although the introduction of wet-grind- 
ing for the coarser tools vastly decreases the chance of mechanical injury 
to the lungs from floating particles in the air, the artisans are often kept 
covered with the muddy water which is constantly being whirled off from 
the stones. Being thus exposed to the combined evil influence of cold and 
wet, they are especially subject to acute bronchitis, pneumonia and 
rheumatism, which may, however, be in part prevented if the men wear 
water-proof clothing whilst they are at work. 

Pottery Dust — In the pottery trade there is often a large amount of 
dust made up of mineral particles, which are very irritating to the lungs 
of the operatives employed. The same may be said of the artisans who 
work at the trade of glass-making, the most dangerous department being 
that of grinding and polishing the cut-glass. Of these men more than 
one-third are said to die of consumption, and their average age at death 
is variously estimated at from thirty to forty-two years. 



DUST AS A CAUSE OF DISEASE. 203 

Match-Makers' Diseases. — The makers of matches, who are exposed 
to the fumes of phosphorus, suffer from a form of ulceration of the jaw- 
bone, if there happens to be any uncovered portion upon which the poison- 
ous vapor can act, as for instance, around the root of a diseased tooth. 
The manufacture of many chemical products is exceedingly dangerous to 
health, and requires special precautions to reduce its evil influence as far 
as possible. 

Danger of Metal Fumes. — In some trades and under certain circum 
stances the fumes of metals or particles of metallic compounds pass into 
the air, and render it very injurious to health for those who happen to 
breathe it. Brass-founders are affected with bronchitis and asthma, as in 
other trades where dust is inhaled by the workmen, but in addition they 
suffer from a disease called brass-ague or brass-founders' ague. It ap- 
pears to be the result of inhaling the metallic fumes, perhaps of the oxide 
of zinc. 

Symptoms of Fume Poison. — The symptoms are tightness and oppres- 
sion of the chest, with uncomfortable nervous sensations, followed by 
shivering; unlike those of genuine ague, are not periodical. Coppersmiths 
are apt to be affected in a similar way by the fumes arising from the 
partly vaporized metal or from the solder. Tin-plate workers likewise 
suffer occasionally from the fumes of the soldering. 

White-Lead Poison. — Workmen in white-lead manufactories often 
suffer in the same way from inhalation of fine powder of white lead, 
chiefly from the beds in which oxidation goes on and in the process of 
packing the product. And the same may be said of house painters to some 
extent, although lead poisoning is more apt to occur in them from swal- 
lowing the lead compound in consequence of want of cleanliness while 
taking food. 

Tobacco Dust. — Operatives in tobacco factories sometimes suffer from 
irritation of the throat, nose and eyes by the tobacco dust, and there are 
some people who cannot become accustomed to an atmosphere of the 
weed. The greatest irritant effect seems to be produced in the manu- 
facture of snuff, but with the large majority of operatives, if proper care 
and ventilation is secured, no serious effects result after the first few weeks 
or months. 

Wall-Paper Poisons. — Perhaps the most common kind of poisoning 
from a metallic dust inhaled Avith the air is that developed in persons who 
spend much time in rooms decorated with arsenical wall papers. In some 
instances, these brilliant yet treacherous decorations, which may be either 



204 PURE AIR AS A CONDITION OF HEALTH. 

green, purple or brown in color, have been found to contain as many as 
thirty-seven grains of the arsenical compound to the square foot, and 
numerous well-authenticated cases of serious injury to health from in- 
halation of the atmosphere of rooms in which this arsenical dust was con- 
stantly floating are on record. Whenever a person who occupies a room 
papered with green or purple hangings begins without any obvious cause 
to suffer from headache, nausea, inflammation of the eyelids, dry cough, 
muscular tremors and impaired nervous power, the cause should at once 
be sought for upon the walls of the apartment, and if the usual chemical 
tests show the presence of arsenic in a little of the paper which has been 
scraped off, both the patient and the paper should be promptly removed. 
Modern Improvements. — In recent years many improvements have 
been made in machinery. Factories made sanitary, workmen protected 
from dangers of all kinds, laws enacted compelling owners of factories to 
protect workmen; so that at the present time the operator and mechanic 
does not have the many dangers to contend with he formerly had. In 
many places illustrated lectures are given, educating him to avoid certain 
dangers and conditions in connection with his work. 



INDEX TO PART IV OF BOOK III 

Preventive Medicine 

Foods and Drinks 

Part IV of Book III relates to foods and drinks 
and tells of their hygienic effects upon the different 
organs of the human body. 



Absorption and Assimilation 218 

Amount of Food Required 211 

Animal Food 223 

Arrangement of the Teeth 213 

Arteries, The 220 

Bile, The 217 

Blood Function 220 

Blood, The 223 

Brushes, Effect of Hard Brushes on 

the Teeth 214 

Capillaries 220 

Care of the Teeth 214 

Cell Nourishment 210 

Cell Organization 210 

Change of Fluids and Tissues 208 

Children's Teeth 213 

Circulation, Course of 222 

Circulation, The 219 

Classification of Foods 223 

Communication of the Stomach *2i6 

Course of Circulation 222 

Diet 207 

Digestibility of Foods 225 

Distribution of Nutriment. 219 

Effects of Hard Brushes on the Teeth, 214 

Fatty Foods 224 

Fluids and Tissues, Change of 208 

Folds of the Intestines 218 

Food, Animal 223 

Food, Meat 212 

Food, Milk, Property of 212 

Food, Mixed 212 

Food, Object of 207 



SUBJECTS OF THE TEXT 

Food Required, Amount of 211 

Foods, Classification of 223 

Foods, Fatty 224 

Foods, Preparation of 224 

Foods, Relative Digestibility of 225 

Foods, Saccharine and Starchy 224 

Foods, What They Must Supply 211 

Function of the Blood. 220 

Function of the Tongue 214 

Gastric Juice 217 

Glands, Salivary 214 

Glottis, The 216 

Gullet, The 216 

Heart Pulsations 221 

Heart, Shape of 221 

Heart, The 221 

Heart- Valves, The 221 

Human Organs, Structure of 210 

Intestinal Canal, Structure of 218 

Intestine, The Large 218 

Intestines, Folds of 218 

Intestines, Mucous Membrane of 218 

Intestines, The 217 

Large Intestine, The 218 

Liver, The 217 

Location *of the Salivary Glands 214 

Lymphatics, The 219 

Material, Waste , 220 

Meat Food 212 

Milk Food, Property of 212 

Mixed Food 212 

Molar Teeth, The 213 

Mucous Membrane of the Intestine 218 



205 



206 



INDEX TO PART IV OF BOOK III. 



Muscles, Operation of. See Swallowing 

Nourishment, Cell 210 

Number and Arrangement of Teeth, 213 
Number and Location of the Salivary 

Glands 214 

Nutriment, Distribution of 219 

Object of Food 207 

Organization, Cell 210 

Organs, Structure of 210 

Pancreas, The 217 

Pancreatic Fluid 217 

Preparation of Foods 224 

Protoplasm 210 

Pulsations, Heart 221 

Quantity of Saliva 215 

Relative Digestibility of Foods 225 

Saccharine Foods 224 

Saliva, Quantity of 215 

Saliva, Secretion of 214 

Salivary Glands, The — 

Number and Location 214 

Quantity of Saliva 215 

Secretion of Saliva 214 

Shape of the Heart 221 

Shape of the Stomach 216 

Starchy Foods 224 



Stomach, The — 

Communication of 216 

Gastric Juice 217 

Shape of 216 

Structure of Human Organs 210 

Structure of the Intestinal Canal 218 

Structure of Teeth 213 

Swallowing — 

Glottis, The 216 

Gullet, The 216 

Operation of Muscles 215 

Teeth, The— 

Care of 214 

Children's Teeth 213 

Effect of Hard Brushes 214 

Molar Teeth, The 213 

Number and Arrangement of 213 

Structure of 213 

Tissues and Fluids, Change of 208 

Tongue, The 214 

Function of 214 

Valves, The Heart 221 

Veins, The * 220 

Waste Material 220 

What Foods Must Supply 211 



LIST OF ILLUSTRATIONS 



Alimentary Canal, The 216 

Blood Corpuscles, Red and White.... 223 

Cells of Human Organism 210 

Circulation, Diagram of 221 

Circulations, Diagram of 222 

Circulation of Web of Frog's Foot. . . .220 
Colostrum Corpuscles in Human Milk, 228 

Diagram of Circulation 221 

Diagram of Circulations 222 

Diagram of Constituents of Food 227 

Folds of the Intestines 218 

Human Organism, Cells of 210 



Human Milk Containing Colostrum 

Corpuscles 228 

Intestine, Small, Villi of 218 

Intestines, Folds of the 218 

Lacteals and Lymphatics 219 

Milk Containing Colostrum Cor- 
puscles 228 

Muscles of Swallowing, The 215 

Red and White Blood Corpuscles 223 

Swallowing Muscles, The 215 

Villi of the Small Intestine 218 



PREVENTIVE MEDICINE 



PAET IV. 
FOODS AND DRINKS 



GENERAL CONSIDERATION. 

Object of Food. — The object of food is primarily to furnish the means 
for growth, repair, heat and energy. The mere gratification of appetite, 
which to the detriment of health too often is regarded with undue prom- 
inence, is a secondary consideration and merely incidental to nature's de- 
mand for nutrition. 

Food, Half of Life's Battle.— It has been said that "food properly 
chosen, properly cooked and properly eaten is half the battle of life," and 
the practical value of the subject will readily be understood when it is 
considered that it plays an important part, not only in maintaining health, 
but in modifying and curing diseases. 

The Problem of Diet. — If all members of the human family were 
alike it is obvious that a bill of fare could soon be arranged which would 
give every person the most perfect nourishment ; but as we each differ, in 
some smaller or greater degree, from all others of our fellowmen, it is 
necessary to study the problem, of diet, as modified and limited by our 
own individual peculiarities and surroundings. Age, sex, occupation, 
climate, nationality, and so forth, all influence the quantity and the char- 
acter of food required, and, on the other hand, the amount and nature of 
food taken govern to no little extent the temperament and characteristics 
of people. 

How Food Affects Races, — It has been pointed out, and doubtless with 
some truth, that racial distinctions are in a measure the result of the 
character of the food taken, and that the Irish and the Hindu would not 
have submitted so supinely to the rule of England had their diet, which 
consists chiefly of vegetables, been more highly nutritious like that of the 
British. 

(207) 



208 FOODS AND DRINKS. 

How Food is Appropriated. — In considering the subject of food, it is 
important to understand the method by which it is appropriated by the 
system and converted into blood, flesh, bone and other tissues, and how 
it is utilized in the generation of heat and force. 

Change of Fluids and Tissues. — During our whole lives the fluids and 
the solid tissues of our systems are constantly undergoing change. New 
materials in the form of infinitely minute particles of muscle, nerve, and 
so forth, are being produced, while the old and worn-out atoms of these 
structures are removed with ceaseless activity. While this incessant 
movement of these constituents of our bodies is not perceptible to the eye, 
even when aided by the most powerful microscopes, it nevertheless goes 
on, and must go on as long as life continues. In fact, the researches of 
physiologists tend to show, with a large amount of certainty, that the 
health, strength and vigor of the whole and of every part of the body is 
in proportion to its youth and newness. Thus it is that exercise, under 
due regulation and management, is a hygienic means of such great value 
in strengthening and developing the whole frame, especially the muscular 
system. 

Relation of Natural Forces. — In endeavoring to reach the "bottom 
facts" of our knowledge in regard to the forces we derive from the food 
taken into our stomachs, we must bear in mind that, in our own bodies, 
as in the whole universe around us, we have, from a scientific point of 
view, to deal only with material entities of various kinds and properties 
which we call matter, such as the chemical elements oxygen, carbon or 
sulphur, and their compounds ; and principles of actions, which we demon- 
inate forces, among which may be instanced heat, electricity, and the at- 
traction of gravitation, as types. 

Natural Forces. — The doctrine of the correlation of forces, abstruse 
as it sounds at first, is simply, as regards two of them, namely, heat and 
mechanical motion, an extension of the commonly observed fact that 
motion, by causing friction, produces heat, as we see in using an ordinary 
Lucifer or friction match. Every time we strike a match we demonstrate 
that motion may produce heat ; and to expand this idea into the doctrine 
of correlation (or relationship) of forces, it is only necessary to prove by 
careful and ingenious experiments, as was first done by Mr. Grove and 
Mr. Joule, that any certain amount of motion applied in any conceivable 
way to the production of heat, causes always exactly the same amount of 
heat, and contrariwise, a particular quantity of heat applied to the pro- 
duction of motion, originates always the same quantity of movement, no 
matter by what kind of machinery it is applied. 



HOW FOOD NOURISHES. 209 

Heat and Motion. — In this way we can, by mechanical experiment, 
establish the existence of a correlation — or, to use the more familiar word 
introduced above, a relationship — between heat and mechanical motion, 
and this relationship has been found to be that the force of a weight oi 
772 pounds falling one foot would, if converted into heat, raise the tem- 
perature of one pound of water one degree of Fahrenheit's thermometer. 

Muscular Effort. — After clearly comprehending this idea, it is only 
necessary to grasp the further suggestion that, if a man is hired to lift up 
again the weight of 772 pounds, which in falling one foot gave us our 
unit of heat (namely, the heating of one pound of water, one degree), we 
further establish, by the additional experiment, a relationship or "correla- 
tion" between the number of muscular efforts he is required to make and 
that same heat unit. 

Food Required. — Lastly, if we weigh the extra beefsteak or half-peck 
of potatoes he needs to eat, to enable him to perform so much extra labor, 
we find out the equivalent ounces of food for the requisite amount of 
muscular exertion employed, which is again the equivalent of our (arbi- 
trarily assumed) unit of heat, the quantity of heat which will raise one 
pound of water one degree. 

The Four Natural Forces. — Thus, even those readers who make no 
pretensions to scientific culture can, it is hoped, understand the nature of 
that mutual relationship or correlation which exists between these four 
natural forces, to wit, heat, mechanical motion (of falling or lifted 
weights), muscular exertion and food. 

What Food Is. — Food, then, is any substance which, when taken into 
the animal body, may enter into such new chemical combinations that it 
gives out its dormant force in the form of heat, muscular movement, nerve 
power, and so forth. 

How Food Nourishes. — If an article of food is completely combined 
with oxygen in the human system, it yields up all the force which it is 
capable of affording; but if it is not so adapted to the wants of the body 
as to be fully oxidized or burnt up, part of its force passes off with other 
refuse matters, and is wasted, as far as that man's nutrition is concerned. 
It is by learning how to avoid this waste, as well as to escape the injury 
excess of undigested food is apt to cause to the digestive organs, that a 
careful study of the articles of diet suitable for each individual, in accord- 
ance with the facts and conclusions detailed below, may be made so profit- 
able and beneficial to every one. 
14 



210 FOODS AXD DRIXKS. 

STRUCTURE OF ORGANIZED BODIES. 

Cell Organization. — All animals and vegetables are built up of minute, 
separate, organized bodies, called cells, which are put together like stones 
in a pavement, so as to form the skin, the muscles, the nerves, and so 
forth. The cell-elements or cell are made up of a nucleus or central living 
mass, which may be aptly compared to the yolk of an egg. 

Protoplasm. — Around this nucleus is gathered a little lump of formed 
material or protoplasm, corresponding to the white of an egg, and' the 
whole is enclosed in a delicate membrane resembling that which lines 
the egg-shell. These cells are extremely small, varying from one four- 
thousandth of an inch to one five-hundredth of an inch in diameter. In 
the epithelial scales or cells, which are packed together to form the skin, 
as already mentioned, the average diameter is about one fifteen-hundredth 
of an inch. 

Building of Human Organs. — The different organs of human bodies 
and those of the inferior animals are built up of cells very similar to those 
found in the vegetable kingdom, as is 
illustrated by the adjoining figure. 
This cut shows the liver-cells of man, 
with the nucleus, a, and oil-drops, b, in 
their protoplasm. At c is depicted a 
free nucleus, that is, one from which 

the cell-wall and the protoplasm have ' **£gg*<§&? "\* 

been accidentally torn away; and at d Cells of Human Organism. 

is shown a large cell with two nuclei, illustrating the tendency to oc- 
casional twin-formation, which seems to run throughout all animated 
nature. 

First Step Toward Human Development. — The first step toward the 
development of a new being in that wonderful yet hourly miracle of re- 
production, as, for instance, of a young chicken inside an egg, is the divi- 
sion of the yolk into a great number of little rounded parts, which soon 
present the appearance of a heap or mass of cells, which for a time 
cannot be distinguished from the white cells in the blood of the parent 
hen. Gradually, however, as the operation of hatching progresses, cer- 
tain groups of these cells vary under the influence of the vital force from 
other groups, until, by a continuing process of development, the liver, the 
heart, the skin, and so forth, are completely formed. 

Cell Nourishment. — In chickens, and birds generally, the young crea- 
ture is nourished until large enough to pick up its own food by the contents 




MIXED DIET. 211 

of the egg, but in animals which bring forth their young alive, a curious 
natural provision is made for supplying the requisite nourishment from 
the blood of the mother. After birth, however, the necessity for food 
immediately becomes apparent, and in order that mere existence shall 
continue, external nourishment of some sort must be regularly supplied. 
Furthermore, if growth and complete development are to go on, this 
nourishment must be accurately proportioned in kind, quantity and com- 
position to the exact needs of the infant animal or man. 

MIXED DIET REQUIRED BY MAN. 

Analysis of cows' milk shows it to contain — 

Albumen and casein 54-05 

Butter 43.05 

Milk Sugar 40.37- 

Salts 5.48 

Water 857.05 

Total 1,000.00 

While this forms a suitable diet for young children, who, though 
rapidly growing, expend in labor comparatively little muscular force, it 
fails to meet the requirements of active adult life. 

Kinds of Diet. — Nor, notwithstanding much argument to the con- 
trary, does an exclusively vegetable diet seem best adapted to man's 
needs. The evidences derivable from the form and arrangement of the 
teeth, the structure and functions of the alimentary canal, and the results 
of direct experiment, all indicate that, in the present age of the world at 
any rate, mankind thrives best, as a general rule, upon a mixed animal 
and vegetable diet 

Amount of Food Required — The requirements of a full-grown indi- 
vidual may be estimated by accurately determining, as has been done by 
scientific men, the quantities of the chemical elements carbon, hydrogen, 
nitrogen and oxygen, which are cast off from the body by the bowels, the 
kidneys, the skin and the lungs, every twenty-four hours, and then calcu- 
lating what quantities of various articles of food, containing these chemi- 
cal elements, must be eaten daily to supply this waste. 

What Foods Must Supply — For instance, if we find, as some English 
investigators have done, that a gang of one hundred average prisoners 
cast off every twenty-four hours, from their lungs, kidneys and bowels, 
about seventy-one and a half pounds of the element carbon, and four 



212 FOODS AXD DEIXKS. 

and a quarter pounds of nitrogen, it is obvious that carbon and nitrogen 
must be supplied to this amount in the food the gang of prisoners eat 
in order to make up for what is excreted. If they were to be fed upon 
bread and water alone it would require 380 pounds of the staff of life 
daily to keep them in good health, because it requires that weight to 
yield the four and a quarter pounds of nitrogen which they daily cast off 
in the ways just mentioned. But in 380 pounds of bread there are 128 
pounds of carbon, which is about fifty-seven pounds more than would be 
needed to replace what these men would excrete. 

Meat Food. — On the other hand, should the authorities try the ex- 
periment of giving them animal food only, it would be necessary to 
allow them 350 pounds of lean meat, because no less than that amount 
would contain the seventy-one and a half pounds of carbon necessary to 
replace the quantity of this element excreted ; but lean meat contains pro- 
portionately a very large amount of nitrogen, and in 354 pounds of it there 
would be found 109 pounds, or 105 pounds nearly in excess of what the 
prisoners really required, and which would therefore be wasted as food. 

Mixed Food. — In the former case which we have supposed, each man 
would have to eat about four pounds of bread, and in the latter about 
three and a half pounds of meat every day, in order to avoid losing 
strength. In the first instance, there would be a good deal of starch in 
the bread, and in the second case, a considerable bulk of nitrogenous 
material, which would be quite unnecessary as food, and apt if taken into 
the stomach to overload it and derange its functions. 

A True Mixed Diet — The true way is to resort to a mixed diet, and 
if such were to be adopted in this instance, we would probably find that 
200 pounds of bread, with sixty pounds of meat, would answer every 
purpose. Two hundred pounds of bread contain, besides water, sixty 
pounds of carbon and two of nitrogen, and sixty pounds of meat about 
twelve of carbon and two and a quarter of nitrogen; making, it will be 
observed, exactly the quantity of each of the primary elements cast off 
by the 100 men daily as waste matter from the processes of life. 

Property of Milk Food — It is manifest, according to this calculation, 
that milk is not accurately suited to supporting an adult population, be- 
cause it contains too little carbon and too much nitrogen to supply the 
waste. This excess of nitrogen is well suited to the young animal which 
is actively engaged in adding to its muscular development, but is not 
adapted to the full-grown man, who is obliged to produce force, or its 
equivalent, heat, by the slow combustion of carbon in his body. It is to 
supply this excess of carbon, beyond what exists in milk, that all the world 



THE TEETH. 



213 



over, bread or starch, which is rich in carbon in some form, is gradually 
added in larger and larger proportions to the food of a growing child. 

Proper Diet List. — Snch calculations, in regard to the other con- 
stituents of our food, form a basis of the utmost value for the economical 
arrangement of diet lists, and the distribution of limited means, as, for 
example, in armies and navies, with the least possible waste of the in- 
gredients at command. 

THE TEETH. 

Number and Arrangement — In the adult human being the teeth, when 
perfect, are thirty-two in number, and are arranged in the following order : 
First, in the middle of each jaw, are the four incisors or cutting teeth; 
next, come one on each side of the group of incisors, the two canine or 
dog-teeth, so-called because they are very large and conspicuous in a dog's 
mouth ; the next pair of teeth, situated just back of each canine tooth, are 
named the first and second bicuspids, on account of their having two 
points or cusps; behind these, again, we find the first, second and third 
molars or grincling-teeth. 

The Molar Teeth. — The last, or third molars, four in number, count- 
ing two in each jaw, of course, have received the name of the wisdom-teeth, 
because they appear about the time that people grow up and are supposed 
to have arrived at years of discretion. 

Children's Teeth. — The permanent teeth are preceded during child- 
hood by a smaller set, only twenty in number, which are styled the de- 
ciduous teeth, for the reason that they fall out or are pushed out by the 
larger and stronger permanent set. These deciduous teeth begin to come 
through the gums of babies when they are from six to twelve months old, 
and unfortunately give rise to much, of the pain endured in childhood. 
The adjoining figure shows how the second set of teeth comes in behind 
the first, or deciduous teeth, pushing these latter out of the jaws from 
the sixth to the tenth or twelfth year of life. 

Structure of Teeth. — Each tooth has, as can be readily seen by cracking 
open one from a dead animal, a very hard outside shell, composed of what 
is called the enamel, a softer and thicker body-substance, denominated 
dentine or ivory, and a hollow place near the centre of this dentine, named 
the pulp-cavity, which during life is filled with a mass of nerves and 
blood-vessels. The pulp or nerve of a tooth is exceedingly sensitive, and 
acutely painful on the slightest touch, or even from mere exposure to the 
air, as, for example, by the breaking off or decaying away of some portion 



214 FOODS AND DRIXKS. 

of the dentine or tooth-bone which naturally protects it, and which when 
removed gives rise to toothache. 

Care of Teeth The prevention of such suffering lies in avoiding the 

decay as long as possible by keeping the teeth clean, refusing corrosive 
articles of food or medicine, and, when cavities begin to form, having 
them stopped up or filled by a skillful dentist before they have time to 
reach the nerve. 

Effect of Hard Brushes. — While frequent cleansing of the teeth is 
important, it is not advisable to brush them too much with hard tooth- 
brushes, and especially with gritty tooth-powders, thus irritating the gums 
and wearing away the very enamel which it is our object to preserve. 

What to Avoid. — The teeth should never be used to break hard ob- 
jects ; hot and cold liquids, especially in quick succession, ought not to be 
brought in contact with them, as in drinking; and strong vinegar, syrups 
and sweetmeats ought likewise to be kept away from the teeth. If candies 
are eaten at all, or at rare intervals, the sugar remaining between the 
teeth and around the gums should be promptly washed away by rinsing 
the mouth. 

THE TONGUE. 

Tongue Function. — Besides being the organ of taste and the chief 
agent in the production of speech, the tongue performs an important duty 
in bringing different portions of a mouthful of food under the molar teeth 
during the operation of mastication or chewing. This office of the tongue 
is shown to be one of great usefulness, by the fact that when paralyzed, 
either wholly or in part, great difficulty is experienced in chewing food, 
because it cannot be pushed between the grinding surfaces of the back 
teeth. 

THE SALIVARY GLANDS. 

Breaking up the food into a sort of coarse powder is only the first 
step in its proper preparation for digestion. It must next be mixed with 
the liquid of the mouth, called saliva, which has the remarkable power 
of turning the insoluble starch of bread and other starchy foods into 
soluble sugar. 

Number and Location — The salivary glands, whose business it is to 
manufacture the saliva, are six in number, four being situated under the 
tongue and the jaw, and the others seated deeply in the cheeks in front of 
the ears. These are called the parotid glands, and are remarkable for 
being the parts affected by the contagious disease named mumps. 

Secretion of Saliva. — The saliva is poured out by different ducts, into 



TP1E ACT OF SWALLOWING. 



215 



various parts of the mouth, so as to become intimately mixed with the 
food. Its active principle, named ptyalin, plays a very important part in 
the digestion of the amylaceous substances, that is to say, articles of diet, 
such as bread, potatoes, corn, and the like, which are chiefly composed of 
starch. 

Thorough Mastication. — It is, therefore, highly necessary that chew- 
ing should be performed slowly enough to give time for a sufficient quan- 
tity of saliva to be secreted, and to be completely mixed with the food, as 
want of care in eating too fast is apt to' be followed by the disease called 
dyspepsia, as already mentioned. It is difficult to urge too strongly the 

importance of a thorough mastication 
of vegetable food. 

Quantity of Saliva. — In the hu- 
man being, the saliva is produced in 
the quantity of nearly four pints 
daily during health; but the secre- 
tion of this very important agent in 
the digestive process is powerfully 
affected by mental emotions, such as 
fear, anger or pity, and it is also 
largely influenced by certain medi- 
cines, such as belladonna or deadly 
nightshade, even in comparatively 
small doses. 

THE ACT OF SWALLOWING. 

Operation of the Muscles. — The 

entire process of swallowing is a 
series of associated muscular acts, 
quite independent of the force of 
gravitation, as may be seen in animals drinking with their heads down- 
wards. Although these complex movements follow each other without any 
check or pause, it is common to divide them into three stages, the first of 
which is the voluntary one of pushing the mass of chewed food back 
to the upper part of the throat or pharynx, so that it is grasped by the 
involuntary muscles, which send it on downward to the stomach. This 
operation the muscles which form the tube called the throat or gullet ac- 
complish by relaxing in front of the morsel of food which is being swal- 
lowed and contracting behind it. 




The Swallowing Muscles. 



The adjoining figure exhibits the deep 



216 



FOODS AXD D-RINKS. 



muscles of the cheek and the pharynx with adjoining parts. The cir- 
cular muscle of the mouth (1) and the buccinator or trumpeter's muscle 
(2) help the tongue to push the food back to 
the upper margin of the gullet, where it is 
seized upon by the three constrictor muscles (3, 
4 and 5) of the pharynx, and pushed down the 
gullet or oesophagus, which is represented as 
being cut off at 6. 

The Glottis — In front of the pharynx is 
an opening into the windpipe named the glottis, 
through which we breathe, but which must, of 
course, be closed during the operation of swal- 
lowing, in order to prevent our food from 
dropping into it. 

The Gullet. — The gullet or oesophagus is 
a muscular and membranous tube, about nine 
inches long, which if dissected out would look 
very much like a thin piece of rubber hose, 
such as is used for watering gardens. Its duty 
is to carry the food from the pharynx to the 
stomach, and in order that it may not get 
stopped up by food getting wedged in it, this 
pipe, in consequence of its muscular structure, 
has the power of contracting itself in succes- 
sive portions from above downward, so as to 
push onward the articles of diet which are 
being swallowed. 




THE STOMACH, 



The Alimentary Canal. 



Shape — The human stomach is a some- 
what egg-shaped bag, the walls, as the substance of the bag is called by 
anatomists, of which are made up first, counting from the inside outward, 
of a layer or coat of mucous membrane which is similar to, and continuous 
with, the moist red mucous membrane which we seen lining the mouth 
and throat. Outside of this is a coat of muscular fibres, some running 
around and others diagonally across the sack, and then outside of these 
again is a layer of membrane or skin. 

Stomach Communication. — The stomach communicates, at its upper 
part on the left side of the body just below the heart, with the gullet, which 



THE DIGESTIVE APPARATUS. 217 

opens directly into it, and it empties itself, on the right side, into the 
upper portion of the small intestine, through a sort of valve, which has 
received the name of the pyloric orifice, because the word pylorus means 
a janitor or gate-keeper. 

The arrangement of the stomach and other portions of the digestive 
apparatus, or alimentary canal, or alimentary tract, is well shown in the 
foregoing figure. 

Gastric Juice. — The whole of the mucous membrane, or inner lining 
of the stomach, is filled with glands, somewhat similar to the salivary 
glands, but so small that they can scarcely be seen with the naked eye. 
These glands all open into the cavity of the stomach, and their business 
is to manufacture, from the blood which flows around them, in a network 
of fine blood-vessels with very thin walls, that important fluid, the gastric 
juice, remarkable for having such a Wonderful solvent power upon the 
meat, eggs and other foods which constitute what is called the nitrogenous 
portion of our diet. 

Quantity of Gastric Juice. — The quantity of gastric juice very much 
exceeds that of the other digestive fluids, being about a gallon and a half 
every twenty-four hours. 

THE LIVER. 

This is the largest organ in the body, being situated below the right 
lung. Its office is the secretion of another digestive fluid known as bile. 

Bile — About one quart of bile is daily produced, it being intimately 
connected with the digestion of fats. Interference with its proper secre- 
tion is largely concerned with the production of constipation and the train 
of symptoms ordinarily known as biliousness. 

THE PANCREAS. 

The pancreas is a long, thin gland, situated behind the stomach, and 
constituting, in the ox, part of what is sold under the name of sweetbread. 

Pancreatic Fluid. — This is secreted daily to the extent of about a pint 
and a half. It supplements the action of the saliva and the bile by helping 
to dissolve the starchy materials and to finely subdivide the fatty sub- 
stances. 

THE INTESTINES. 

The small intestine is a membranous pipe or tube about twenty feet 
long, but twisted and looped together in such a way as to occupy only the 
small space of a few inches in the cavity of the abdomen, which forms the 



218 



FOODS AXD DEINKS. 



lower half of a person's trunk, or body, as it is often called, in contra- 
distinction to the limbs and head. This tube is continuous with the pyloric 
opening of the stomach at its upper end, and at its lower extremity empties 
into the side of a much wider membranous tube, about five feet in length, 
called the large intestine. 

The Large Intestine. — Most of the large intestine has received the 
name of the colon, and it may be justly compared to the main sewer of a 
city, into which pass all the waste refuse and foul materials which are of 
no further use, and must be gotten rid of as 
soon as possible. 

STRUCTURE OF INTESTINAL CANAL. 

Mucous Membrane. — The whole intes- 
tinal tube is lined with a mucous membrane, 
and in the small intestine this has its inner 
surface covered with hundreds of thousands 
of little tongue-like projections called villi. 
These villi are represented as they appear 
when highly magnified in the marginal illus- 
tration, which is a diagram of a thin slice cut lengthwise from the wall 
of the tube. 

Folds of Membrane. — Although the intestinal canal is so prolonged as 

to measure, when stretched out, over 
twenty-five feet, its internal surface 
is not sufficient to perform all the 
work of absorbing the digested ma- 
terials of diet. Hence, the lining 
mucous membrane is thrown into 
folds, as shown in the appended 
wood-cut, simply in order, it appears, 
to afford surface enough for absorb- 
ing all the nutriment from the 
articles of food, and so disposing of the substances we swallow to the best 
and most economical advantage. 




Villi of the Small Intestine. 




The Valvulse Conniventes, or Folds 
of the Intestines. 



ABSORPTION AND ASSIMILATION. 

In order that the food-stuffs, when altered by the digestive process, 
may be of any real use to the animal economy, the nutritive materials 
must be distributed through the different tissues and organs of the body. 



THE OTRCT'LATION". 



219 



Digestion Not Sufficient — The mere digestion of food is by no means 
sufficient, and no matter how much we eat, it would accomplish nothing 
toward keeping our muscles, hearts and brains in active operation, un- 
less food-elements were absorbed after digestion into the blood, and as- 
similated from it into the very structure of all the different portions and 
organs of the animal frame. 

The Lymphatics. — As shown in the adjoining illustration, the lacteals, 

LAC, which take their 
origin in the villi of the 
small intestine, converge 
and unite together, meet- 
ing the combined lym- 
phatics of the lower ex- 
tremities in a kind of 
bag, called the recep- 
tacle of the chyle, which 
is situated deeply in the 
abdomen and in front of 
the spine, near its mid- 
dle. From this the 
mingled chyle and 
lymph are carried along 
the thoracic duct, up to 
the root of the neck on 
its left side, where they 
are poured into the 
large veins, and so mix 
with the blood and be- 
come a part of that 
vital fluid. 

Distribution of Nu- 
triment. — The nutritious 
principles of the food 
having been absorbed by the lacteals and carried onward by the lymphatics 
to the general circulation are now distributed to the various organs by 
the blood. 

THE CIRCULATION. 
Through these channels the blood is kept in constant motion by the 
action of a muscular pump, the heart, first passing into strong-walled 




The Lacteals and Lymphatics. 



220 



FOODS AXD DRINKS. 



branching arteries, the walls of which gradually become thinner as the 
branches grow smaller. These end in a network of delicate capillaries, or 
hair-like tubes, through which the crimson tide flows slowly into the wider, 
soft-walled veins, appointed to carry it back to the heart, and thus com- 
plete the round of the circulation. 

Blood Function. — In its course, it receives the nutritive materials 
from the stomach and intestines after digestion, the special products of 
the liver, spleen and the lymphatic glands, and the oxygen absorbed from 
the air in the lungs. It therefore contains and carries to their destina- 
tion all the materials required for the chemical and vital changes of the 
various tissues necessary to life. 

Waste Material. — While passing through the capillary networks of 
the different organs and structures, it takes up the waste materials re- 
sulting from the wearing out and decay of these portions, and carries them 
to the proper point of escape from the body, as, for example, the kidneys 
or the bowels ; at the same time the nutriment needed to rebuild the worn- 
out organs is allowed to ooze through the delicate vessel-walls of the 
capillaries, and be diffused into the surrounding tissues. 

Capillaries. — In the human being it is difficult to demonstrate the 
circulation of the blood in the capillaries, but the fineness of their network 
and the pressure of the blood which 
is kept up in them to force along the 
vital fluid may be readily shown by 
pricking the finger with a needle, 
the point of which, no matter how 
small it is, can scarcely fail to pene- 
trate some minute blood-vessel, and 
let out a tiny drop of crimson blood. 
This wonderful arrangement can be 
most conveniently demonstrated in 
the thin membrane of a frog's foot, 
stretched out under a microscope 
magnifying two hundred times. 

Arteries and Veins Of the 

two sets of blood-vessels, the ar- 
teries, which convey the blood from 
the heart to the tips of the fingers 
and the ends of the toes, carry bright scarlet blood, and are generally 
deeply seated in the interior of the body and limbs, so as to be, as far 




Circulation in the Web of a Frog's 
Foot. 



THE CIRCULATORY SYSTEM. 221 

as possible, out of harm's way. The veins, which lie more generally 11::.:* 
the surface of the body, as, for example, just beneath the skin on the back 
of the hand and arm, are filled with dark purple blood, which is much less 
pure than the arterial fluid, because it contains large amounts of the 
broken-down materials, the ruins, as it were, of the various bodily or- 
gans, which are now on their road to be thrown away out of the system 
through the lungs, the kidneys and the bowels. 

The Heart. — The heart has small chambers at the upper part to re- 
ceive the blood, and larger, thicker chambers at the lower end, called 
ventricles, to pump it out. The human heart is also double, having a right 
side made up of a moderately strong auricle and ventricle, to send the 
blood to the lungs, and a powerful left side or left heart, with a thicker 
auricle and a very thick, strong ventricle, to drive blood to all other parts 
of the body. 

The Illustration, — This arrangement of the two independent sides 
of the heart will be better understood by the 
aid of the diagram in the margin, which repre- 
sents the two sides of the heart as separated, 
as they are in reality in the human breast, 
although there fastened together and appar- 
ently forming but a single organ. The arrows 
indicate the direction of the blood-current in 
the entire round of its circulation. 
Diagram of the Circulation. Shape of the Heart — The human heart is 

a pear-shaped muscle, about the size of the 
fist, hollow, like a bag, but with very thick walls. It is divided inside by 
fleshy and membranous partitions into four parts, very much as a four- 
roomed house is divided into rooms by its ceiling and partitions, with 
communicating doors through each of the latter. 

The Valves. — The valves consist of a skin or membrane hung across 
each side of the opening between the chambers of the heart, like curtains, 
in such a manner that the blood, in running one way, presses them flat 
against the sides of the hole, and then, as the heart's contraction attempts 
to drive the vital fluid back again, some of the blood is forced in behind 
the curtains, and swelling them out so that they meet in the middle, makes 
them entirely shut off the return-current of the blood. 

Pulsations. — The throbbing of the heart may be felt on the left side 
of the body, near the lower edge of the ribs, and the beating of the pulse, 
which in health corresponds to the pulsations of the heart, at the wrist and 




222 



FOODS AND DRINKS. 



over the course of large arteries elsewhere, when situated sufficiently near 
the surface. 

Number of Beats. — In adult men these beats usually number about 
seventy, in women about seventy-five, and in children still more frequent ; 
in infancy being about one hundred and twenty in a minute, and decreas- 
ing in frequency with increasing years. Within the limits of health the 
heart's action may vary considerably, some habitually having a rapid and 
others a sluggish pulse, when in the same individual such conditions as 
exercise, emotion, depression or even the process of digestion, may de- 
cidedly modify its frequency. 

Course of Circulation. — The left side of the heart, marked L. H. in the 
figure, pumps the blood into the systemic arteries, and thus keeps these 
vessels over-filled; the larger systemic arteries, A., by their elasticity, 
exert continuous pressure on the blood with which they are distended; 
the smallest systemic arteries, A', by their vital contractility, check and 
regulate the amount of blood flowing out of the larger arteries into the 
capillary network, and thus keep up the constant pressure or tension in 
the larger arteries ; the systemic capillaries, marked S. C, are the portions 
of the vascular system where the great opera- 
tions of the blood are carried on, that where 
the worn-out particles from all the tissues of 
the body are removed and the new atoms for 
rebuilding these same tissues are supplied; 
the wide systemic veins, V., are the passive 
channels conveying the impure blood back to 
the right side of the heart; the right or pul- 
monary side of the heart, E. H., pumps the 
blood into the arteries of the lungs and dis- 
tends them, though less fully than is the case 
with the systemic arteries; by the pulmonary 
arteries, P. A., the blood is carried through 
the pulmonary arterioles or smallest arteries, 
Pa, to the pulmonary capillaries, P. C, where 
it is exposed to the inbreathed air and ex- 
changes its poisonous carbonic acid for the ac- 
tive life-giving oxygen ; the letters Ui indicate 
the lymphatics, ending in the thoracic duct, as 
already described, and receiving in their 

course the lacteals, Lc, which absorb the nutriment of the food from the 
stomach and intestines, designated by T. in the diagram. 




S.C, 

Diagram of Both Circulations. 




CLASSIFICATION OF FOODS. 223 

Description of Blood — Human blood, when exposed to the air, from 
which it rapidly absorbs oxygen, is of a bright scarlet color ; but when 
deprived of oxygen it is dark purplish-red. This difference is the great 
characteristic distinguishing arterial from venous blood, and should always 
be borne in mind when attempting to staunch the bleeding from a 
wound, since entirely different treatment is needed in the two cases. 

Red Corpuscles. — The blood is not a red fluid, as it appears to be when 

first shed; it is composed of a watery por- 
tion, called the plasma, which has a light 
yellow color, and an immense number of 
minute corpuscles, which give to the blood 
its crimson hue. These little bodies, which 
\^J are called the red blood corpuscles, are ex- 

Red and White Blood Corpuscles, hibited in different positions in the accom- 
panying cut, as they appear when highly 
magnified; the illustration also shows two white or colorless corpuscles, 
one on the extreme left in a rounded condition, and the other at T\ T , 
misshapen and entangled in some fibrin threads. 

CLASSIFICATION OF FOODS. 

The foods may be divided into the following classes: 

1. Nitrogenous substances, or proteids, which go to form the tissues 
of the body, and are represented by meat, eggs, the casein of milk, and 
other substances consisting chiefly of albumen. 

2. The fatty or heat-producing aliments, which are derived from 
both the animal and vegetable kingdoms, although chiefly from the former ; 
they include the animal fats, such as lard or suet, butter and the vege- 
table oils, among which that from the olive is the one most consumed by 
civilized man. 

3. The carbo-hydrates, of substances containing carbon and hydro- 
gen without nitrogen; these are the saccharine or sugary, and the amy- 
laceous or starchy ingredients of human diet, comprising therefore sugar, 
molasses, bread, potatoes, beans, etc. 

4. The saline or salty articles, consisting largely of common kitchen 
salt, with potash, lime, magnesia, and a little iron in various combina- 
tions. These ingredients of the human body, small as some of them are 
in amount, possess a very great importance. 

Animal Food. — "When men are called upon to perform any extra 



224 FOODS A1\ T D DRINKS. 

amount of severe labor, involving great muscular exertion, there is no 
doubt that an additional supply of meat is of great service. 

Fatty Foods. — In regard to the functions of the fatty constituents 
of food, we may at once conclude that, since the diet resorted to by in- 
habitants of cold countries invariably contains a large proportion of fatty 
ingredients, these elements play an' important part in the maintenance of 
animal heat. Indeed, it has been demonstrated by experiment that the 
respiratory or heat-producing powers of fat are two and a half times 
greater than are those of the vegetable hydro-carbons, such as starch or 
sugar. 

Saccharine and Starchy Foods. — The saccharine and starchy constitu- 
ents aid the fatty matters in developing animal heat, although they are 
much less efficacious in this respect. Starch is, however, capable of being 
rapidly converted into fat by the wonderful operations of nature's labora- 
tory, as we see in the process of fattening pigs upon corn for market, and 
in this way a large store of the best heat-producing materials may be laid 
up in the system as a provision for the winter's cold. 

PREPARATION OF FOODS. 

Soups and Broths. — Where economy of nutriment is an important 
object to be attained, it is probable that the production of broths and 
soups, from vegetables and meat in combination, affords many and great 
advantages. In making nutritious broths with a fair,, allowance of 
butcher's meat, it is advisable, when possible, to cook the vegetables sep- 
arately, and the meat, if intended to be eaten with the soup, should be 
cut up into small pieces. In any case, the meat should be put into cold 
water, but should not be boiled, except when the vegetables are cooked in 
the same utensil, a temperature of about 150 degrees Fahrenheit being 
quite sufficient. If the meat is plunged into hot or boiling water at the 
outset, the external layer of albumen is coagulated, and the juices are 
prevented from exuding. 

Boiled Meat. — In boiling meat, on the other hand, when the object 
is to retain as much as possible of the soluble juices in the meat, the piece 
ought to be of good size, and it should at once be plunged into boiling 
water, to coagulate the outside albumen. After being kept boiling for 
about five minutes, the saucepan should be placed aside, and the tem- 
perature allowed to lower gradually ; or it may be lowered by the addition 
of three pints of cold water to each gallon of boiling water. 

Boiled Fish — In boiling fish, the addition of salt makes the flesh 



NUTRITIVE PROPORTIONS OF FOODS 



90 100 



Potatoes 



Spinach 




Egrsrs 



Rice 



Salts. Albumin. Starch, Fat. 

sugar. 



Water. Indigestible 
Substances. 



DIGESTIBILITY OF FOODS. 225 

firmer and more retentive of the flavor. In cooking green vegetables, 
they should first be carefully washed in cold water, but not allowed to 
remain in it, then plunged into boiling water and cooked rapidly. Po- 
tatoes should be boiled in their skins, and after boiling for about five 
minutes most of the water should be poured off, and then the potatoes 
should be steamed. 

Roasted Meat. — In roasting meat, the joint should be placed at first 
beiore a brisk, hot fire, with a view, as in boiling, to coagulate the outside 
albumen, and then the roasting may be conducted more slowly. 

Stewed Meat. — Stewing has this advantage over dry-baking — that 
there is no risk of charring, and the meat is rendered juicy and tender. 
Tough and strong-flavored meats are, perhaps, best cooked in this way, 
because they can be rendered very palatable and digestible by the addition 
of vegetables and seasoning. 

Fried Meat. — Frying is even worse than baking, unless very carefully 
done; but broiling on the gridiron is an excellent way of cooking chops, 
steaks, kidneys and small dishes of fish or fowl. 

RELATIVE DIGESTIBILITY OF FOODS. 

'Not until 1825 was the question of the relative power of the stomach 
to digest different foods satisfactorily demonstrated. 

Liquids. — Liquid, such as water, both pure and when containing a 
small amount of nutriment in solution, as is the case with beef-tea or 
broth, are often quickly absorbed by the lining membrane of the stomach, 
very much as water is sucked up by a sponge, and pass directly into the 
blood. 

Milk — Milk is usually coagulated or clotted as we see it when curdled 
by rennet, which is the dried stomach of the calf, by one of the ferments 
in the gastric juice, but it is commonly soon dissolved again and absorbed. 

Bread. — Wheat-bread composed, as already mentioned, chiefly of 
starch, cannot be regarded as holding a place among the quickly digestible 
foods, since it has been found to require nearly three hours and a half for 
solution." 

Eggs — Eggs, if eaten raw, may be digested in two hours, but if 
boiled soft may take three hours, and if hard boiled or fried, require 
three and a half hours for digestion. 

Meats. — Meats of various kinds differ a good deal in their digestibil - 
ity; thus, for example, boiled turkey has been found to disappear from 
the stomach in about two hours and a quarter; boiled lamb in two and a 
15 



226 FOODS AND DRINKS. 

half hours, and roast beef in three hours; while fried pork requires over 
four hours, and roast pork five hours and a quarter for complete digestion. 

Fish. — Fish prove, as a rule, more easy to digest than meats; and 
the ordinary vegetables present less difficulty to the action of the stomach 
than bread, boiled rice being particularly manageable and requiring only 
about an hour for its entire solution. 

Rules Regarding Meals. — In regard to the periods for eating, experi- 
ence prove*s that habit is one of the most important agents in determining 
the times we ought to partake of nourishment. When a systematic regu- 
larity in respect to the period when we introduce food into the stomach 
is observed, the digestive processes are all better accomplished, and the 
food is more thoroughly and completely assimilated, than when meals are 
eaten irregularly. 

Time for Meals. — The prevailing custom in this country is to break- 
fast, soon after rising in the morning, on food nourishing enough to repair 
the exhaustion consequent upon the long fast of the night, and yet not so 
heavy as to overload the stomach during the morning, when the most 
active exertion of the day is usually performed. Whether the most sub- 
stantial meal be taken at mid-day or in the evening must depend largely 
upon individual preference, convenience, occupation, and so forth. 

Exercise — A very deliberate walk for half an hour or so in the open 
air, when the weather is not too cold, accompanied by the stimulus of 
cheerful, but not exciting nor absorbing, conversation, is a material aid 
to digestion. 

Thorough Mastication. — As already indicated, the thorough mastica- 
tion of articles of diet, especially by the third set of teeth, is essential to 
proper digestion, because, during this process of chewing, nature intends 
not only that the alimentary substances shall be broken up into a coarse 
powder, but also that this powder shall be completely mixed with the 
saliva, which has a powerful influence in preparing jthe starchy ingredients 
for solution. Hence persons should eat very slowly, chew thoroughly and 
move the mouthful of food freely about from one cheek to another, in 
order to amply impregnate it with the fluids of the mouth, and this pre- 
caution is particularly valuable when the food happens to be less digestible 
in quantity or quality than is customary. 

The diagram on following page shows the percentage of the different 
nutritious elements of food in eight of the common articles of diet. 

Effects of Overeating. — An English observer has calculated that for 
every death from starvation, seven occur from the effects of over- 



DIGESTIBILITY OF FOODS. 



227 



indulgence in food. When the stomach is overloaded with food beyond 
its power of digestion, nature often relieves the abused organ by the 
process of vomiting, which no doubt frequently saves people who violate 
the laws of hygiene in this respect from the penalty of death, or at least 
of prolonged illness. When, however, the digestive organs are not un- 
loaded in this manner, the ordinary chemical changes, which occur in 
warm, moist animal and vegetable matter outside of the body, set in, and 
fermentation or putrefaction occur, large quantities of gas being some- 
times produced. 

Excess of Nitrogenous Food — When a superabundance of proteid sub- 
stances is eaten, and perhaps imperfectly digested, whilst at the same time, 
as often happens, a diminished quantity of exercise or labor is performed, 
there must almost necessarily be a disproportion between the oxygen in- 
haled by the lungs and the nitrogen absorbed from the food, when they 



Proteid*. Fats. Carbohydrates. Water. 

ai— a im— a 




6 i 

Constituents of Foods. 



meet in the blood, and therefore a disturbance of the assimilative pro- 
cesses. It is probable that gouty and perhaps rheumatic affections arise 
partly in this way, although the direct influence of certain alcoholic drinks 
in producing gout is indisputable. 

Excess of Starchy Food. — Superabundance of starchy articles of diet 
appears to be less directly hurtful to the system, because a larger propor- 
tion of the excess passes off from the bowels in an unchanged condition. 



228 FOODS AND DRINKS. 

Troublesome corpulence may sometimes result, however, from eating too 
much starchy food, and it has been supposed that attacks of diabetes, a 
disease which is characterized by the presence of sugar in the urine, are 
occasionally due to the same error in diet. 

Contaminated Food. — Food is often rendered unwholesome and unfit 
for use by inherent disease by contamination with poisonous substances 
and by putrefactive changes. Moreover the peculiar power of absorption 
possessed by some foods, as milk, pineapples and bananas, is capable of 
causing the transmission of certain diseases. 

Decomposing Food. — Decomposing food may give rise to alarming and 
fatal poisoning through the absorption of septic materials into the system. 
It is probable that where chemical analysis fails to reveal a cause for death, 
many cases giving evidence of violent gastro-intestinal inflammation or of 
profound impression of the nerve centres, are in reality due to such causes. 

Meat of Diseased Animals. — The meat of animals affected with such 
diseases as pleuro-pneumonia, murrain, anthrax, tuberculosis, Texas cattle 
fever and parasitic affections, as tape worm and trichiniasis are unfit for 
food, and precautions should be observed to guard against their employ- 
ment. 

Adulteration of Milk. — The results of the adulteration of milk are 
mainly those caused by withholding gJAVojPo 

certain nutritious principles from the .^^f^o^P©* -*** 

food supply. Their evil effects are o^^ -l^^^i^o 

seen particularly in infants fed upon o#o^°oo cSjS^oBSsL 

cow's milk, who are thus deprived of §x c $$£?f&% 




fis&8&a& 




much that is necessary to their sub- 
sistence and growth. The skimming ^KS^^i^J^oKJ^ft 
of milk, or the addition of water, are iii& 5? .^sP&l o°JMMM^e 

alike productive of this result. 

Transmission of Disease by Milk. — 
The results of investigation into the 

causation of numerous epidemics and Tr , r ... n . . n . 

. - , , x Human Milk Containing Colostrum 

isolated cases of contagious diseases Corpuscles. 

have shown conclusively that some of these are capable of being conveyed 
through the agency of milk. By carelessness in cleansing dairy utensils, 
by feeding cows with contaminated food and watering them from stagnant 
or infected pools and by exposing the milk to foul and poisonous emana- 
tions, milk may become a source of danger to those who take it. Among 
the diseases which have been often spread in this way are the following: 
Tuberculosis, typhoid fever, scarlet fever, diphtheria, and so forth. 



INDEX TO PART V OF BOOK HI 

Preventive Medicine 

Outward Enemies to Health 

Part V of Book III deals briefly with many out- 
ward enemies to health, such as light, heat, climate, 
soil, etc. 

SUBJECTS OF THE TEXT 



Blood, Cold and. 232 

Climate, Diseases Affected by 233 

Climate, Soil and Health 233 

Climates, Traveling in Hot Climates, 231 

Clothes 232 

Clothing, Poisoned 232 

Clothing, Regulation of 232 

Cold and the Blood 232 

Cold as a Cause of Disease 231 

Cold and Elderly People 231 

Cold, Local Injuries from 232 

Cold and Perspiration .232 

Colored Light 232 

Contagion 233 

Disease, Cold as a Cause of 231 

Disease and Heat 231 

Diseases Affected by Climate 233 

Electricity 233 

Electricity in Medicine 233 



Eyes and Light 232 

Health, Climate and Soil 233 

Heat and Disease 231 

Heat of the Sun 231 

Hot Climates, Traveling in 231 

Injuries from Cold (local) 232 

Light 232 

Light and the Eyes 232 

Lights, Colored 232 

Morbid Poisons 234 

Perspiration and Cold 232 

Poisoned Clothing 232 

Poisons, Morbid 234 

Regulation of Clothing 232 

Soil, Climate and Health 233 

Soils 233 

Sun's Heat, The 231 

Sunstroke 231 

Traveling in Hot Climate 231 



229 



PREVENTIVE MEDICINE 



PAKT V. 
OUTWARD ENEMIES OF HEALTH 

Heat and Disease. — Heat becomes a predisposing cause of disease as 
soon as the temperature rises above 70 degrees or 80 degrees. When 
it begins to affect healthy life the pulse, the heart action and respiration 
are quickened. The skin and lungs are unable to equalize temperature, 
and the condition of the entire body becomes one of susceptibility to 
disease. 

The Sun's Heat. — Exposure of the body for long periods to the heat 
of the sun is apt to result in more or less serious disturbances, such as 
congestions, brain hemorrhages, meningitis, etc. Hence the need of pro- 
tection against the direct rays of the sun. 

Sunstroke. — Sunstroke, or thermic fever, is the result of exposure to 
heat rays. Its early symptoms are faintness, thirst, great heat and dryness 
of skin, with prostration. As quickly as possible the body should be sub- 
jected to the ice or cold water treatment to neck and head. 

Traveling in Hot Climates. — Do not travel during the heat of the day. 
Protect the person by some covering which will deflect the sun's rays. 
Rest during the mid-day hours. Content yourself with a scanty, unstimu- 
lating diet. Use gently stimulating baths. Wear thin, light, loosely-fit- 
ting clothes. 

Cold as a Disease Producer. — Cold becomes a disturber of bodily func- 
tion as soon as it falls to a temperature which ceases to be agreeable. 
The tissues shrink, the capillaries grow sluggish, perspiration is sup- 
pressed, sensibility is impaired. 

Sudden Cold. — Sudden falls of temperature are marked by a long 
train of diseases, or by aggravated or fatal turns to existing diseases. 
This is particularly true of consumption, catarrh, influenza or grippe and 
bronchitis. 

Cold and Elderly People. — From thirty years on the human body 

(231) 



232 OUTWARD ENEMIES OF HEALTH. 

begins to draw on its surplus power. This power is constantly diminish- 
ing as we age. Hence cold affects the aged most seriously by calling 
largely on a diminishing power. It is difficult to sustain a "blood heat." 

Cold and Perspiration. — Cold produces disease by checking perspira- 
tion, thus preventing the escape of injurious materials from the blood, 
and throwing more work on kidneys and lungs, which often become over- 
taxed. 

Cold and the Blood. — Cold tends to drive the blood from the blood- 
vessels to the surface, thus filling one or more of the circulating organs 
too full of blood. If any of these vessels be weak the man is handicapped 
in his battle against disease. 

Clothes. — The body loses heat by radiation, by evaporation, by rapid 
air movement. Hence the necessity for clothing, which cuts off radia- 
tion of heat, interferes with the evaporation from the body, and limits the 
conduction of heat by rapid air movements. Clothing, therefore, plays 
a most important part in warding off diseases and disease-producing 
conditions. 

Regulation of Clothing — Garments worn next the skin should be of 
wool or silk, as best absorbents of perspiration, and as non-conductors of 
heat. Weights may be light or heavy according to the seasons or different 
constitutions. White or gray clothes are preferable to black, when one is 
subjected to direct solar heat. 

Poisoned Clothing. — Clothes made of dyed materials are sometimes 
injurious to health, as containing poisons. This is particularly so of bright 
colored stockings or underclothing. 

Local Injuries. — Cold gives rise to painful local affections, such as 
frost-bite and chilblains, the former involving the nose, ears and fingers, 
the latter the feet. Heat applications in any of these cases must be 
avoided. The cold treatment is best. 

Light. — Light has a powerful effect on the system, through both the 
blood and nerves. It is, therefore, an active agency in the generation of 
diseases and their cures. It is the essential of all growth, and particularly 
affects the outer tissues as well as the internal organization. 

Light and the Eyes — Light for the eyes should be carefully gradu- 
ated, so as to prevent impairment of vision. It has the effect, if profuse, 
of rendering the eyes sensitive, so that they cannot bear the effects of 
even subdued daylight without pain. 

Colored Light. — Many advantages are claimed for colored light. Blue 
and green lights are preferable to orange, yellow or red for the eyes. 



CONTAGION. 233 

Certain of the colored lights act beneficially on animal and vegetable 
growths, and have a great influence in hastening the cures of certain 
diseases. 

Electricity. — Electrical conditions of the atmosphere have a direct 
effect on the human system. On the approach of a thunder storm, one 
may frequently notice a difficulty of breathing. Rheumatics are pain- 
fully affected, neuralgia is intensified. Many existing maladies are aggra- 
vated by electrical conditions. 

Electricity in Medicine. — As a medical agent electricity has grown 
rapidly in favor. As a remedy for many nervous diseases and for pain the 
galvanic battery has come into quite general use. It is a clean, con- 
venient and safe remedy. It is also economical, for the cost of an electri- 
cal machine is within the means of most every one, and it can be self- 
operated. For the X-ray consult index. 

Climate, Soil and Health. — It is not alone in temperature that climates 
differ from one another, and are endowed with the power to check or 
engender diseases. Into its influences on the human body must enter all 
the manifestations of humidity, tempest, fog, dew and wind directions. 
Diseases Affected by Climate — Among the diseases favorably affected 
by a change of climate are consumption, bronchial affections, diseases of 
the throat, asthma, chronic gout and rheumatism, dyspepsia, kidney affec- 
tions, especially Bright's disease, and neuralgia. The advantages of a 
climate where sea air abounds, or where the air is rarefied and dry, are 
fully recognized by medical men. 

Soils. — These affect health in the most direct manner, and through 
their mineral, animal and vegetable matter, also their air and water. 
Diseases connected with moist soils are of almost every type, rheumatism, 
catarrh and typhoid being most general. Moist soils are favorite breeding 
places for germs affecting health, and drainage systems should be made 
as perfect as possible. 

Contagion — The subject of contagion is one of popular notoriety and 
apprehension. Certain receptive conditions, or a predisposition, the 
nature of which is as yet unknown, exist in individuals, which appear 
essential to the development of the specific poisons, and the establishment 
of the disease. An immunity against the repetition of a malady is gen- 
erally conferred by one attack of a contagious disease. This safety has 
been proved real upon an enormous scale in regard to small-pox, and, in 
relation to the other contagious disorders, a belief in such immunity from 
second attacks is founded upon very extended observation ; but the protec- 



234 OUTWARD ENEMIES OF HEALTH. 

tion acquired by a first attack of any of these diseases is of no avail against 
the rest. Measles, for instance, renders the human body proof, as a rule, 
against measles, but leaves it as open to small-pox as before, and so on 
with all the rest. 

Morbid Poisons. — With regard to the co-operative effect of fermenta- 
tion, putrescence or decomposition there is some reason to believe that 
it may quicken the activity or facilitate the development of specific 
morbid poisons in the way of a predisposing cause to their reproduction. 
There is no small amount of circumstantial evidence tending to show that 
conditions of this kind may be thus favorable to the propagation of 
specific diseases, even to the extent of rendering them epidemics, in con- 
sequence of the predisposing agency of putrefying emanations. 



INDEX TO PART VI OF BOOK III 

Part VI of Book III deals with the Germ 
theory of disease, explains how germs propagate and 
grow and the necessity of sanitary measures to pre- 
vent infection from them. 



PAGE 

Antiquity of Germ Theory 237 

Avoidance of Germs 243 

Bacteria , 238 

Disease Germs 242 

Germs — 

Antiquity of Theory 237 

Avoidance of 243 

Effect in the Body 241 

Laws Respecting 237 

Multiplication of 242 

Of Scabies or Itch 241 

Period of Ripening 241 



PAGE 

Rapidity of Propagation 243 

Size of 242 

Itch Germs 241 

Laws Respecting Germs 237, 242 

Multiplication of Germs 242 

Pasteur Controversy 227 

Period of Germ Ripening 241 

Rapidity of Propagation 243 

Sanitary Regulations 242 

Size of Disease Germ 242 

Transmission of Disease 241 



ILLUSTRATIONS 



Colored Plate Showing Germs of 
Cholera, Trichina, Encysted 



Trichina and Cholera, with Ex 
planatory Notes 



239 



235 



PREVENTIVE MEDICINE. 



PART VI. 



THE GERM-THEORY OF DISEASE 

Antiquity of the Theory. — In order to make the sanitary precautions 
thus rendered advisable clearly understood, it should be explained in the 
first place that the germ-theory of disease, traced by some to the celebrated 
Pliny, vastly extended by the renowned botanist, Linnaeus, more than a 
century ago, since placed upon a scientific basis, particularly through 
the labors of the celebrated Pasteur, of Paris, and Professor Koch, of 
Berlin, to whom more than to all of their co-laborers in this important 
field belongs the honor of proving what had long been suspected, the rela- 
tion of micro-organisms to disease, and removing this subject from one 
of theory to one of incontestable fact. 

The Pasteur Controversy. — Without relating in detail the controversy 
that Pasteur's announcement made in 1857 that fermentation and putre- 
faction were brought about by specific ferments and that these were com- 
posed of living cells, it is, sufficient to state that this assertion led the 
way for further investigation, discovery and proof, with the result that the 
micro-organisms causing the diseases of relapsing fever, discovered by 
Obermeier ; that of typhoid fever, by Eberth ; of diphtheria, by Loeffler ; 
of cholera and tuberculosis, by Koch ; of pneumonia, by Friedlander and 
Frankel, and the origin of many other diseases are now known as the 
result of the labors of other investigators, whose claims were subjected 
to the test of the laws formulated by Koch before their character was 
established as proven. 

Germ Laws. — In substance these laws insist (a), "that in order to the 
acceptance that a specific micro-organism is productive of disease, it must 
be demonstrated, (b) That it is constantly present in the fluids or tissues 
of the individual subject to that disease, (c) Its absence from all other 
diseases, (d) Its isolation, growth and repeated cultivation on proper 
culture media, (e) Its power of reproducing the disease after inocula- 
tion in susceptible animals." 

(237) 



238 BACTERIA. 

BACTERIA (See Adjoining Plate). 

Bacteria (Greek, stick). — Bacteria are the diminutive organisms com- 
monly called Microbes (Greek, little). They are visible only under a 
microscope of high magnifying power. 

Forms. — There are three recognized forms of bacteria. 

Spiralus. — 1. The spiral, or wriggling, form, the only form capable 
of progressive motion. 

Bacillus. — 2. The stick-like, or straight rod-like form, incapable of 
motion. 

Coccus (berry). — 3. Very like, when magnified, a period in print; 
incapable of motion. 

The Plate. — Upper left-hand object. The circle shows the size of 
the little drop of liquid subjected to the microscope. It is called the 
microscopic field. Within, in red, is a magnified section of human muscle. 
In its folds are seen, in white, the encysted spirala, called trichinae (hairs). 
They are found in diseased pork, and enter man through the eating of raw 
or under-cooked pork. Thorough cooking kills them. 

The Plate. — Upper right-hand object. This is the trichina magnified 
and more mature. It has taken on the spiral form, due to growth, and is 
consuming the muscle in which it is embedded. 

The Plate. — Lower left-hand object. This shows (1) in white, four 
cells scraped off the intestines, in which cholera germs may lodge. The 
little dark objects are the spirala of cholera. They are found in the 
intestinal canal and feces of cholera patients. 

Form. — They are short, comma-like elements, also in the form of 
U and S, and again long and spiral. They are capable of motion. They 
are cultivated in gelatin, agar-agar, blood serum, potto and bouillon. 

The Plate — Lower right-hand object. This shows the bacillus of con- 
sumption (tuberculosis). It is rod-like in shape, slightly curved, and 
rounded at both ends. It is not mobile. It may be cultivated in blood 
serum, glycerine and agar-agar. 





fntysted Trichma //? Human Muscle 
Double natural size. 



Trichina in Human Muscle 
Highly magnified. 



H'-Vv 







The Cholera Oerm and four intestinal Cells 

(Comma Bacillus) 

Magnified to 400 Diameters. 



The Fungoid Growth causing Consumption 
(BacillusTuberculosis) 
Magnified to 800 Diameters. 









. 



GERM-THEORY OF DISEASE. 241 

Results of Germs in the Body. — The results of the introduction of liv- 
ing organisms into the system are local or general ; the local disturbances 
are of an inflammatory nature caused by mechanical irritations arising 
from the presence or activities of the organisms and are accompanied by 
proliferation of cells and the formation of new tissue. 

General Disturbances. — The general disturbances may possibly result 
from (a) nutritive derangement; or (b) the organisms may cause innu- 
merable foci of local inflammation, producing general disturbance, as for 
example in tuberculosis; or (c) by their activities of growth, reproduc- 
tion, nutrition, etc., they may give rise to poisonous materials (ptomaines, 
toxalbumins, etc.), which act on the system as any general poison, malaria 
is probably an example of this class. 

Period of Germ Ripening. — The period of incubation is the time be- 
tween the introduction of the specific organism of a disease (exposure to 
small-pox for example), and the manifestation of its' symptoms. 

Increase of Symptoms. — The gradual increment of the symptoms is 
attributed to the progressive growth of the millions of minute fungoid 
plants, whose period of greatest luxuriance marks the acme of the attack, 
and the death and destruction of which correspond to the decline of the 
disease. The contagiousnes of the communicable maladies is accounted 
for very beautifully by the existence of the immense number of bacteria 
forming the true seeds of disease, constantly produced, evolved from the 
affected individual, and carried through the air of a room or house either 
alone or attached to some of the innumerable epithelial cells, which are 
being rubbed off by millions from the surface of human bodies. 

Absence of Second Attacks. — The general absence of second attacks is 
admirably explained by the hypothesis that the parasitic fungus on the 
first occasion has exhausted all, or nearly all, of some peculiar (unknown) 
organic ingredient in the body, which is absolutely requisite for its sup- 
port, according to the very same law that will cause, as every farmer 
knows, his wheat to fail if he plants it repeatedly in the same ground and 
neglects to secure a due rotation of crops. 

Transmission of Disease. — Hence, according to this doctrine, con- 
tagious diseases are conveyed from one person to another by the trans- 
planting of miscroscopically visible organisms and spores or seeds which 
have a separate vitality of their own, each after its kind, and which are to 
be escaped just as one would escape hordes of animal or swarms of insect 
pests by shutting them out or killing them before they can succeed in 
fastening upon human bodies. 

The Itch Germ. — It is curious how we have seen in regard to small- 
16 



242 GKEEM-THEORY OE DISEASE. 

pox and diphtheria, etc., the same old battle fought which fifty years 
ago was so strenuously contested by Biett and Morgagni on the one hand, 
and the microscopists on the other, in relation to scabies or the itch, now 
universally admitted to be caused by a tiny insect which burrows beneath 
the human skin. 

Size of Disease Germs. — As having an important bearing upon the 
hygienic precautions instituted, great benefit would probably result from 
its being understood by every man, woman and child that the contagion of 
small-pox, scarlet fever, typhoid fever, yellow fever, measles, diphtheria, 
cholera, and so on, is composed of exceedingly minute forms of life, so 
small that 25,000 of them, placed end to end, would measure less than one 
inch in length. 

Multiplication of Germs. — Bacteria under favorable circumstances 
multiply with inconceivable rapidity, reproduction occurring most fre- 
quently by cell division; this is technically known as fission, constriction 
taking place in the centre of the cell, with ultimate separation at this 
point into two separate living beings ; from one parent organism, maturity 
occurring in one hour, a progeny of fifteen millions is theoretically possible 
in twenty-four hours. 

Nature's Law. — It is, however, probable that the same law of the 
prodigality of nature, exemplified in the spawn of the herring and salmon, 
holds good, and not more than one spore in a thousand, a million, or a 
hundred millions, perhaps, has an opportunity to reproduce its species. 

Care Required. — As there is no doubt that the contagion of the dis- 
eases just enumerated may penetrate into your system by the air that is 
breathed, the food that is eaten, and especially the water that is drunk, it 
is obvious that only the most scrupulous care can save us from these 
extremely minute seeds, or insure their destruction after entrance into our 
bodies is accomplished. If these germs were singly disseminated, it would 
be almost impossible to avert constant infection; but as they generally are 
carried about by winds or currents in aggregations of thousands or tens 
of thousands, of course the chances of imprisoning them, or otherwise 
shielding ourselves from them, are largely increased. 

Sanitary Regulations. — The obvious deductions from these facts tend 
to strengthen the urgent recommendations of sanitarians, that every effort 
should be made, first to prevent these morbific germs from being let loose 
upon the world; and second, when they have made their escape into 
the free air or water, to destroy all these forms of life that are likely 
to come in contact with unprotected persons — that is to say, human 



GERM-TILEORY OF DISEASE. 243 

beings from whose bodies one crop of small-pox (or cow pox) fungus, 
yellow-fever bacteria, relapsing-fever spirala, and so forth, has not al- 
ready been raised. Each individual affected with small-pox, scarlet fever, 
diphtheria, or any other of the diseases above mentioned, is, according 
to this theory, to be looked upon as a sort of hot-bed or forcing-house for 
the seeds or spores of that malady. 

Germs Grow Like Weeds. — Now, these germs, just like the seeds of 
larger noxious weeds, which, when allowed to gain a foothold in fields 
and gardens propagate themselves with such immense rapidity, yet with 
few exceptions, have no power to move of their own accord, and can only 
develop if they meet with air, moisture, and congenial soil suited to their 
peculiar requirements — that is, if a small-pox patient is shut up in an air- 
tight room, so that the seeds cannot escape ; or if, whilst in the open air, 
that air is stagnant, so that no seeds are wafted away from the immediate 
neighborhood of the individual; or if, when carried along by the wind, 
they are blown away from any human habitations, or are desiccated in a 
dry atmosphere, baked by the sun's rays or artificial heat, frozen by ex- 
treme cold (as seems to be the case with yellow-fever germs) ; or, finally, 
if they happen to meet with no persons but those who have had small- 
pox or been sufficiently vaccinated; in other words, if they do not "fall, 
upon good ground," all this wealth of provision by which nature tries 
so hard to secure the perpetuation of the poisonous plant causing small- 
pox in our systems, becomes unavailing, and her malevolent design against 
our race, carried out with such a prodigality of murderous weapons, 
utterly fails. 

Avoidance of Germs. — The germ-theory of disease teaches that every 
new case of the contagious maladies is the immediate offspring of a preced- 
ing case, and the direct result of exposure of an unprotected human 
being to the chance of having the spores or seeds of disease implanted in 
its system, an exposure which it only requires sufficient knowledge, suf- 
ficient foresight, and sufficient care to avoid. 



PART VII OF BOOK HI 

Treats of the manner in which a house should be 
constructed to be thoroughly sanitary and shows the 
advantages derived from this method of construction. 



Air, Composition of Soil Air 248 

Currents in Ground-Air 249 

Ground 251 

Motion of Soil Air 249 

In the Soil 248 

Sources of Polluted Ground- Air.. 249 

Aspect of House 251 

Chimneys 252 

Coal Gas in Dwellings 249 

Composition of Soil Air 248 

Conditions Necessary for a Healthy 

Home 247 

Construction of Walls 252 

Consumption and Damp Soils 248 

Currents in Ground-Air 249 

Dangers of Made Ground 250 

Decorations, Interior 253 

Diseases Due to Damp Soils 248 

From Soil Emanations 250 

Dwelling Houses, Healthy 247 

Elimination of Soil Dampness 251 

Ferments in Soil 250 

Floor Coverings 253 

Floors 252 

Foundations of House 252 

Furnishings 253 

Ground Air 25 1 

Air, Currents in 249 

Pores, Closing of 249 



Health, Damp Soil Injurious to 251 

Effect of Soil on 248 

Healthy Dwelling Houses 247 

Home, Conditions Necessary for.. 247 

House, Aspect of 251 

Foundation of 252 

Interior Decorations 253 

Furnishings 253 

Made Ground, Dangers of 250 

Polluted Ground- Air, Sources of 249 

Porous Soils, Danger of 250 

Prevention of Soil Exhalations, 251 

Roof, The 252 

Site, Choosing of 247 

Soil, Air in 248 

Air, Composition of 248 

Air, Motion of 249 

Clean ? 250 

Consumption and Damp Soils 248 

Dampness, Elimination of 251 

Damp Soil Injurious to Health . .251 

Danger of Porous Soils 250 

Diseases Due to Damp Soils 248 

Effect of on Health 248 

Emanations, Diseases from 250 

Exhalations Prevention of 251 

Ferments in 250 

Walls, Construction of 252 

Wall Coverings 253 

Woodwork 253 



245 



PREVENTIVE MEDICINE. 



. PAET VII. 
HEALTHY DWELLING HOUSES 



A healthy dwelling house is a very potent factor in the prevention 
of disease. If the house or its surroundings be unsanitary its inmates are 
subject to disease in many ways that would not otherwise occur, and there- 
fore it is important that the sanitary or unsanitary condition of his abode 
should be considered by every householder. 

SITE, CONSTRUCTION AND INTERNAL DECORATION. 

Conditions of a Healthy Home. — The conditions necessary to insure a 
healthy habitation may be summarized as follows: 

1. A site dry and not malarious, and an aspect which gives light 
and cheerfulness. 

2. A ventilation that carries off all respiratory impurities. 

3. A system of immediate and perfect sewage removal wmich shall 
render it impossible that, the air shall be contaminated from excreta. 

4. A pure supply and proper removal of water, by means of Avhich 
perfect cleanliness of all parts of the house can be insured. 

5. A construction of the house which shall insure perfect dryness 
of the foundations, walls and roof. 

Choosing a Site. — The site for a dwelling is rarely selected from 
a consideration of the healthiness of the location, particularly in its rela- 
tion to the conditions of the soil. Other considerations, often of an acci- 
dental character, more frequently determine the choice. And yet there 
is no more important subject to be taken into account in planning a house, 
none which demands a closer scrutiny, in view of its influence upon the 

247 



248 HEALTHY DWELLING HOUSES. 

health of the occupants, than the character of the soil in which its foun- 
dations are laid. 

Effect of Soil on Health. — It is only within recent years that public 
attention has been generally directed to the important relationship exist- 
ing between certain physical characteristics of the soil and health. The 
ground-air, ground-water and dampness have all been studied in con- 
nection with their agency in the production of certain diseases of common 
occurrence, and important facts have been arrived at, which are of great 
advantage in instituting measures for the preservation of health. 

Diseases Due to Damp Soils — Paroxysmal fevers, typhoid fever, 
bilious remittent fever, dysentery, diphtheria and cholera (during epi- 
demics of that disease) have all been attributed to earth effluvia. It is a 
well-known fact that dampness of the soil will cause catarrhal affections, 
rheumatism and neuralgia. 

Consumption and Damp Soils. — It hasTbeen clearly shown that damp- 
ness of the soil under houses is one of the chief factors in the production 
of consumption — that plague of our climate which destroys more lives 
than any other disease. Typhoid fever has also been supposed to be 
connected with changes in the water in the soil. A similar view is held 
with regard to dysentery, bilious remittent fevers and cholera. It is thus 
seen how potent are the influences of certain conditions of the soil in 
undermining health, and in causing disease, and therefore bow important 
it is to use every means for protecting ourselves against these enemies 
of health. 

The Air in the Soil. — All soils and most rock formations are more 
or less porous, and are capable of holding in their pores and spaces air 
or water, or both. When air as well as water is present, the soil is said 
to be moist. Only the hardest rocks are free from air. Gravel and loose 
sands are well known to be very porous, the latter containing often as 
much as half their bulk of air. The amount of air in some varieties of 
soft sandstones sometimes reaches 40 per cent. 

Composition of Soil Air — The composition of the air in the soil is 
variable, and differs widely from that of the free atmosphere. Carbonic 
acid in variable quantity is usually one of its constituents. The origin 
of this gas is supposed to be due to organic changes taking place in the 
soil itself. It cannot be derived from water precipitated from the atmos- 
phere, as the amount of this gas in meteoric water is exceedingly small. 
.Nor is it to be sought for in the ground-water as a source; but is most 
likely derived from the soil, and is imparted to the ground-water and 



SITE, CONSTRUCTION AND INTERNAL DECORATION. 249 

ground-air simultaneously, but more freely to the latter on account of 
its greater absorbent capacity. 

Sources of Polluted Ground- Air — The ground-air contains moie or 
less moisture, and is liable to be contaminated by effluvia and organic 
matter arising from the constituents of the soil. A frequent source of 
ground-air pollution in inhabited places is the impurities which soak 
into the soil from leaking cesspools and drains, from badly-constructed 
sewers, from leaky gas-mains, and from deposits of filth upon the surface 
of the ground. 

Motion of Soil Air — It is important to observe that the air in the 
soil is in continual movement. This movement is especially active in 
dry, porous soils. The motion of the air in the ground is caused by press- 
ure of the atmosphere and wind against its surface; by changes in the 
temperature of the lower strata of the atmosphere and of the upper sur- 
face of the soil, by the rainfall, and by changes in the level of the ground- 
water ; and to some extent by the operation of the law of diffusion of gases. 

Closing of Ground-Pores. — At every rainfall, the pores of the super- 
ficial layers of the ground are closed by the inflowing water, so that the 
upward escape of the imprisoned air is hindered, while the rise in the 
ground-water exerts a pressure from the opposite direction; under the 
circumstances the ground-air seeks an outlet at the point of least resist- 
ance, and in many cases escapes into dwellings — the more freely, the 
more extended and copious the rainfall. 

Currents in Ground-Air. — A current in the ground-air may be caused 
by local conditions ; thus, a house artificially heated, being warmer inside 
than the external air, will cause a current of air to enter it from the 
ground on which it stands. Any impurities in the surrounding soil may 
find access to the house through this channel. 

Coal-Gas in Dwellings. — Numerous instances have been recorded of 
the penetration of coal-gas into dwellings through the pores of the soil 
under the basement floors, the entrance of the gas being facilitated by 
the activity in the current of ground-air caused by the heated house. Ill- 
health, and even death, has been caused by gas escaping into houses in 
this manner. In the same way the air made noxious by the oozings from 
cesspools and broken drains, and by foul matters contained in the soil, 
may gain entrance through the foundation floors. 



250 HEALTHY DWELLING HOUSES. 



FEATURES OF A HEALTHY SITE. 

A Clean, Natural Soil. — A clean, natural soil, such as is free as pos- 
sible from those organic changes or processes which cause unhealthy 
emanations, should be the prime object in changing the location of a 
dwelling. Xo effort should be spared in improving the healthiness of 
a site. This may be accomplished by keeping the soil clean through effi- 
cient drainage, abolition of cesspools and other sources of filth-impreg- 
nation, and an abundant source of water for maintaining cleanliness in 
all parts of the house. And further, by making the ground floors and 
walls, as far as possible, impermeable to air. 

Dangers of Made-Ground. — "Made-ground" is to be looked upon with 
the greatest suspicion. Such a soil, generally composed of the refuse 
of a town, is necessarily very impure, and a house built upon it is liable 
to be unhealthy. A process of purification by oxidization and the influence 
of rain naturally takes place in the course of time, but the uncertainty 
of the result should always be determined by an examination of the 
ground. It is, however, best to avoid such a location altogether. 

Of Porous Soils. — Porous soils, such as those composed of gravel or 
rubble, are generally supposed to be healthy, but the assumption is not 
to be taken without qualification. The great facility which they afford 
for the circulation of air, and, through this medium, of conducting im- 
purities for a long distance, aided by the suction power of the house, 
makes it essential that such soils, in order to be healthy, should be free 
from noxious effluvia and deposits of animal or vegetable matter. 

Danger of Porous Soils. — Dry, porous soils, otherwise unobjectionable, 
may be the source of morbid exhalations. The ground in inhabited 
places, and even about isolated dwellings, often becomes impregnated 
with filth from sewers, broken drains, cesspools, and refuse heaps, which 
undergoes decomposition and gives rise to noxious gases which are danger- 
ous to health in proportion to the degree of concentration. 

Ferments in Soil. — Such a filth-sodden soil is, moreover, a convenient 
nidus for the production of those morbific ferments which seem to be 
connected with certain palpable organisms, which are looked upon as very 
important agents in the production of some of the common diseases that 
afflict humanity. 

Diseases from Soil Emanations — Among the diseases which have been 
attributed to emanations from the soil may be mentioned typhoid fever — 



PKEVEXTIOX OF SOIL EXHALATIONS. 251 

that scourge of the country as well as the city — cholera, fevers, dysentery 
and diphtheria. 

To Prevent Soil Emanations — As it is impossible to prevent the cir- 
culation of the air in the ground, structural devices must be employed 
to keep the soil-exhalations from rising up into the house. This is best 
accomplished by covering the entire site of the house with a layer of 
cement, concrete, asphalt or some other impervious material. A layer 
of concrete at least six inches deep, well rammed and well grouted with 
liquid cement, and made smooth upon the surface, makes a most satis- 
factory barrier to the ground-air and dampness. 



PREVENTION OF SOIL EXHALATIONS. 

Ground Air. — Every house should be protected from access of ground 
air. The selection of a proper site has much to do with this, but not all, 
for since it is impossible to prevent the circulation of ground air, certain 
devices must be employed to keep soil exhalations from rising into the 
house. 

The Best Device. — The best device for this is to cover the entire site 
with a layer of cement, concrete, asphalt or some impervious material. A 
layer of concrete six inches deep, well rammed and grouted with liquid 
cement, is a most satisfactory barrier to ground air and dampness. As- 
phalt over concrete also affords an excellent barrier. Such a floor has the 
advantage of being free from cracks and holes which harbor vermin. 

Dampness of Soil Injurious — Dampness of soil is dangerous to health. 
A dry, porous soil with possibilities of natural drainage will be found to be 
salubrious. Elevation of site is an indication of the presence of this con- 
dition. A damp condition of soil may be kept up by injudicious planting 
of trees and shrubs too near the house or by neglect in diverting drainage 
to some distant outlet and thereby preventing its absorption by the soil. 

House Aspect. — In choosing a. house site preference should always be 
given to the aspect or exposure which gives most light and cheerfulness, 
insures free circulation of air without being subjected to violent gusts of 
weather and is defended as far as possible from North and East winds ; a 
location free from mists and fogs, sudden shiftings of temperature and 
malarial and other injurious influences. 

Removing Soil Dampness. — Eor a building to be healthy the subsoil 
water should never be allowed to rise to the level of the foundations. To 



252 HEALTHY DWELLING HOUSES. 

prevent this ordinary land drainage pipes should be so laid as to carry off 
the subsoil waters into some sewer or other outlet. 

Foundations.- — Foundation walls should be composed of the best ma- 
terials and to prevent moisture being absorbed by the materials, thereby 
injuring the walls and timbers and rendering the atmosphere within 
unhealthy, a damp-proof course of some impervious substance like cement 
should be built in the wall just above the surface of the ground. 

External Walls. — The walls of a house are sometimes rendered damp 
by exposure to continued wet weather. Various means have been em- 
ployed for protecting the outside walls in exposed positions. Smooth, hard 
bricks, glazed bricks, slate, cement, weatherboards and tin have all been 
satisfactorily used for this purpose and under a variety of circumstances. 
Some walls are improved by a coating of good paint, but its frequent re- 
newal makes it expensive. Hollow walls are not infrequently constructed 
as a protection against dampness. Two parallel walls are constructed with 
a space between them three or four inches wide and joined together with 
bonding-ties of iron or stoneware. By this plan not only is dampness ex- 
cluded but a more equable temperature is maintained in the house. 

Construction of External Walls. — Whatever be the material chosen for 
the external walls it should be of the best quality and well put together. 
If stone or brick be chosen, and the latter is always preferable as being 
fire-proof, the laying should be done in well-tempered mortar or cement, 
and the wall should be of sufficient thickness to insure stability, keep out 
weather and protect the air of the house from the influence of sudden 
weather changes. 

Chimneys. — To insure safety against fires the brick work of chimneys 
and fire-places should be at least nine inches thick, and no wooden plugs or 
bricks should ever be inserted in it lest they become charred and ignite 
and set the house on fire. Terra-cotta linings to chimneys are a source of 
safety and cleanliness. So far as possible chimneys should be straight and 
have a smooth interior so as to facilitate the draught. 

The Roof — A good roof is an important part of a sanitary house. If 
not properly constructed it is a constant source of annoyance. Slate, tiles, 
zinc, copper, lead, tin and shingles all make substantial roofs. Tarred felt 
and gravel compositions are not to be recommended except for temporary 
structures. Metal roofs require but little slope, but the slope of slate, 
shingle or tile roofs should be steep. Great care should be taken in the 
arrangement and making of gutters, spouting and pipes. 

Floors — These should be of well-seasoned lumber and laid so as to 



PREVENTION OF SOIL EXHALATIONS. 253 

present a smooth, even surface, free from cracks. The plowed and grooved 
floor and the doweled floor have great advantages. Fire-proof floors are 
desirable but not adapted to ordinary dwellings. Basement floors should 
be of concrete. 

Moor Coverings. — The inlaid floor composed of different woods 
and known as parquetry is ornamental and very effective when it is in- 
tended to dispense with carpets. Carpets were formerly much more used 
as floor coverings than at present. They are not a sanitary covering on ac- 
count of their susceptibility to collect dust and dirt and they are difficult to 
remove and shake. The present fashion of abandoning the closely fitting 
carpets and substituting parquetry rugs and square carpets on stained or 
varnished floors is an important step toward effecting improvement in the 
sanitary condition of dwellings. 

Wall Coverings — For cottages and inexpensive dwellings no wall 
covering is better or healthier than lime whitewash. It may be ren- 
dered artistic by coloring, and can be renewed readily and cheaply. Paint 
answers as an excellent wall covering. It produces a smooth, hard, non- 
absorbent surface which can be washed when necessary. Paper is most 
used at present as a wall covering, but it is doubtful if it is a good sanitary 
covering, as it is absorbent of moisture and is very apt to become saturated 
with impurities in the heated air of rooms. Moreover, many wall papers 
are dangerous from the fact that some of their colors, especially the 
green, are derived from poisonous substances. 

Woodwork — The woodwork about the house may be stained and 
varnished, or oiled and polished, or painted. Natural wood, oiled and pol- 
ished, or varnished, the pores first having been "filled," makes a most de- 
sirable finish, and is rapidly coming into general use. Whatever may be 
the choice in this respect it is important that the materials used shall, as far 
as possible, be impervious, and so applied as to present a smooth, even 
surface that will repel dust and dirt and admit of being easily cleaned. 
This recommendation applies with equal force to all the interior finishing 
of the house. 

Internal Decorations and Furnishings. — The internal decoration and 
fittings or furnishing of the house may exert no inconsiderable influence 
on health, and it is therefore important that they conform, as far as pos- 
sible, to the principles of sanitation, so as to conduce to the health as well 
as the comfort of the occupants. It is clearly evident that all furniture, 
which, by its excessive decoration or peculiar construction, collects and con- 
ceals dust and dirt that cannot be easilv detected and removed; all heavy 



254 HEALTHY DWELLING HOUSES. 

drapery, so commonly hung in profusion about living and sleeping apart- 
ments, which cannot be cleaned with facility and which excludes light and 
air ; all over-ornamentation of ceilings and cornices by elaborate mouldings 
which defy all attempts at cleansing ; the so-called artistic furniture loaded 
down with ornaments of china and glass, and "what-not," which furnish 
so many hiding places for the ever-present dust ; all these are, to a great 
extent, objectionable and unhealthy. 



PART VIII OF BOOK III 

Shows how necessary to health it is to remove all 
refuse matter, solid and liquid, from dwellings and 
their vicinity. 



Air Pollution, Sources of 257 

Cleanliness, Safety in 257 

Closet, Construction of Sanitary 

Closet 258 

Sanitary 257 

System, Earth 258 

Disease, Filth as a Cause of 257 

Drainage, House 257 

Drains, Flushing of 258 

Dry System of Removing Excreta ...258 

Earth-Closet System, The 258 

Filth as a Cause of Disease 257 



House Drainage 257 

Drains, Flushing of 258 

Polluted Air, Sources of 257 

Water, Sources of 257 

Rain- Water Leaders 258 

Safety in Cleanliness 257 

Sanitary Closets 257 

Closet, Construction of 258 

System of Removing Excreta, Dry ..258 
Water Pollution, Sources of 257 



255 



PREVENTIVE MEDICINE 



PAET VIII. 
SANITARY CLOSETS 



The thorough removal of refuse matter, solid and liquid, from build- 
ings and their vicinity, is indispensable to healthy life. Neglect of this 
is a cause of a vast number of preventable diseases. 

Why Filth Produces Disease — Accumulations of filth about houses 
taints air, water and soil. Septic particles, or ferments, given off in the 
putrefaction of organic matter, evolve the seeds of many diseases. 
Typhoid and enteric fevers are thus engendered. Privies and privy drain- 
age and soakage have given rise to typhoid epidemics. Cholera, dysentery 
and allied diseases spring from the same source. Many other diseases 
owe their origin to filth poisons. Many suppose that consumption may be 
due to filth particles. Filth is the breeding place of the germs of diphtheria 
and other fatal diseases. 

Safety in Cleanliness. — All refuse matter calculated to poison air, 
water or soil near a dwelling should be sedulously removed. This neces- 
sity exists everywhere, in city as well as in country. 

Sources of Air and Water Pollution — Nuisances traceable to air and 
water pollution are: 

1. Defects of public sewerage. 

2. Defects of house drainage. 

3. Faults of cess-pool arrangement. No cess-pool should exist as a 
simple hole in the ground. It should be walled or bricked dry, and 
the bottom laid similarly. It should be frequently cleansed. No wells 
should be near it. 

House Drainage. — Every house drain should insure the removal of all 

liquid refuse, waste-water and fecal matter, without leakage. The pipes 

should be of iron or earthen ware, for at least eight or ten feet distant 

from the house ; but if a spring or well be near the piping should continue 

far beyond it. All pipes should be laid in a bed of clay, and the joints 

firmly cemented. Cement beds for pipes are the best. 

257 
17 



258 SANITARY CLOSETS. 

Flushing of House-Drains — All house-drains should be occasionally 
flushed by pouring large bodies of water into them. Field's flush tank 
is used for the purpose of flushing drains in the country. 

Rain-Water Leaders. — A convenient plan of disposing of rain water 
is to pass it through the drain pipes. This affords an excellent flush, but 
care must be taken against freezing in winter ; all conductors of rain water 
should be kept outside the house, lest the back gases should enter the 
house. 

Dry System of Removing Excreta — The dry system is adapted to towns 
and villages and to single cottages. It consists in the admixture of dried 
earth, coal ashes, or other dried refuse, with the excrement in sufficient 
quantity to absorb and reduce it to an inodorous form. The absorbent 
material must be perfectly dry, and must be applied immediately, and in 
sufficient quantity to cover the excretions and remove all fluidity. All 
slops and sink water and solid matter must be carefully excluded. In 
rural districts this plan can be made very satisfactory, but in towns it is 
seldom that the removal takes place sufficiently often to meet the require- 
ments of the case. The receptacles should be made of impervious mate- 
rials, and the closet should be located either out of doors, or in an isolated 
part of the building, or in an apartment projecting from the house. The 
apartment should be well ventilated. 

The Earth-Closet System — Moule's earth-closet system comes under 
the head of the dry-removal systems, and is the plan with which the public 
is most familiar. On account of the absorbing and deodorizing qualities 
of dried earth, this substance is selected for use in closets, especially within 
the house. The original apparatus, designed by Mr. Moule, consists of 
a wooden box divided into two main compartments. The lower one contains 
a receptacle or pail for the sewage, and the upper one the reservoir or 
hopper from which the dried earth is supplied in requisite quantity when- 
ever the closet is used. The hopper in the upper part of the apparatus 
is capable of holding an ordinary coal-scuttle full of earth. A plug is 
attached to its outlet, and is operated by a lever connected with a handle. 
Beneath the seat is a guard, which directs the dried earth into the pail 
without allowing any of it to escape at the sides. 

Construction of Sanitary Closet. — (1) A concrete bin, six feet long, 
three feet deep and two and one-half feet wide in measurements, divided 
into three compartments of equal size by concrete partitions, the first of 
which is built so as to leave a six-inch space at the bottom and the second 
a six-inch space at the top. 



PART I OF BOOK IV 

Treats of the eruptive diseases ; their classification, 
prevention, symptoms and treatment. 



Adults, Doses for 264 

Ague 322 

Treatment of 324 

Anthrax 344 

Causes of 344 

Intestinal 345 

Malignant 345 

Treatment of 345 

Bacilli, Means of Conveying 278 

Typhoid 278 

Bed Sores, Treatment of 286 

Black Vomit 294 

Blood Poison 347 

Cause of 347 

Pus 348 

Treatment of 348 

Break-bone Fever 274 

Bubonic Plague , 301 

Cause of 301 

Treatment of 302 

Cachenia, Malarial 320 

Cerebro-Spinal Meningitis 287 

Change of Medicines 265 

Children, Doses for 264 

Chill, Congestive .326 

Cholera, Asiatic 328 

Cholera Morbus 327 

Causes of 327 

Treatment of 328 

Chronic Malaria 320 

Treatment of 321 

Classification of Disease 261 

Complicated Diseases 263 

Congestive Chill 326 

Constitutional Diseases 262 

Continued Fever 325 

Continued Fever, Protracted Simple.. 293 

Cow-pox 272 

Dengue 274 

Diphtheria 335 

Cause of 335 

Complications in 337 



Laryngeal 337 

Nasal 336 

Pharyngeal 335 

Prevention of 338 

Treatment in 339 

Siiseases, Classification of 261 

Doses for Adults 264 

For Children 264 

How to Graduate 264 

Dosing, Care in 263 

Edema 345 

Emetics, Doses of 264 

Ephe meral Fever 293 

Causes of 293 

Treatment of 293 

Eruptive Diseases 261 

Erysipelas ' 346 

Causes of 346 

Treatment of 347 

Estivo- Autumnal Fever 320 

Farcy * 343 

Febricula 293 

Febris Recurrens 291 

Fever, Break-bone 274 

Continued 325 

Ephemeral 293 

Estivo- Autumnal 320 

Gibraltar 294 

Intermittent 322 

Irregular 325 

Malarial 316 

Perincenis Malarial 320 

Pernicious Malarial 326 

Protracted Simple Continued ....293 

Purpuric 288 

Relapsing 291 

Remittent 325 

Sailors' 294 

Spotted 287 

Typhoid 277 

Typhus 275 

Yellow 294 



259 



260 



INDEX TO PART I OF BOOK IV. 



German Measles 273 

Gibraltar Fever 294 

Glanders 343 

Cause of • 343 

Treatment of 344 

Graduation of Doses 264 

Grippe, La 342 

Hookworm Disease 309 

Cause of 309 

Treatment of 311 

Influenza 342 

Causes of 342 

Treatment of 343 

Intermittent Fever 322 

Intestinal Anthrax 345 

Irregular Fever 325 

La Grippe 342 

Laryngeal Diphtheria 337 

Malaria, Chronic 320 

Malarial Cachenia 320 

Malarial Fever, Perincenis 320 

Malarial Fever, Pernicious 326 

Malarial Fevers 316 

Cause of 316 

Treatment of 320 

Malignant Anthrax 345 

Pustule 344 

Measles, German 273 

Medicines, Change of . . .» 265 

Meningitis, Cerebro-Spinal 287 

Nasal Diphtheria 336 

Opiates, Doses of 264 

Pellagra 314 

Perincenis Malarial Fever 320 

Symptoms of 320 

Pernicious Malarial Fever 326 

Treatment of 326 

Pharyngeal Diphtheria 335 

Plague, Bubonic 301 

Protracted Simple Continued Fever., 293 

Causes of 293 

Treatment of 294 



Purpuric Fever 288 

Pus Blood Poison 348 

Pyemia 348 

Causes of 348 

Treatment of 349 

Relapsing Fever 291 

Cause of 2pi 

Treatment of 292 

Remittent Fever 325 

Cause of 326 

Treatment of ^526 

Rotheln 273 

Rubella 273 

Sailors' Fever ...294 

St. Anthony's Fire 346 

Septicemia 347 

Simple Continued Fever, Protracted. .293 

Sleeping Sickness 306 

Cause of 306 

Treatment of 308 

Small-pox 265 

Cause of 265 

Nursing in 270 

Treatment of ' , . .268 

Vaccination in 270 

Varieties of 266 

Spotted Fever 287 

Causes of 287 

Treatment of 289 

Typhoid Bacilli 278 

Typhoid Fever 277 

Nursing in 285 

Treatment of 282 

Walking 286 

Typhus Fever 275 

Vaccina 272 

Vaccination as a Preventive of Small- 
pox 270 

Variola 265 

Walking Typhoid 286 

Wool Sorter's Disease 345 

Yellow Fever 294 

Treatment of 300 



ILLUSTRATIONS 

The Cholera Germ 328 Yellow Fever Mosquito 

Hookworm Cut 310 



295 



Book IV 



CURATIVE MEDICINE 



PAET I. 
THE ERUPTIVE DISEASES 

The Plan and Scope of the Subject. — In this part of the work, the 
author proposes to give an outline of the natural history of each disease, 
advice as to the modes of preventing its onset when threatened, recom- 
mendations as to its hygienic management, hints as to its probable course, 
fatality, and ultimate results upon the system, if recovery takes place, and 
finally suggestions in regard to its medical treatment. 

Home Value of the Book. — As already advised, the most skillful physi- 
cian who can be procured should be called in to treat disease ; but in the 
emergency, until he arrives, much can be done in accordance with the 
directions here given to allay the sufferings of the patient, to place him in 
a more favorable position for speedy recovery, and, above all, to prevent 
the calamity which has befallen him from becoming aggravated before the 
doctor comes, through want of proper care. 

Manner of Treatment. — Since a large proportion of the "ills which 
flesh is heir to" are rarely seen in this country, and have therefore but 
little importance to inhabitants of the United States, except as matters of 
curiosity, it is proposed to give very brief notices of these infrequent 
maladies, in order to economize space for a fuller account of those prev- 
alent diseases which, sometimes in their lives, will, alas, personally in- 
terest a majority of the readers of this book. 

THE CLASSIFICATION OF DISEASE. 

Among the almost innumerable methods of classifying diseases which 
afflict the human family, one of the latest, and probably the best, is that 
devised by the Eoyal College of Physicians of England, and adopted by 

(261) 



262 THE ERUPTIVE DISEASES. 

law as the basis for all those statistical reports relating to medical subjects 
of which the British nation is justly entitled to be proud. This, with 
some unimportant variations, is the system adhered to in the present 
section. 

English Names for Diseases — The plan of this nomenclature is to give 
an English name to the disease, employing the terms in popular use when- 
ever they are not absolutely inaccurate, and to use only one word, or as 
few words as possible, in naming a disease. Definitions are attached to the 
English names in certain instances only, that is in cases where there might 
otherwise be some ambiguity in the signification of the title. The classi- 
fication of diseases thus designated is based on their anatomical seat in the 
human body, the division being first into general diseases and local diseases. 

General Diseases. — The general diseases are those which affect the 
whole frame, and are subdivided into two sections. The first compre- 
hends those disorders which appear to involve a morbid state of the blood, 
and for the most part present the following characteristics. They run a 
definite course, are attended with fever, and frequently with eruptions on 
the skin ; are more or less readily communicable from person to person, and 
possess the singular and important property of generally protecting those 
who suffer with them from a second attack ; they are apt to occur as epi- 
demics. Small-pox is a good example of this group, and in our ceaseless 
combat with disease it is with disorders of this section that hygiene and 
preventive medicine have won their grandest triumphs and accomplished 
their most beneficent work. 

Constitutional Diseases. — The next of the general diseases comprises 
for the most part maladies which are apt to invade different parts of the 
same body, simultaneously or in succession. These disorders are some- 
times spoken of as constitutional diseases, and they often manifest a 
tendency to transmission by inheritance. Gout and rheumatism furnish 
good illustrations of this type of disease. 

Diseases of the Organs — The second class, that of local diseases, com- 
prehends all those which affect the structure of special organs, or par- 
ticular parts of the human body, leading to marked disturbance of their 
functions. Diseases of the eye, such as cataract, and local inflammations, 
such as pneumonia or inflammation of the lungs, exemplify the characters 
of this group. Owing to the wonderfully close association and sympathy 
between all the different parts of the human frame, no one organ can 
suffer alone, and hence with the local diseases constitutional disturbances, 
such as fever, generally arise, and may totally mislead an inexperienced 
observer. 



CAKE IN DOSING, 263 

Recognition of Local Diseases. — The recognition of local disease in 
obscure cases is often, indeed, one of the most difficult problems a physi- 
cian can be called upon to solve. Commonly complaint of pain in some 
particular part directs attention to that spot as the seat of primary dis- 
turbance, and leads to its thorough examination, which should be made 
with the aid of all the mechanical appliances, such as the stethoscope, the 
microscope, the thermometer, and so forth, which medical science has 
placed at our disposal. It is only when after all these means are exhausted, 
in a vain effort to detect local disease at the seat of pain or of pronounced 
discomfort, sufficient to account for that disturbance, that we are justified 
in considering local distress as a mere symptom of general disease. 

Complicated Diseases. — Unfortunately, neither a general nor a local 
disease gives the sufferer any positive security against the onset of another 
malady at the same time, and we often see people burdened with a compli- 
cation of disorders, each of which by its symptoms obscures the rest, and 
perhaps renders the proper treatment for them inadmissible. It is this 
tendency to the development of complications, either secondary to the 
chief disease or entirely independent of it, which in many affections is the 
indirect cause of death. 

Damaged Organs. — Frequently, too, after a severe illness, some impor- 
tant organ is damaged in its structure, and the patient for the rest of his 
life suffers for want of its proper performance of function throughout his 
whole organism, which is really as much crippled in its work as a man 
would be if his leg or arm had been left upon a battlefield. This is 
especially the case with the heart after an attack of inflammatory rheu- 
matism, which, by affecting the cardiac valves, prevents the circulation of 
the blood from being duly carried on, and, as it grows worse in later years, 
is apt to terminate existence abruptly by sudden death, or by the painful 
method of prolonged and lingering illness. 

Care in Dosing. — The greatest care must be exercised in portioning 
out the doses of medicines suggested for the treatment of the diseases 
described, and it should always be recollected that a mistake which, is a 
mere blunder in other vocations may at any moment become a crime in 
the occupations of prescribing, preparing, or administering medicines. 
Hence the doctor, the apothecary and the nurse, who have always the 
life of the patient in their keeping, should be persons who are willing and 
able to fully realize their responsibility; those who, whilst on duty, are 
unceasingly and vigilantly on guard against committing an error of any 
kind. 



264 THE ERUPTIVE DISEASES. 

Doses Are Always for Adults. — The doses of medicines recommended 
in this section of the work are always for adults, unless otherwise ex- 
pressly stated, and must he proportionately reduced for children according 
to age. Thus, for a young person of from fourteen to sixteen years, two- 
thirds of the ordinary dose should be given; from ten to thirteen, about 
one-half; from eight to ten, two-fifths; from six to eight, one-third; for 
a child of four or five years, one-fourth ; for one of three years, one-fifth ; 
for one of two years, one-seventh; for an infant of one year, one-thir- 
teenth ; and for a baby of from three to six months, one-twenty-fourth. 

Doses for Children. — For example, the average dose of bromide of 
potassium for a grown person being twenty grains, that for a youth 
between fourteen and sixteen years would be sixteen grains ; between ten 
and thirteen, ten grains; between eight and ten, eight grains; between 
six and eight, seven grains; between four and five, five grains; at three 
years, four grains ; at two years, three grains ; at one year, a grain and a 
half; and at six months, three-quarters of a grain. 

How to Graduate Doses. — These fractional amounts are most conven- 
iently arranged for young children by diluting a single dose for an adult 
with the requisite number of teaspoonfuls of pure water. That is to say, 
using the above illustration, if it is desired to administer bromide of potas- 
sium to a child one year old threatened with convulsions, twenty grains of 
the drug might be dissolved in thirteen teaspoonfuls of water, and a tea- 
spoonful given every hour or two. 

Why Doses Should Vary. — The doses of medicine vary, as already 
pointed out in the earlier part of this volume, in accordance with sex, 
idiosyncrasy and habit, and one of the most important advantages enjoyed 
by a skilled family physician is his power, gained by long practical experi- 
ence, of so adapting each dose of medicine to every individual of a family, 
as to gain the greatest amount of benefit with the least amount of injury 
in any particular case. 

Opiates and Emetics. — The general rule given above in regard to doses 
of medicines to children has some exceptions, the most important being 
in regard to opium, which is not well borne in childhood, and calomel or 
castor-oil, of which a larger proportionate quantity may be administered. 
In regard to the frequency of repetition of medicines, it should be under- 
stood that when not otherwise stated, this may be judged of by the effect 
produced. Thus, as a rule, an emetic may be repeated in fifteen minutes 
if the patient does not vomit ; an opiate may be repeated in an hour if pain 



SMALL-POX. 265 

still continues without mitigation, and a cathartic in from six to eight 
hours if no purgative action is effected. 

Change of Medicines. — In those unfortunate patients who cannot take 
laudanum, morphia, or paregoric for the relief of pain, which constitutes 
the great symptom of disease, codeia, chloral, hyoscyamus, bromide of 
potassium, Indian hemp, and lactucarium may he used as substitutes, but 
vrithout much expectation that they will fully serve the purpose of opium, 
that greatest boon to suffering humanity. 

THE ERUPTIVE AND ACUTE INFECTIONS 

SMALL-POX OR VARIOLA. 

Definition. — An acute and highly contagious disease characterized (a) 
by an eruption, which by the third day is papular, by the sixth day is 
vesicular and by the ninth it becomes pustular (b) by a fever which ap- 
pears with the onset, disappears with the eruption, but returns again when 
the eruption becomes pustular. 

History. — Small-pox was first accurately described by Ehazes, an 
Arabian physician, in the ninth century, and distinguished by him from 
measles, but it is believed to be the same as the pesta magna described by 
Galen (A. D. 130-200). It is known to have prevailed during the sixth 
century and again about the time of the Crusades. The disease is believed 
to have been introduced into America by the Spaniards early in the six- 
teenth century. 

Cause. — Small-pox is one of the most virulent of the contagious dis- 
eases, the poison of which is extremely tenacious of life; it may remain 
latent in clothes for a long time, and then be capable of exciting the 
disease. The contagion exists in the secretions and excretions, and in the 
exhalations from the lungs and skin. The dried scales constitute by far 
the most important element, becoming attached to clothing and furniture ; 
and are conveyed by j)ersons who have been in contact with the sick. The 
disease is probably contagious from a very early stage, though it has not 
yet been determined whether the contagion is active before the eruption 
develops. The degree of mildness or severity of a case does not influence 
that of another caused by it, the severest cases being at times followed by 
the mildest forms, and vice versa. 

Age. — Unless protected by vaccination or a previous attack, nearly 
every one is susceptible, from the aged to the child in the womb. The 
disease is usually fatal in the very young. 



2(j(5 THE ERUPTIVE DISEASES. 

Sex. — Male and female are equally affected. 

Eace. — The North American Indian and the negro are particularly 

susceptible to it. 

Nature of the Disease. — The eruption consists in an infiltration of cells 
into the rete mucosum or into the true skin. Genuine pock marks are fre- 
quently found in the mouth, oesophagus and larynx and there are paren- 
chymatous or soft cellular tissue degenerations in other organs. 

Varieties. — Discrete, confluent, malignant and varioloid. 

Symptoms. — 1st. Discrete form: After a period of incubation of 
from nine to fifteen days (Osier), seven to twelve days (Tyson), the 
disease is ushered in with a chill in adults, and with a convulsion in chil- 
dren. There is an intense frontal headache and agonizing lumbar pains, 
and vomiting. The pains in the limbs and back are more severe in the 
initial stage of this than of any other eruptive fever, and connected with 
the frontal headache and vomiting are specially and decisively charac- 
teristic, or pathognomonic, of this disease. 

Fever sets in rapidly and may go as high as 103 or 104 the first 
day ; the pulse is rapid, hard and strong at this stage. Delirium may be 
present, and is at times violent. The face is flushed and the eyes are 
bright and clear. 

The Eruption. — About the third or fourth day small red spots are 
noticed, first on the forehead and wrists, from which it rapidly spreads 
over the face and extremities. At this stage the eruption is not unlike 
measles, but in another twenty-four hours it is quite different, the papules 
having a "shot-like feeling/' from which stage they pass into the other 
two stages mentioned in the definition. As the eruption comes out the 
fever falls, symptoms abate and the patient feels more comfortable. On 
the fifth or sixth days the papules become converted in the vesicles, which 
contains a clear fluid, the vesicle itself having a depressed or umbilicated 
centre. By the eighth or ninth day the vesicles are converted into pustules, 
the umbilication disappears and the fluid becomes a grayish-yellow, owing 
to the contained pus. At this stage the fever rises and the general 
symptoms return. In the discrete form the fever does not usually remain 
high for more than twenty-four or twenty-six hours, so that on the tenth 
or eleventh day the fever disappears and convalescence sets in. By the 
fourteenth day the pustules become dry. are converted into crusts and 
drop off, leaving, in mild cases, a simple discoloration which in time dis- 
appears, but in severe cases a more or less deep ulcer, or, if cicatrization 
be complete, a simple pit. 








SMALL-POX. 

Discrete or Separate Form. 







« 




K. J. S. 



SMALL-POX. 
Confluent or Enmassed Form. 




o 
O rt 

Wo 



W 



SMALL-POX. 267 

Symptoms of the Confluent Form. — 2d. This form has the same initial 
symptoms as the discrete, but they are of greater severity. The eruption 
in this variety comes out earlier than in the above-mentioned form. 
Sydenham early called attention to the fact that the earlier the eruption 
appeared the more danger there was in its assuming the confluent variety. 
In this variety the fever does not abate on the appearance of the eruption 
as it does in the discrete form. The face, hands and feet present an almost 
continuous pustule, which often bursts in places, and, the pus partly dry- 
ing, there results a picture which is horrible in the extreme. True pocks 
nearly always develop in the air passages, and give rise to a copious fetid 
discharge from the nose and throat. Should the patient recover it is only 
after a tedious convalescence, with great facial disfigurement and often 
with defective vision and hearing. 

Malignant Form. — 3d. In some cases this form of the disease is 
ushered in with a high fever, excruciating pains in the back and vomiting. 
The hemorrhagic rash appears early, while the hemorrhage takes place 
from the mucous membrane or surfaces, generally on the evening of the 
second or third day, and the patient may die in from two to six days, some- 
times even before the eruption makes its appearance. The face is swollen 
and large conjunctival hemorrhages, with the deeply sunken cornese, give 
a ghastly appearance to the features. The mind generally remains clear, 
but death is the usual result. 

Varioloid. — 4th. This is small-pox which is modified by a previous 
attack or by vaccination. The attack may come on with the symptoms as 
severe as in the discrete form, but usually the initial fever is less, the erup- 
tion is less general and may abort in its early development, the secondary 
fever is less marked and convalescence sets in earlier. Vesication, or 
blistering, takes place rapidly, as there is rarely any scarring. 

Diagnosis. — The diagnosis or recognition of small-pox is of great im- 
portance, and many an anxious hour is often passed by the physician, 
the patient, and the friends of the latter before it is possible to decide with 
certainty as to the nature of the disease. While small-pox may be mis- 
taken for a number of affections, the chief difficulty after the eruption 
begins to come out is in distinguishing it from measles and from chicken- 
pox. Of course, it is very important to make the diagnosis at the earliest 
possible moment, in order that timely precautions against the spreading 
of the disorder shall be instituted. After the pimples begin to contain 
fluid, the danger of mistaking the malady for measles is over, because the 



268 THE ERUPTIVE DISEASES. 

general eruption of measles is never vesicular, although a few little 
blisters are occasionally seen in bad cases. 

To Distinguish from Measles. — In many instances a probable opinion 
can be given that a disease is measles and not small-pox, from the fact that 
the eruption of pimples is softer, less shot-like, and arranged in obscurely 
denned crescents upon the arms and neck. In others, however, it is impos- 
sible to decide before the second day of the eruption, when, as a rule, some 
few of the pimples will be found slightly vesicular if the disease is 
small-pox. 

To Distinguish from Chicken-Pox — When the vesicles appear, the great 
point of distinction between them and the vesicles of chicken-pox is that 
the small-pox vesicle is depressed in the middle, giving it what is called the 
umbilicated or navel-like aspect. This is an important characteristic, and 
should always be carefully looked for. Before the eruption comes out, 
only a probable guess can be made in many instances. 

Unusual Symptoms. — Dr. Flint, perhaps the most acute diagnostician 
in America,, says that decided fever following immediately after a chill, 
the fever continuing without much remission for two days, pain in the 
back being a prominent symptom, if it be known that the patient has been 
exposed to small-pox, or if this disease is prevalent, renders the diagnosis 
extremely probable. In comparatively rare cases, unusual symptoms in an 
attack of small-pox might for a day or two render the diagnosis difficult 
from scarlet fever, the simple mild fever called febricula, the skin disease 
called lichen, some of the pustular eruptions of the venereal disease, and 
in its very earliest stage from erysipelas and typhoid fever. 

Treatment. — Since we have as yet discovered no antidote for the 
small-pox poison, the chief treatment is the relief of symptoms, as far as 
possible, as they arise, and careful nursing, in order to avoid needless 
aggravation of the disease or the development of complications. The mild- 
est cases, as well as those which are more severe, should be kept in bed in 
a cool apartment, which is ventilated as freely as possible, without pro- 
ducing dangerous draughts. 

The Back. — In bad cases the patient's back ought to be frequently 
examined, and suitable precautions taken against the formation of bed- 
sores, as recommended under the head of typhoid fever, the hair cut 
off close, in order to avoid the matting with the corruption from the 
pustules when that begins to discharge. 

The Bowels — The bowels should be well opened as soon as fever 
develops with a tablespoonful of castor-oil, or a saline purgative, such as' 




Two children in the Municipal Hospital, one unvaccinated and the other vaccinated on 
the day of admission — the crust is still seen upon the leg. This child remained in the 
hospital with its mother (who was suffering from small-pox) for three weeks, and was dis- 
charged perfectly well. The unvaccinated child admitted with small-pox died. (Welch and 
Schamberg.) 



E. T. S. 



SMALL-POX. 269 

a Seidlitz powder or a bottle of citrate of magnesia, and then a cooling 
and diaphoretic mixture, composed of half a teaspoonful of sweet spirits 
of nitre, ten grains of bromide of potassium, or phenacetum, four grains, 
every three or four hours, for fever, and an ice cap to the head for the 
violent headache, administered every two or three hours if there is much 
pain or restlessness. After the primary fever subsides, with the coming out 
of the eruption, there are often a few days during which no medical treat- 
ment is necessary ; but with the appearance of the secondary fever, the 
cooling mixture should be resumed. Quinine, tincture of iron and brandy 
should be given in full doses. 

The Itching. — To relieve the itching, which is sometimes almost intol- 
erable, the surf ace of the skin may be sponged over with a weak solution 
of sulphurous acid or of carbolic acid, six or eight drops to the ounce of 
water. If no relief is obtained from these, anointing the body with cosmo- 
line or with cold cream may be tried; but it is sometimes needful to 
muffle the hands, especially of children, in order to prevent them from 
scratching open the pocks after they begin to heal, and so rendering the 
resulting scars much deeper and more permanent. Keep the patient in a 
dark room and cover the face with a mask of mercurial ointment, and to 
prevent pitting the pustles may be touched with tincture of iodine. 

The Fever. — The fever, when high, must be kept within limits, either 
by cold sponging or by the cold bath, the water being at a temperature of 
75 degrees when the patient is first put in and then gradually lower it to 
68 degrees. During convalescence bathing should be frequent, as it helps 
to soften the crusts. In malignant small-pox, which generally proves 
fatal, where very soon the face becomes so swollen that the eyelids are 
tightly closed and glued together, they should be frequently bathed with 
a saturated solution of boric acid. The mouth and nose should be kept 
clean and soft by frequent injections. The patient should have plenty of 
cold water. Should the heart become weak hypodermics of strychnine, 
one-thirtieth of a grain, or dram doses of aromatic spirits of ammonia by 
the mouth. 

Treatment of Malignant Small-Pox. — In malignant small-pox, and in 
the petechial or hemmorrhagic form, the black small-pox of common lan- 
guage, the only chance of successful treatment is to support the strength 
with quinine in four-grain doses thrice daily, or Peruvian bark and other 
tonics, and with stimulants such as wine or brandy or milk-punch, in the 
forlorn hope that unusual vigor of the constitution may thus be reinforced 
long enough for the violence of the disease to become expended. If the 



270 THE ERUPTIVE DISEASES. 

patient can thus be kept alive nntil after the twelfth or fifteenth day with- 
out any important organ becoming seriously damaged in its structure, the 
chance of recovery will subsequently increase every day. The disease 
being self-limited, it is obviously our chief duty, in the absence of any 
known specific, to direct our energies toward sustaining the patient's 
strength in his battle with the disorder, and the prospect of recovery, or 
prognosis, as it is termed, turns upon the relative power of endurance of 
the disease-poison and the patient's constitution. 

Diet. — The diet in the early stage of small-pox, like that in most 
febrile conditions, should be light and unstimulating, consisting of rice, 
cornstarch, bread and milk, or arrow-root. Oranges or lemonade in modera- 
tion may be allowed, unless there is a tendency to diarrhoea. Ice water, 
lumps of ice, or iced carbonic acid water may be given ad libitum. Later 
on in the disorder, when the strength begins to fail and the pulse grows 
weaker, strong animal broths, beef essence, and other highly nutritious 
aliments are necessary; and if the pulse at the wrist should seem very 
feeble, and especially if it should become intermittent, milk-punch, egg- 
nogg, or other powerful stimulants ought to be resorted to. 

Nursing in Small-Pox. — The general care of a small-pox patient ought 
to be afforded in accordance with directions contained in the chapter on 
^Nursing, and most of the special precautions for avoiding the extension 
of the disease, and so forth, have been pointed out in the article on Con- 
tagious Influence. On account of the danger of pneumonia and pleurisy, 
particular watchfulness is needed against taking cold from draughts of 
air, and during the delirium of the fourth stage, in bad cases, the atten- 
dant must be constantly on guard to prevent the patient from injuring 
himself or others. The nurse should wear an overall and remove it on 
coming out of the room, and her head should be covered with a cap. 

VACCINATION THE GREAT PREVENTIVE OF SMALL-POX. 

Seeing, then, that small-pox is a most painful, loathsome, and fatal 
disease, for which we have no cure, it becomes infinitely important to avail 
ourselves of the protection against its ravages afforded by Dr. Jenner's 
beneficent discovery of vaccination, a discovery which ought to make his 
name honorable whilst the world stands. 

And yet, strange to say, there are people bearing the general aspect 
of reasoning beings who oppose vaccination; and in England, where vac- 
cination has been made compulsory by law, a league has been formed to 



cow-pox. 271 

combat its enforcement. Kecently the folly of these fanatics met, it is 
stated, with a most righteous punishment in the following circumstance: 
A leading anti-vaccinationist, Escott by name, who refused to have any 
of his children vaccinated, lately lost two of them and his wife by small- 
pox. Escott borrowed a suit of clothes from a friend to attend his wife's 
funeral, and returned them without disinfection, with the result that the 
lender caught small-pox and also died of it. Subsequently nearly every 
house in the neighborhood was infected, producing a local epidemic of 
small-pox, during which sixteen patients were removed to the pest-house. 
The only excuse for the obstinacy of such deluded people is, that more 
than half a century of deliverance from the horrors of small-pox has ren- 
dered most persons practically ignorant of its dangers. In the latter half 
of the eighteenth century, that is, from 1750 to 1800, small-pox attacked 
almost every inhabitant of England, and about one out of every five seized 
with it died, whilst nearly another fifth of its victims were disfigured or 
crippled for life. It is estimated that two-thirds of the blind people in 
England at that time lost their sight from small-pox. To give an idea of 
its relative mortality, Dr. Guy states that it caused eighteen per cent, of 
all the deaths, and was one hundred times as fatal as diarrhoea, with its 
allied intestinal disorders, and six times as fatal as apoplexy, palsy and 
sudden death taken together. 

Objections to Vaccination — These, aside from the mere sentimental 
ones are that in some instances erysipelas and venereal disease have been 
apparently caused by it, and that it has been accused of being the means 
of inoculating the human system with scrofula, consumption and certain 
cutaneous affections. Now, all of these objections can be removed by the 
use of what is called bovine virus, obtained direct from the cow, with- 
out ever having passed through any human body. Glycerinized lymph is 
now conceded to be the better vaccine virus. 

Duty of Vaccination — This is rendered far more imperative by the 
danger which every unprotected person in a community exposes his neigh- 
bors to by becoming the starting-point of an epidemic of small-pox. Hence, 
although a man may have the privilege of thus trifling with his own life 
and health, he has no right to imperil others by his perversity or ignor- 
ance ; and the good of society, which is a higher law than that of personal 
liberty, demands that compulsory vaccination be legally established, as 
it is hoped it will be ere many years elapse. 

Making Sure of Immunity. — Even after exposure the individual 
should be vaccinated, for though it may not prevent small-pox, it will cer- 



272 THE ERUPTIVE DISEASES. 

tainly moderate the severity of the attack. The writer has had a case of 
this kind to come under his personal observation. 

COW-POX OR THE VACCINE-DISEASE. 

How Produced. — This disease, called Vaccina in medical books, is 
induced in the human being by the process of vaccination, either acci- 
dentally, as in the case of the young milkmaid who led Dr. Jenner to his 
grand discovery, or, as is usual nowadays, by being rubbed into a slight 
wound made for the purpose. It is apparently a modified form of small- 
pox, in which a cow-pox vesicle on the udder of a cow or heifer is the com- 
mon original source of the infecting matter. 

Character. — The disease is attended, as a rule, with no further erup- 
tion than the vesicle, ripening into a pustule at the point or points where 
the matter is inoculated. It is communicable by inoculation, but not by 
the other ordinary modes of infection, mild in its course, and yet, gen- 
erally speaking, protective against small-pox. 

Operation of Vaccination. — This is by no means so simple and unim- 
portant as it seems at first sight, and it therefore ought always to be per- 
formed by a physician. It is better not to cut so deep in vaccinating as 
to cause much of a flow of blood, lest this fluid should wash the virus out 
of the incisions. The usual place for vaccinating is on the outside of the 
arm, an inch or two below the shoulder ; but if the operation fails here, as 
is sometimes the case after repeated trials, an attempt may be made on 
the calf of the leg, just below the knee. 

When to Vaccinate. — Vaccination should be performed on all chil- 
dren between the ages of one and three months, unless some special rea- 
son exists for its postponement, and it is recommended to insert the virus 
in four or five places close together, so as to produce several pustules, 
although, by a majority of physicians in this country, one pock is thought 
sufficient. 

Re vaccination. — Eevaccination should be performed about once in 
seven years, as in some instances the protection afforded appears to wear 
out in that time ; and, as there is no means of recognizing them, the safer 
way is to renew the vaccination. 

The Virus — The animal or bovine virus is supplied from carefully 
vaccinated calves by a number of producers in various parts of the country. 
It is usually furnished on little ivory points, shaped like a lancet-blade, 
or on pieces of quills. Either of these is to be moistened in pure water, 



BREAK-BONE FEVER. 273 

and then rubbed on a lightly scarified surface, prepared as already 
described. The bovine virus is apt to make a very sore arm, but has the 
great advantage of avoiding all possibility of introducing the horrible 
poison of venereal disease into the blood of the infant operated upon. 

VARICELLA OR CHICKEN-POX. 

For full description and treatment of this disease, peculiar to chil 
dren, see Children's Diseases. 

MEASLES OR RUBEOLA OR MORBILLI. 

For full description and ' treatment of measles, see Diseases or 
Children 

RUBELLA, ROTHELN OR GERMAN MEASLES. 

Definition. — An acute infectious disease resembling both scarlet fever 
and measles, but differing from these in its short course, slight fever and 
freedom from complications. 

Cause. — It is propagated by contagion and spreads with great rapidity. 

Incubation. — About two weeks. 

Symptoms. — This is a mild contagious affection, very similar in many 
respects to ordinary measles, but apparently differing from it, because 
neither disease affords any protection from the other. The color of the 
eruption is rather more rose-tint than in ordinary measles, the pimples 
are round instead of oval, and the crescentic arrangement is wanting or 
extremely obscure. Children are chiefly affected with German measles, 
although it also occurs after adult age is attained, but in any case the 
malady is so slight that the patients rarely feel sick enough to keep in bed, 
and no instances of death from the uncomplicated affection are recorded. 

Treatment — The treatment, diet and nursing appropriate to German 
measles are the same as those recommended in the ordinary form, in the 
few cases where any special care is needed. 

SCARLET FEVER OR SCARLATINA. 

For description and treatment of scarlet fever, see Diseases of 

Children. 

18 . - - • 



274 THE ERUPTIVE DISEASES. 



BREAK-BONE FEVER OR DENGUE. 



Synonyms. — Dandy, or break-bone fever. 

Definition. — An acute and infectious disease characterized by febrile 
paroxysms; pain in the muscles and joints and sometimes by an eruption 
on the skin. 

History and Geographical Distribution. — The disease was first recog- 
nized in 1779 in Cairo and in Java. The description by Benjamin Rush 
of the epidemic in Philadelphia in 1780 is one of the first and one of the 
very best articles ever written on the disease. S. H. Dickson gives a 
graphic description of the disease as it appeared in Charleston in 1828. 
Since that date there have been five or six widespread epidemics in 
tropical countries, the last occurring along the Gulf States in the summer 
of 1897, where for some time it was supposed to be yellow fever. Xone 
of the recent epidemics have extended to the Northern States, but in 18S8 
it prevailed as far north as Virginia. 

Cause. — The rapidity of diffusion and the pandemic character are the 
two most important features of dengue. There is no disease, not even 
influenza, which attacks so large a proportion of the population. A micro- 
coccus has been found in the blood of patients by McLaughlin, of Texas. 

Symptoms — Incubation. — Three to five days, during which the patient 
feels well. Persons who catch this curious complaint are often attacked 
with it very suddenly, frequently in the night after retiring in their 
usual health. The temperature rises in a few hours to 103 degrees and 
in one or two days may reach 106 or 107 degrees, the skin becomes dry 
and hot, and the countenance indicates utter helplessness and prostration ; 
with this febrile condition there is usually pain in the head, back, limbs 
and small joints, which latter swell up as in rheumatism. The pulse is 
rapid; loss of appetite, coated tongue, slight nocturnal delirium and con- 
centrated urine. The pain may be so severe that the patient cannot move. 

Duration. — The average duration of the first febrile stage is about 
forty-eight hours, although it may vary from twelve hours to three day?, 
after which the symptoms begin to subside and a period of remission of 
two or three days occurs. 

Debility and Eruption. — During this time general debility and mus- 
cular pains predominate, and fever is usually absent, but on the fourth 
day it reappears, and on the fifth or sixth an exanthematous eruption 
develops, which is sometimes more like the flush of erysipelas than the 



TYPHUS FEVER 2 < 5 

papules of either measles or scarlet fever. The color, however, is not so 
intense, and it spreads over the whole body in forty-eight hours. 

Pains and Swelling. — When the eruption reaches its height, painful 
swellings of the lymphatic glands of the neck, back of the head, armpits 
and groins occur. With this tumefaction of the glands, the nose, mouth 
and throat become implicated, swelling up and growing excessively pain- 
ful. On the seventh or eighth day desquamation commences and the acute 
stage terminates. 

Malady Not Fatal. — The victims of dengue are to be commiserated 
for the horrible and agonizing pains which they are called upon to suffer, 
and which are peculiar to the disease; but they may find some comfort 
in the assurance that the malady is rarely, if ever, fatal. 

Recurrence of Pain. — The recurrence of the excruciating pains in the 
limbs at a time long after the subsidence of the fever must be borne in 
mind, as influencing any opinion ventured in regard to the probable 
duration of the illness. 

Diagnosis — The diagnosis of dengue must occasionally be made from 
rheumatism, measles, scarlet fever and erysipelas ; but a complete history 
of the case can hardly fail to clear up any doubts, particularly if dandy 
fever is prevailing in the locality as an epidemic. 

Remedies. — Since the malady is not a dangerous one, anodynes to 
relieve the excruciating suffering, especially hypodermic injections of 
one-eighth or one-sixth of a grain of morphia. During convalescence 
iodide of potash is recommended for the arthritic pains and tonics are 
indicated. 

TYPHUS FEVER. 

Synonyms. — Ship, jail or putrid fever. 

Definition. — An acute infectious disease favored by closely crowding 
human beings together, characterized by sudden onset, a maculated rash, 
marked nervous symptoms and a termination by crisis about the end of 
the second week. 

Causes. — It is excited by an unknown poison which is capable of 
being carried in the clothes. It is rare in America, though there were 
two mild epidemics in the Philadelphia Hospital in 1866 and in 1883; it 
is not uncommon in England and Ireland. Bad food, impure air and 
overcrowding are predisposing factors. 

Incubation. — Incubation is placed at about twelve days, but may be 
less, and its duration from ten days to two weeks. 



276 THE ERUPTIVE DISEASES. 

Symptoms. — The fever begins abruptly with severe pain in the head, 
back and limbs; extreme prostration, and fever which reaches its maxi- 
mum (104 degrees to 105 degrees) in two or three days. The temperature 
remains high for about ten days when it falls by crisis (suddenly). 

The Eruption — It is a continued fever, attended with a dark-red or 
purplish mottled rash over the body, with great nervous prostration, rest- 
lessness and delirium, or dullness and stupor, but without any specific 
affection of the bowels. The eruption, which makes its appearance from 
the third to the eighth day of the disease, is at first slightly elevated and 
disappears when pressed upon with the finger; but after the second day 
from the time it comes out, it is persistent under pressure and continues 
to show this character until it fades, ten or twelve days afterward. 

Fatality. — When it proves fatal, as it does in about fifteen per cent. 
of the cases, death usually occurs between the twelfth and twentieth days 
of the attack. 

Advent Symptoms. — The advent of the disease is somewhat gradual, 
beginning with general soreness, discomfort and weariness, with loss of 
appetite and disturbed sleep. Shivering and a feeling of coldness, espe- 
cially along the spine, sometimes amounting to an actual chill, not un- 
frequently mark the commencement and are soon followed by heat of skin, 
rise in temperature and severe frontal headache. This headache is 
occasionally very severe and rarely absent at first, but abates about the 
tenth day. 

Disturbed Sleep. — Slumber is disturbed by dreams, is unrefreshing, 
and when the patient is not asleep there is a constant tendency to heavi- 
ness, the mind ceases to think and the attention cannot be concentrated 
upon any subject. He may lie with his eyes open, evidently not in 
slumber, yet indifferent or insensible to all which goes on around him. 

Bodily Weakness. — This is frequently extreme, and the sufferer often 
voluntarily takes to his bed on the first day of his illness. This exhaustion 
and prostration is totally disproportionate to the amount of muscular 
exertion which has been made. The eyes, when examined, are found to 
be dull and heavy, the white portion injected or blood-shot and a peculiar 
dusky flush overspreads the cheek. 

The Delirium. — As the days pass debility rapidly increases and de- 
lirium comes on the latter part of the first or early in the second week. 
In persons of nervous, excitable temperament it commences sooner and 
may appear on the third or fourth night of the fever, showing itself 



TYPHOID FEVER. 277 

primarily, perhaps, by a little confusion of thought on awaking from a 
restless doze. 

The Tongue — The tongue is coated at first with a white fur, but 
after six or eight days often may become dry, swollen and covered with 
thick, brownish crusts of mucus and cast-off epithelial cells, which make 
up what is called sordes. 

The Bowels. — The bowels are, as a rule, constipated, and this should 
especially be borne in mind, because it forms an important distinguishing 
mark between this disease and typhoid fever, with which typhus was 
formerly confounded. 

The Pulse. — The pulse is quickened from the outset and in grave 
cases continues to increase in rapidity until it may more than double 
its ordinary frequency, beating from one hundred and forty to one 
hundred and sixty times per minute. 

Complications. — Broncho pneumonia is perhaps the most common 
complication. It may pass on to gangrene ; in certain epidemics gangrene 
of the nose, hands and toes have occurred. 

Diagnosis. — The diagnosis of typhus fever requires to be made in this 
country chiefly from typhoid fever and relapsing fever, but it is some- 
times difficult to distinguish it at first from small-pox, plague, erysipelas 
and cef ebro-spinal meningitis. 

Treatment. — As the treatment, diet and nursing of typhus fever are 
similar in most respects to what is required in the far more common 
disease, typhoid fever, the reader is referred to our article upon the latter 
affection for further information. 

Isolation — When an epidemic of typhus fever breaks out in a crowded 
jail, hospital or tenement, the great cause of its prevalence should, of 
course, at once be abolished by separating those exposed to it as widely 
as possible and treating the sick in isolated sheds, huts or even in tents. 

TYPHOID FEVER. 

Symptoms. — Enteric fever, autumnal fever or typhus albuminalis. 

Definition. — An acute infectious disease due to the implantation and 
proliferation of the bacillus of Eberth, characterized by ulceration of the 
lymph follicles of the intestines of the mesenteric glands and by an en- 
largement of the spleen. 

Historical. — The disease is easy recognizable in the descriptions of 
Hippocrates (B. C. 460-357) and Galen (A. D. 130-200). Doubtless John 



2^3 THE ERUPTIVE DISEASES. 

Iluxam's "slow, nervous fever/' described in his "Essay on Fevers" was 
the typhoid of the present day, and his "putrid malignant" the yellow 
fever of to-day. It was, however, the writings and teachings of the great 
French physician, Louis, which did most to disseminate a knowledge of the 
true nature of typhoid fever, to which he gave the name it bears. Among 
some of his pupils were the Americans W. W. Gerhard and C. W. Pen- 
nock of Philadelphia and James Jackson, Jr., of Boston. To the former, 
however, is due the great honor of having first clearly laid down the 
difference between typhoid and typhus. 

Causes. — Typhoid fever prevails in temperate climates in which it 
constitutes the most continued fever. It is widely distributed throughout 
all parts of the world. 

Seasons. — It prevails most in the autumn months, especially follow- 
ing a dry summer. 

Sex — Males and females are equally liable. 

Age. — Typhoid fever is a disease of youth and adult life. The 
greatest susceptibility is between the ages of fifteen and twenty-five. It 
is rare after sixty and infants are seldom attacked. 

Immunity. — As in other fevers, not all exposed to the infection take 
the disease. Some writers claim that one attack protects, but others 
claim that one attack predisposes to another. 

THE BACILLI OF TYPHOID. 

Bacilli in the Body. — The bacilli are found in the lymphoid tissues of 
the intestines, in the mesenteric glands, in the spleen, liver, bile and in 
the bone marrow. They also occur in irregular clumps in the contents of 
intestines and in the stools ; they have also been found in the blood, urine, 
sweat and sputa. 

Bacilli Outside the Body. — The bacilli retain their vitality in water 
for weeks, but disappear from ordinary water in competition with sapro- 
phytes in a few days. In milk they undergo rapid development without 
changing its appearance. They may increase in the soil and retain their 
vitality for months. They are not killed by freezing, but, as Pruden has 
shown, may live in ice for months. 

MODES OF CONVEYING BACILLI. 

1. Contagion — The possibility of the direct transmission through the 
air from one person to another must be acknowledged, although, as 



TYPHOID FEVEK. 279 

shown by Germano, when completely dried in air currents, the specific 
bacillus quickly dies. There are house epidemics in which water and food 
contamination can almost be excluded. The nurses and attendants who 
have to do with the stools and body linen of the patient are alone liable 
to direct infection. 

2. Infection of Water — This is unquestionably the most common 
mode of conveyance. Many epidemics have been shown to have originated 
in the contamination of a well or a spring. 

3. Milk. — Milk may be the source of infection, as it may be con- 
taminated in washing out the cans with infected water. 

4. Ice and Salads. — In addition, the germs may be conveyed in ice, 
salad, celery, and so forth. A fly which has alighted on the soiled linen 
or discharges from a patient may contaminate the milk or food. 

Bad Sewage and Drainage. — Filth, bad sewers or cess-pools cannot in 
themselves cause typhoid fever, but they furnish the conditions suitable 
for the preservation of the bacillus. 

Symptoms. — Typhoid fever, also called gastro-enteric fever, owing to 
the circumstance that the stomach and intestines are the chief seats of the 
disease, is characterized by a faint, scanty eruption of rose-colored spots, 
appearing chiefly upon the abdomen, from the fourth to the eighth day, 
and coming out in successive crops. Each crop of spots continues visible 
for about three days. 

Cesspool Fever. — On account of its frequent connection with bad 
drainage, this fever has received the vulgar but expressive name of "drain 
or cess-pool fever," which, despite its indelicacy, it would be well to per- 
petuate as a constant warning against that neglect of sanitary arrange- 
ments in buildings to which it is chiefly due. 

Initial Symptoms. — The onset of this dangerous and fearfully prev- 
alent disease is very often a gradual one. The patient for some days feels 
Aveak, languid and depressed, loses his appetite, suffers from headache, 
and is restless at night. In other cases, however, the malady begins with 
a slight chill, or a feeling of coldness running up and down the back, and 
among children the first decided symptom may be an attack of convulsions. 
Frequently, too, slight bleeding of the nose is noticed, and a little tend- 
ency to looseness of the bowels, which may even be aggravated by errors 
in diet, or other imprudence, into active diarrhoea. 

Secondary Symptoms. — After the stage of invasion is completed, the 
pulse and temperature rise steadily, the former going up to 100 beats or 
110 beats, and the latter ascending to 101 degrees, or sometimes 105 



280 THE ERUPTIVE DISEASES. 

degrees during the first week. The heat of the body is almost always 
greater at night than in the morning, and this increment is so regularly 
advanced during the onset of the disease, that it is quite possible for a 
skilled physician to recognize typhoid fever by a glance at the record of 
temperature, or "temperature chart," alone in many instances. 

The Diarrhoea. — The diarrhoea rapidly grows more severe, and in bad 
rases is frequently very profuse, fifteen or twenty thin, watery evacuations 
occurring in every twenty-four hours. In many cases the bowels are con- 
stipated. Pain in the abdomen, especially in the region of the right 
flank, is nearly always complained of, and with the diarrhoea is due to the 
characteristic ulceration of certain oval spots in the lower portion of the 
small intestine, which have received the names of Peyer's patches. Bron- 
chial irritation and cough are common. 

Facial Appearance. — The face sometimes wears an anxious, haggard 
look, but frequently, even early in the disease, it shows the dull, indiffer- 
ent aspect, so often indicating an oppression of the brain, which will 
deepen into stupor, then coma and finally death. The flush of the face 
is apt to have a more dusky, purplish tint than in other fevers, and the 
skin is more dry and burning, or pungent, from the smaller amount of 
perspiration. 

The Delirium. — In the second week delirium generally comes on, and 
although occasionally violent and requiring the patient to be controlled by 
physical force, it is more frequently of a low, muttering character. The 
tongue becomes dry and brown, and tympanites, or the accumulation of 
gas in the bowels, is generally considerable, and may cause by its enormous 
distension great suffering, or even lead directly to a fatal result. Ringing 
or buzzing in the ears with deafness is very often noticed. In bad cases 
the diarrhoea is often very profuse, and discharges of fluid blood, perhaps 
in large quantity, sometimes occur and prove quickly fatal. 

The Third Week — In the third week, if the case is to end unfavorably, 
the pulse grows frequent and feeble, the tongue is dry, cracked and cov- 
ered with brown sordes, the delirium and stupor are constant, involuntary 
discharges from the bowels occur, and the patient may die exhausted, or 
if the fatal issue comes earlier, before complete prostration of muscular 
strength, it may be preceded by convulsions. 

Signs of Recovery. — If, on the contrary, recovery awaits the patient, 
the pulse falls off in frequency, the temperature gradually diminishes, the 
tongue cleans off usually from the edges, appetite slowly returns and the 
mental powers are little by little regained. 



TYPHOID FEVEE. 281 

Unfavorable Symptoms — The unfavorable symptoms, besides those 
above mentioned, are an unusually high temperature, 106 degrees or over, 
picking at the bedclothes, slipping down in the bed, and entreaties, often 
of pitiful earnestness, to be taken home. 

Special Features and Symptoms — 1. A severe facial neuralgia may 
put the practitioner off his guard. In cases when the patient has kept 
up, "fought the disease," the first manifestation may be pronounced 
delirium. In rare cases the disease sets in with the most intense cerebro- 
spinal symptoms, simulating meningitis. 

2. There may be pronounced pulmonary symptoms. In a few cases 
the disease sets in with a single chill, with pain in the side and all the 
characteristic features of lobar pneumonia. 

3. There may be intense gastro-intestinal irritation. Occasionally 
there are cases with such intense vomiting and diarrhoea that poisoning 
may be suspected. 

Fever.— The fever has invariably a step-ladder rise ; the evening tem- 
perature is from one to one and one-half degrees higher than the morning 
remission. 

Fever of Convalescence. — After the temperature has been normal for 
live or six days the fever may rise suddenly to 102 degrees or 103 degrees, 
and after persisting from one to three or more days fall to normal. With 
this condition there is no furring of the tongue and no distension of the 
abdomen. This condition is by no means uncommon, and is of especial 
importance, as it is attributed in most cases to errors in diet, constipa- 
tion, or excitement of any sort, such as seeing friends. 

Complications — 1. Thrombosis of the femoral vein, more frequently 
on the left side, resulting in the "milk leg." It occurs, according to Mur- 
chison, in one per cent, of all cases. Embolic abscesses may occur in the 
kidneys and lungs. 

2. Albuminuria is present to some extent in all severe cases, com- 
monly as the result of the fever, but sometimes is the direct result of an 
acute nephritis. 

3. Hemorrhages usually occur during the third week, and are indi- 
cated by a sudden fall of temperature, followed by dark red or tarry stools. 

4. Cardiac complications, including pericarditis, endocarditis and 
myocarditis, are sometimes present. The latter may be the cause of 
sudden death. 

5. Peritonitis may result from perforation or from extension by con- 
tinuity; the former is more common and is recognized by a sudden pain, 



282 THE ERUPTIVE DISEASES. 

a fall of temperature, distension of the belly and symptoms of peri- 
tonitis. 

6. Pneumonia may supervene in the second or third week of a ty- 
phoid fever, as a complication, in which the true relation is difficult to 
determine. 

Diagnosis. — The diagnosis of typhoid fever must be made in its early 
: tage from typhus fever, relapsing fever, scarlet fever, measles and small- 
pox. At a more advanced period it might be confounded with the typhoid 
condition met with in uremia and pyemia, and also with enteritis or in- 
flammation of the bowels, peritonitis or inflammation of the membrane 
covering the intestines, meningitis or inflammation of the membranes of 
the brain, acute bronchitis or pneumonia, and with acute consumption. 

The Rose-Colored Spots. — If a patient who has been suffering from 
headache, prostration, loss of appetite, restlessness and gradually increas- 
ing fever, has a slight bleeding at the nose unprovoked by accident, we 
may strongly suspect typhoid ; but until the rose-colored spots appear there 
is no certainty. 

Treatment. — The medical treatment in typhoid fever must be directed 
toward mitigating suffering, warding off complications and obviating the 
tendency to death. In the early stages of the complaint headache is one 
of the most prominent symptoms. All we can hope for is to procure some 
mitigation of the intense suffering it frequently occasions. 

Ice Application. — The application of ice to the head, either in a 
bladder or India-rubber bag, or, what is still better, by means of an ice- 
cap, made of numerous coils of thin rubber pipe, through which ice-water 
is kept flowing, generally diminishes the pain, which, if very intense, may 
require the application of one of two leeches behind the ears. 

For Checking Diarrhoea — Diarrhoea, if troublesome, is to be checked, 
but not stopped by chalk-mixture, bismuth-mixture or astringents with 
opium, when necessary. 

Creosote 6 drops 

Bismuth subnitrate 3 drachms 

Mix and make into 12 papers and take one every three 
hours. 

Or, when ordinary measures fail — ' 

Silver nitrate 5 grains 

Extract of gentian ; 4 " 

Mix and put into pills, making 20. Take one every three 
hours. 



TYPHOID FEVER. Z8o 

Its use, however, after the first few days, must be continued with 
great caution, on account of permanently blackening the patient's skin. 

Rest. — Absolute rest in bed, with the use of the bed pan, must be 
enforced. 

Rendering Stools Innocuous. — The stools should be rendered innocu- 
ous. This may be done by dissolving a pound of the chloride of lime 
in four gallons of water. Add a quart of this solution to each discharge 
and allow it to remain in the vessel at least an hour before disposing of it. 
Soiled bed clothes should be thoroughly boiled. 

Restlessness. — In cases where restlessness rather than stupor pre- 
dominates small doses of bromide of potassium or a five-grain supposi- 
tory of powdered asafoetida in the bowel will allay the condition. When 
the tongue becomes dry, ten drops of the oil of turpentine given in mu- 
cilage every four hours, often have a very happy effect, end its influence 
upon the healing of the intestinal ulcerations is highly lauded, while it 
aids in the expulsion of the gas. 

Stimulants. — Generally, during the second week, sometimes a few 
days earlier, and occasionally a few days later, according to the violence 
of the attack and the patient's strength of constitution, it is advisable to 
begin with the use of stimulants. The best indication of their becoming 
needful is a slight failure of the strength of the pulse, but much experi- 
ence is necessary to judge correctly of the time, the quantity, and the 
frequency with which alcohol be administered. 

Kinds of Stimulants — At first half an ounce of good whiskey or 
brandy, with two or three ounces of milk and half an ounce of lime-water, 
if nausea persists, may be allowed three times daily, but this amount must 
generally be increased from day to day, sometimes with great rapidity, 
until in the worst cases a pint and a half of brandy is swallowed in twenty- 
four hours. Beef tea, beef essence, and some farinaceous food, such as 
arrow-root or cornstarch, ought also to be urged upon the patient at this 
time. 

To Stop Hemorrhages. — In cases of hemorrhage from the bowels, 
ergotin hypodermically, in full doses, fred. extract of ergot by the mouth 
or morphia hypodermically ; and if perforation of the intestine, in 
consequence of the eating through of one of the ulcers, takes place, th 
very slender hope of recovery is increased a little by the administration 
of large doses of a grain every hour of opium and by securing perfect 
rest in bed. 

Hydrotherapy. — Since many of the worst symptoms of typhoid fever 



284 THE ERUPTIVE DISEASES. 

seem to be due to the effect of overheated blood upon the brain, efforts 
to reduce the temperature by the aid of cool baths of about 70 degrees 
Fahrenheit six or eight times daily, or cold sponging of the whole body, 
have of late years taken a very prominent place in the treatment of the 
disease, and are believed to reduce markedly its rate of mortality. Where, 
in spite of judicious employment of means to bring down the temperature, 
unconsciousness continues, great watchfulness is necessary in regard to 
the evacuation of the bladder, which may become dangerously distended, 
and even burst for want of attention. 

Drawing the Urine. — When examined and found to be over-full, the 
urine should be at once drawn off by means of a catheter, and the opera- 
tion repeated twice or thrice every twenty-four hours, until the patient 
resumes control over his functions. 

Other treatment would be the 

1. Sponge Bath. — The water should be cold or ice-cold, according to 
height of fever, and a thorough sponge bath should take from fifteen to 
twenty minutes. I have added alcohol to the water with good results. 

2. Cold Pack. — If tub is not available the patient may be wrapped up 
in a sheet wrung out of water at 60 degrees to 65 degrees and then cold 
water sprinkled over him with a watering pot. 

3. The Bath. — The tub should be long enough so that the patient can 
be completely covered, except his head. Every third hour, if tempera- 
ture is above 102 degrees, the patient is placed in a bath at 70 degrees 
Fahrenheit, which, after the patient is put in, can be lowered a degree 
or two. In it he remains for fifteen or twenty minutes. He is then 
taken out, wrapped up in a dry sheet and covered with a blanket. The 
patient's limbs and body are gently rubbed while in the bath, and on re- 
moving he should have a stimulant. Rectal temperature should be taken 
directly after the bath, and again forty-five minutes later. Should the 
patient be too weak for the bath, frequent sponging or Leiter's coils should 
be used. 

Constipation. — Should constipation be present, though as a rule it 
does no harm, it is well every third or fourth day to give an enema. If 
a laxative is needed during the disease give Hunyadi-Janos water. 

Hemorrhage. — Should hemorrhage exist it should be treated with 
full doses of opium and acetate of lead. Ice should be freely given, and 
food should be restricted for eight or ten hours. If there should be any 
symptoms of collapse give stimulants. 

Diet. — The diet of a typhoid fever patient must be watched over with 



TYPHOID FEVER. 285 

unceasing vigilance, as upon it and proper nursing, more than upon medi- 
cal treatment, the chances of success often depend. In the first stages it 
should be light, entirely unstimulating and unrelaxing to the bowels. 

No Solid Food — Throughout the whole course of the disease no solid 
food ought to be allowed, and this precaution should be rigidly enforced 
on account of thereby avoiding the risk of mechanically rupturing some ? 
little hole in the intestine, at the seat of an ulcer which had almost per- 
forated the wall of the bowel. Such a catastrophe must, as already 
hinted, lead to almost certain death. 

Drink. — As the thirst is usually very great, whilst the appetite is 
nearly lost, it is a good plan to make the drinks somewhat nourishing . 
in order to support the strength. Hence, gum-arabic water, barley-water, * 
albumen-water or milk thickened with tapioca, sago or cornstarch are often 
highly advantageous. 

No Fruits. — If the usual tendency to diarrhoea is at all marked, fruits 
of all kinds ought to be entirely withheld by the nurse, and even where 
the bowels are not disordered, fruits and vegetables, other than those 
enumerated, should be very cautiously given, on account of the disposi- 
tion to looseness of the bowels which generally exists. Many cases of 
death from typhoid fever may be directly traced to the murderous impru- 
dence of nurses and attendants in this respect. 

Diet for Second Week. — During the second week, when slight indica- 
tions of debility usually begin to manifest themselves, a more nutritious 
diet becomes necessary. Thicker preparations of the farinaceous foods 
above mentioned should be employed, beef tea and beef essence may be 
added to the list, and as debility increases eggs beaten up with milk, 
flavored perhaps with a little wine, if they have been well borne during 
health, may be administered. In the latter stages, when the whole 
capacity of the enfeebled digestive organs is needed to take up sufficient 
food to sustain life, strong meat-soup, beef essence, eggs beaten up with 
wine, and milk punch should alone be urged upon the patient. 

Injected Food. — Life has apparently been saved in some instances by 
frequently repeated small injections of beef essence, brandy and milk, with 
a few drops of laudanum, in order to prevent the enema from being 
rejected from the bowels, as is often the case in spite of all our efforts. 

Nursing. — In nursing the case of a typhoid fever patient, watchful 
and judicious care of a skillful attendant often contributes in those in- 
stances having a favorable termination, as most candid physicians will 
r.dmit, more than medical treatment to the sick man's recovery. The 



2$Q THE ERUPTIVE DISEASES. 

suitable administration of medicines to control diarrhoea, according to the 
varying phases of that important symptom; to relieve restlessness and 
allay excitement; the proper employment of baths to reduce febrile heat 
and diminish cerebral congestion; the constant guarding of the patient 
from injurious articles of food; the increasing effort to economize the 
failing strength, which otherwise may prove just a little lacking in the 
last great day of struggle with the disease, notwithstanding all the rein- 
forcements called upon in the way of stimulants and nutrients to support 
it, all these offer an ample field for the highest intelligence and the noblest 
self-sacrifice. 

Watching the Delirium. — The attendant upon a typhoid fever case 
must be on his guard, lest in his momentary absence the delirious patient 
gets out of bed and attempts to escape from the house, or perhaps throws 
himself out of a window. Even the effort at walking across the room 
may, in the weak conditions met with in the latter portion of the fever, so 
exhaust the failing strength as to lead to dangerous or fatal collapse. 

Treating Bed-Sores. — The tendency to bed-sores, which are particu- 
larly apt to form over the portions of the body pressed upon in lying upon 
the back during typhoid and typhus fevers, must be overcome; as far as 
possible, by frequent change of position, the" use of perforated pillows or 
cushions and of water-beds, and the patient should be well rubbed with 
alcohol twice a day, especial care being used over the parts of the body 
that the patient rests on while in bed, i. e., back, buttock, and so forth. 
As a general rule, the formation of a bed-sore in a case of typhoid fever 
not lasting more than twenty-five to thirty days, is evidence of care- 
lessness on the part of the nurse, and should never be permitted to occur. 
When once developed, bed-sores must be kept clean and carefully dressed 
once or twice daily, in the hope of preventing them from spreading, as 
the chance of curing them until the patient can sit up is. exceedingly small. 
Xot only is the suffering from bed-sores very great, but the free discharge 
of pus which they generally yield is extremely debilitating and quickly 
exhausts the little remaining stock of strength. 

Typhoid Mortality— The mortality of typhoid fever varies in differ- 
ent epidemics from 10 to 20 per cent. The older the patient the less is 
his chance of recovery from the malady, whilst among children the pro- 
portion of deaths is quite small. 

Walking Typhoid — Some of the mildest cases, those to which the 
name of "walking typhoid" has been appropriately applied, may suddenly 
terminate in perforation of the bowel, and death in a few hours from 



SPOTTED FEVER. 287 

collapse or from peritonitis. On this account a typhoid fever patient, no 
matter how slight his symptoms of illness may be, should stay in bed, and 
swallow nothing but liquid food, until the searching test of the ther- 
mometer shows that all febrile movement has subsided. 

Management of Convalescence. — Even after convalescence has fairly 
set in, great watchfulness is necessary. Permission to sit up in bed even 
ought not to be given until several days' have passed without any fever, 
as proved by the thermometer, which should be used morning and evening 
throughout the complaint, and the return to solid food must be both slow 
and gradual. Any imprudence in diet, or slight over-exertion, may bring 
on a relapse, which is much worse than the original attack, and its causes 
ought therefore to be most sedulously shunned. 

Prevention of Typhoid — The great means of preventing typhoid fever 
by unceasing vigilance in regard, to the purity of the water, milk and air 
supply has already been urgently insisted on. Prevention of typhoid is 
now being carried out in the army and institutions by means of hypo- 
dermic injections of bacterius. 

CEREBROSPINAL FEVER OR SPOTTED FEVER. 

Definition. — An infectious disease occurring sporadically and in epi- 
demics, caused by a diplococcus, characterized by an inflammation of 
the cerebro-spinal meninges and symptoms of great pain in the head, back 
and limbs, convulsions, irregular fever, and at times petechial eruption. 

History. — In 1801 Vieussens first described a small outbreak in 
Geneva. There had been several outbreaks in the United States prior to 
1875, but since that time there have been several extensive epidemics. 
There was a serious epidemic in Western Maryland in 1892, in Eew 
York in 1893, and from the spring of 1896 to the spring of 1898 the dis- 
ease has prevailed extensively in Boston and its neighboring towns. 

Causes. — Over-crowding, poor food, foul air and bad drinking water 
seem to be the predisposing causes. The epidemics have occurred most 
frequently in winter and spring. The concentration of individuals, as of 
troops in barracks, seems to be a special factor; in civil life children and 
young adults seem most susceptible. 

Symptoms. — Many different forms have been described, but they aro 
best grouped into three classes : 

1. Oirdinary Form. — This is a malignant epidemic fever, usually 
tended with painful contraction of the muscles of the neck and retraction 



OSS THE ERUPTIVE DISEASES. 

of the head, and frequently accompanied by a profuse purpuric eruption. 
It is a disease which generally comes on suddenly, runs its course with 
o-reat rapidity, and proves fatal in a majority of instances. The malady 
is more than a mere inflammation of the membranes of the brain, or 
meningitis, for the whole nervous system seems to be very gravely affected 
from the first. 

Premonitory Symptoms — Premonitory symptoms are rare, but when 
they are met with, show themselves simply as slight headache and pain 
in the back, or a little uneasiness and weariness experienced for several 
days before acute symptoms set in. These may commence with a chill or 
marked shivering-fit, followed by intense vertigo, headache of intolerable 
severity, obstinate and violent vomiting, painful muscular stiffness, soon 
developing into continuous spasms, affecting particularly the muscles of 
the head and back. 

Head Distress. — Distress in the head is constant so long as conscious- 
ness lasts. The eyes are blood-shot, and express agonizing suffering, the 
pupils are contracted, and the countenance is pale. Excessive restlessness 
and general muscular agitation prevail, and the sensibility of the whole 
surface is so great that every touch and movement causes excruciating 
pain, and even touching the hair is painful. 

Third Day Symptoms — These symptoms increase up to the third or 
fourth day, when the power of swallowing begins to be affected, and the 
process of respiration to be imperfectly and irregularly performed, the 
head being dragged tightly back as far as possible, and the features fixed 
in the horrible and characteristic grin of lockjaw. The delirium usually 
developed during the third day, if it has not sooner appeared, passes into 
stupor, and this in its turn deepens into coma, from which or from suf- 
focation death commonly releases the sufferer between the fifth and eighth 
day of the complaint, or in a few cases the patient may gradually improve, 
and after three or four weeks enter upon a tedious convalescence of many 
months' duration. 

2. Malignant Form — There is an abrupt onset with a chill, followed 
by vomiting, headache, moderate fever, convulsions and rash. 

3. Abortive Form — The disease begins abruptly with grave sym- 
toms, but terminates in a few days in recovery. 

Diagnosis. — The diagnosis between this disease — which, it should be 
stated, has also been named epidemic cerebro-spinal meningitis, or pur- 
puric fever — and typhus fever, typhoid fever, tetanus or lockjaw, tuber- 
cular meningitis and typhoid pneumonia, is usually not difficult, except in 



SPOTTED FEVER. 289 

the earliest stages. The fact of its epidemic prevalence generally aids at 
once to its recognition, except in the first few cases which occur, and even 
in "these the intolerable headache, retraction of the head, and excessive 
sensitiveness of even the hair to the lightest touch, are almost always suffi- 
cient to characterize this strange and terrible malady. 

Complications. — Deceptive vision from inflammation of the cornea 
or atrophy of the optic nerve ; defective hearing from inflammation of the 
auditory nerve or from suppurative inflammation of the middle ear. 
Pleurisy, pericarditis and parotitis are not uncommon, and headaches more 
or less severe may remain for months or years. 

Treatment. — The treatment consists of dry or wet cups to the nape of 
the neck and along the spine, cold to the head by means of ice-bags or 
bladders, or better still the ice-cap, opium in quantities of a grain every 
two or three hours, and especially hypodermic injections of morphia, to 
relieve the agonizing suffering as well as for the direct curative effect 
which opiates seem to possess in some instances, and iodide of potassium, 
in full doses of five grains every four hours, is indicated during con- 
valescence, and blisters to the spine are also highly recommended. 

General Remarks as to Prevention. — Cerebro-spinal Meningitis is a 
very contagious disease with a very -high death rate. Death may occur 
within a few hours to a few days. It is caused by a germ which is found 
in the fluid in the spinal cord. 

Outbreaks are more common in the winter and spring than in warm 
weather. It occurs both in large cities and sparsely settled country places. 
Its development is favored by the presence of filth, exposure to cold and 
wet, overwork, injury to the head, etc. Individuals of all occupations 
and professions can catch this disease. Its danger lies in its being a dis- 
ease especially of children and young adults. After forty years of age it 
is rare, though in a severe epidemic anyone is liable to catch it. 

The early symptoms of cerebro-spinal meningitis consist of a child 
or adult being seized with a violent headache, chill, nausea and vomiting. 
The patient is dizzy and acts like a drunken person. Dragging pains occur 
in the neck which extend along the spine and into the legs and arms. 
The patient suffers agonizing pain upon bending the head forward or from 
side to side. Later convulsions develop, and the patient becomes rigid. 
with only the back of his head and heels touching the bed. The back is 
arched, eyes may be crossed and bulging and he presents a terrible and 
hopeless picture of suffering and despair. The slightest touch will pro- 
19 



290 THE ERUPTIVE DISEASES. 

dnce pain and cause the patient to utter terrifying screams. Delirium 
develops, followed by stupor, and unles the patient has a good consti- 
tution and receives special care and treatment, death follows. 

The rash of spotted fevers occurs as tiny scattered reddish spots, some 
are dark or purplish red and contain, when stuck with a needle, a reddish 
fluid. In the severe cases death may occur in a few hours. 

The germ causing this disease is supposed to enter the body through 
the mouth and nose and finally reaches the brain and spinal cord. 

The after effects of spotted fever are what makes the disease so dan- 
gerous. Thus various forms of paralysis, loss of intelligence, due to the 
brain having been inflamed (meningitis), complete deafness and loss of 
vision. 

The spread of the disease can be prevented by a person following the 
laws of personal cleanliness, and removing all filth, dust, etc., from about 
the premises. Avoid catching a cold, and do not approach a house where 
a case is. 

Every case of spotted fever must be reported to the health authorities 
by the physician or guardian of the patient. Don't wait a minute. If 
there is a case in your neighborhood, be on guard and at the slightest 
sign of any child or young adult being taken ill with the symptoms, men- 
tion the above, summon your physician or the nearest health authority. 

The patient must be placed in a darkened, well-ventilated room. 
Screen all doors and windows. The attendant or nurse must not leave 
the room without leaving the clothing inside and the hands must be 
dipped in chloride of lime. 

The Board of Health will place a placard on the front and back 
doors. Whenever possible, send the patient to the contagious hospital. 
All bed linen, clothing, dishes, etc., must be dipped in chloride of lime 
solution (one-half pound to a pail of water) before being washed. All 
cloths in which the discharges from the nose and throat have been collected 
must be burned. The kissing of patients is dangerous as the disease may 
be contracted in this manner. Xo one must enter or leave the room in 
which the patient is confined except the doctor or nurse. 

After recovery, the room must be fumigated by the Board of Health. 
Leave in the room all clothing worn by the patient and nurse, bed linen, 
carpets, curtains, etc., must be spread out so that the disinfectant can 
destroy all germs. Kill all flies or mosquitoes seen in or about the room 
or house, as they carry the disease. 



RELAFSIKG FEVER. 291 



RELAPSING FEVER OR FEBRIS RECURRJENS. 

Definition. — It is an infectious disease caused by the spirochetes of 
Obermeier, characterized by a definite febrile paroxysm which usually 
lasts six days, and is followed by a remission of the same length of time, 
then by a second paroxysm, which may be repeated three or four times. 

Cause. — This disease is also known as "famine fever" and "seven- 
day fever." The special conditions under which it develops are similar 
to those of typhus fever. 

Symptoms — Period of incubation appears to be short and in some 
cases the attack develops promptly after exposure, more frequently, how- 
ever, from Hive to eight days. Its onset is usually abrupt, without any 
preliminary symptoms, and the febrile attacks, usually severe though of 
short duration, pass away leaving the patient comparatively well for a few 
days. After an interval of about a week, however, a repetition of the 
primary attack is experienced, and this relapse, from which the disease 
takes its name, may recur four or even five times. 

Blood Germs. — Relapsing fever is remarkable for being the first 
human febrile affection of a paroxysmal character which has been defi- 
nitely connected with the development of a vegetable organism in the 
blood. The peculiar vegetable organisms belonging to the spirochetes are 
found in the blood of relapsing fever patients by tens of thousands, and 
disappear during the temporary convalescence, to reappear with the recur- 
rence of the febrile attack. 

Symptoms Beginning. — The onset of the malady is marked by a chill 
or shivering-flt, severe headache, vomiting and often jaundice; a white, 
moist tongue, tenderness over the pit of the stomach, constipation, en- 
larged liver and spleen, high-colored urine, a frequent, full and often 
bounding pulse, pains in the back and limbs, and frequently delirium. 

Further Symptoms. — These symptoms abruptly terminate between 
the fifth and eighth day, as a general rule, by an exceedingly copious 
perspiration, and, after an interval of a week, during which it may be sup- 
posed that a new crop of bacteria are ripening, and in which time the 
patient is often well enough to get up and walk about, a sudden relapse 
takes place, running through the same phases as the original outbreak, 
except, perhaps, that it is a little shorter. 

At Death. — When death occurs, it is apt to happen from a fainting- 
fit, following excessive perspiration, or from coma, the result of suppres- 



292 THE ERUPTIVE DISEASES. 

sion of the renal secretion, but as seen in America the fatality is very 
small, being on an average less than two per cent. 

Diagnosis. — The diagnosis of relapsing fever cannot be positively 
made by the general symptoms during the primary onset, but may be 
strongly suspected, and the relapse looked for if the disease is prevailing, 
and exposure to the contagion has occurred. A microscopic examination 
of the blood during the height of the febrile movement will, however, 
determine the presence of the spiro-bacteria, and this investigation ought 
therefore always to be made. 

1. Treatment. — Although so far advanced in our knowledge in regard 
to the vegetable nature of the true contagion of relapsing fever, we have 
not yet made equal progress in the specific treatment of this complaint. 
The great problem, of course, is to find some mineral substance which can 
be taken up in the blood in sufficient quantities to check or prevent the 
growth of the bacteria in that vital fluid, without seriously injuring the 
patient himself. Quinine, so useful in intermittent fever, has proved al- 
most worthless in this disease, and our chief reliance to reduce the high 
temperature is at present on cool baths or cold sponging. 

2. For the Headache. — If the headache is very severe, dry cups to the 
back of the neck and along the spine may be employed, or one or two 
leeches may be applied behind the ears, although, since the tendency of 
the disease is toward great debility, it is better to avoid the abstraction 
of blood if possible. Opium or morphia by the stomach, or still better by 
hypodermic injection, is often necessary to relieve the headache and the 
severe pain in the limbs, and if symptoms of prostration come on early, 
wine or brandy must be resorted to. 

3. The Urine — A very careful watch must be maintained over the 
functions of the kidneys, since one of the great dangers of the disease 
appears to be the failure of these organs to perform their duty of purify- 
ing the blood from urea, which, when allowed by renal negligence to 
accumulate in the system frequently causes death by uremic poisoning. 
The urine should, therefore, be frequently examined, its total daily 
quantity noted, and the existence of albumen tested for. On account of 
its favorable action on the kidneys, sweet spirits of nitre in quantities of 
a teaspoonful every four hours is particularly applicable. 

4. For the Pain — For the muscular pains it is reasonable to expect 
that phenacetine, antifebrin or antipyrin will be of great service. The 
febrile paroxysm demands much the same treatment as typhus fever. 
Sponging or cold baths and nutritious and easily assimilated food. 



FEBRICULA OR EPHEMERAL FEVER. 293 



FEBRICULA OR EPHEMERAL FEVER. 

Definition. — A fever of short duration, depending on a variety of 
irritative causes. A febrile movement, lasting twenty-four hours and then 
disappearing, may for convenience be called ephemeral fever ; if of three 
or four days' duration, febricula. 

Causes — The most frequent cause of this form of fever is probably 
the ingestion of foods difficult of digestion. As a rule dyspepsia is per- 
haps the most frequent cause of such a fever. This is especially the case 
with children, where it is often spoken of as gastric fever. Another 
cause is exposure to cold, insufficient to produce bronchitis, tonsilitis or 
-some other affection too slight to be recognized by the usual signs. 

Symptoms. — The symptoms of irritative fever are those usual to fever 
in a mild degree, i. e., moderate elevation of temperature rarely above 
103 degree Fahrenheit, frequent pulse, flushed face, headache, sense of 
lassitude and weariness, loss of appetite, nausea and restlessness ; in chil- 
dren perhaps delirium. The fever is apt to terminate suddenly by crisis 
on the third or fourth day. 

Diagnosis. — -Typhoid fever — at first the diagnosis may be impossible, 
but the absence of diarrhoea, tympanites, abdominal tenderness, spleenic 
enlargement and eruption will soon make the diagnosis apparent. 

Treatment. — Absolute rest in bed, a liquid diet and repeated doses 
of calomel may be employed to relieve the constipation. The fever may 
be controlled by the following mixture : 



Tincture of aconite root 3 drops 

Spirits of nitrous ether % ounce 

Acetate of liquid ammonia, add sufficient to make 3 fluidounces. 
A dessertspoonful every two hours for a child 4 years old. 



PROTRACTED SIMPLE CONTINUED FEVER. 

Definition and Cause. — It seems necessary for the present to continue 
this term for a feverish process of a longer duration than febricula — a 
fever of long duration that is not typhoid, nor influenza— lasting from two 
weeks to three months and without definite lesions may be put under thi* 
head. Cases of prolonged fever succeeding pneumonia and pleurisy which 
subsequently recover may well be ascribed to this disease. 



294 THE ERUPTIVE DISEASES. 

Symptoms are, as will be readily understood from this explanation, 
slight chill or chilly feelings for the initial disturbance, followed in a few 
hours by headache, quickened pulse, rise in temperature and constipation. 
Very often in persons of sensitive stomachs there is a little nausea or 
vomiting for twelve or twenty-four hours, and again with those of sensitive 
skins there may be a slight eruption of roseola, or prickly-heat, as it is 
often called, especially about the loins and over the back. The fever may 
run high enough for the overheated blood to disturb the brain and pro- 
duce some delirium, especially at night ; but at the end of a period, vary- 
ing in duration from twelve hours to ten days, the febrile symptoms 
usually subside without any further derangement of the system than a 
very copious and debilitating perspiration, or perhaps an outbreak of the 
vesicles of herpes, commonly denominated "cold sores," about the fade* 
or elsewhere. Such attacks as these cause much needless anxiety, needless 
at least in the Northern States, to both physicians and patients, the former 
dreading the onset of typhoid fever or other dangerous disease, and the 
latter suffering an agony of suspense from which, for a time, all the 
knowledge of Hippocrates or ^Esculapius himself could not deliver them. 

Treatment — The patient in these puzzling cases should be kept in 
bed, and allowed only light and unstimulating liquid food. Cold applica- 
tions may be made to the forehead and temples to relieve headache, and 
diaphoretics combined with anodynes, such as nitre and morphia, as al- 
ready directed, to reduce fever and allay restlessness. Lumps of ice are 
useful and refreshing to the throat when swallowed and whilst there 
is constipation small doses of calomel repeated until there is a free bowel 
movement. 

YELLOW FEVER. 

These germs, in the course of ten to fourteen days, undergo a process 
of development and multiplication. At the end of the period of develop- 
ment the germs migrate to the biting organ of the mosquito, from where 
they are transmitted into the blood of a healthy person through the skin, 
when bitten. Each germ, in turn, when deposited in the blood vessel of 
the human body, multiplies and develops, and, liberating its toxin, spreads 
through the circulation and produces the yellow fever in it most pro-, 
nounced form. ( 

Yellow Fever, sometimes called Yellow Jack, Sailor's Fever, Black 
Vomit, Gibraltar Fever, etc., is a disease occurring in tropical and sub- 
tropical countries. Its cause is unknown, but science has proven that the 



YELLOW FEVER. 



295 



poison causing Yellow Fever is carried from one sufferer to another by 
the mosquito called the Stegomyia fasciata. 

Yellow Fever is supposed to have been imported into the Western 
Hemisphere by the Spanish navagitors. It was first described as a dis- 
ease in the middle of the seventeenth century, where it was discovered in 




THE YELLOW FEVER MOSQUITO. 



the Antilles. The disease affects seaport towns and maritime districts in 
tropical and subtropical countries. Epidemics occurred in the seaport 
cities of the United States in the nineteenth century. Philadelphia suf- 
fered from a disastrous epidemic during the end of the eighteenth 
century. 



296 THE ERUPTIVE DISEASES. 

Yellow Fever always occurs in the summer and autumn months and 
ends upon the appearance of frost. Havana, Cuba, Vera Cruz, Mexico; 
Eio Janeiro, Brazil, and Xew Orleans during the nineteenth century, until 
the occupation of Cuba by the Americans, were the cities known as the 
spots in which Yellow Fever was usually present, and from which the 
disease spread to other seaport cities of tropical and subtropical coun- 
tries and the United States. 

The Mosquito as the Carrier of Yellow Fever — Dr. Finlay, of Havana, 
in 1881 first called attention to the fact that the mosquito was associated 
with Yellow Fever, and about 1890 was the first to explain clearly the 
mosquito theory of the transmission of Yellow Fever, but he could not 
prove it at the time by experiment. 

The American occupation of Cuba, however, brought into application 
in a practical way this theory of Dr. Finlay's. Thousands of cases of 
Yellow Fever occurred throughout the island and became a menace to the 
health and lives of our troops. This brought home to the United States 
Government the dangers and prevalence of Yellow Fever in so close a 
neighbor, and renewed efforts were made to prove that the mosquito car- 
ried the poison which caused Yellow Fever. 

In 1900 Dr. Finlay had produced yellow fever in a man by allowing 
a mosquito to bite him two days after the insect had bitten a sufferer 
from Yellow Fever. This lead to experiments carried on by the U. S. 
Yellow Fever Commission, which confirmed, without doubt, that the mos- 
quito (Stegomyia fasciata) ^spreads the Yellow Fever. This Commission 
had a mosquito-proof house built with a partition dividing it into two 
rooms. Into one room was placed a non-immune person in a bed and mos- 
quitoes which had previously bitten Yellow Fever patients were liberated. 
They attacked and bit the volunteer, who had purposely exposed his arms 
and chest. This procedure was repeated three successive times. Five 
days after this experiment, this man developed Yellow^ Fever. On the 
evening that this first man exposed himself to the mosquito, two other men 
who never had Yellow Fever slept in the second room, which was screened 
and contained no mosquitoes, and they did not catch the disease from the 
man in the adjoining room ; this experiment proving that the disease 
could not be caught by being near or in contact with a patient. 

A second mosquito-proof house was constructed in which bed- 
clothing and wearing apparel which had been soaked in the discharges 
from a sufferer from Yellow Fever, were placed, and this house was en- 
tered for twenty-one consecutive nights by two soldiers and a surgeon 



YELLOW FEVER. 



297 



who handled and shook the soiled articles. This experiment was repeated 
by three different sets of men, each remaining twenty-one nights. Not a 
man contracted Yellow Fever, nor was any the worse for the experiment. 
This experiment proved that Yellow Fever was not contagious and could 
not be caught by the handling of clothes, etc., from a patient who had 
Yellow Fever. 

The absolute proof that Yellow Fever was carried by the mosquito 
was put to a practical test by Dr. Gorgas, of the U. S. Army, who in the 
cleaning of Havana destroyed every mosquito seen, cleared away all breed- 
ing places and screened all homes, hospitals and camps where Yellow 
Fever patients were confined. Thus Havana was made as free from Yel- 
low Fever and as safe to live in as the healthiest city in the world. 

It requires three to four days for a person to develop Yellow Fever 
after being bitten by a mosquito which has sucked the blood of a patient 
suffering from the disease. Experiments have proven that the mosquito 
cannot convey the disease to another until he has had the poison in his 
body for twelve days after biting a Yellow Fever patient. One attack of 
Yellow Fever renders the person immune to another . attack — that is, 
they cannot have it twice. 

Prevention. — The best course in Yellow Fever is to prevent its spread. 
Place the patient in a screened room or hospital. It is not necessary to 
keep him or her away from others with the disease or to exclude the family, 
as Yellow Fever is not contagious. Only be sure that all mosquitoes are 
killed and kept out of the room by screened doors and windows. In cases 
of an epidemic the local Board of Health will do well to call upon the 
State and Federal authorities to aid in fighting this dreaded disease. 
Every town or city in tropical or subtropical countries should do every- 
thing possible to destroy the mosquito and its breeding places. The 
following are the rules adopted by the United States Army for the pro- 
tection of troops from the yellow fever mosquito : 

"1st. The universal use of mosquito bars in all barracks and espe- 
cially in all hospitals, and also in field service when practicable. 

"2d. The destruction of the larvse or young mosquitoes, com- 
monly known as Sviggletails,' by the use of petroleum on the water where 
they breed. 

"The mosquito does not fly far and seeks shelter when the wind 
blows ; so it is usually the case that each community breeds its own supply 
of mosquitoes in water barrels, fire buckets, post holes, old cans, cesspools 
or undrained puddles. 



298 THE ERUPTIVE DISEASES. 

"An application of one ounce of kerosene to each fifteen square feet 
of water, twice a month, will destroy not only all the young but the adult 
females who come to lay their eggs. The water in cisterns or tanks is 
not affected for drinking or washing purposes by this application if only 
it is drawn from below and not dipped out. 

"For pools or puddles of a somewhat permanent character draining 
or filling up is the best remedy." 

Definition — An acute infectious disease characterized by yellowness 
of the skin and accompanied in the severer cases by black -vomit, sup- 
pression of the urine, with hemorrhage from the stomach, nose and mouth. 
It is almost peculiar to tropical climates and not apt to spread in tempera- 
tures below 72 degrees Fahrenheit. It is extremely fatal. It is not con- 
tagious. It can only be acquired by bite of the female mosquito known as 
Stegomyia fasciata. 

Symptoms. — Yellow fever presents three well-defined stages. The 
first is characterized by intense pain in the head and back, injected eyes, 
rapid pulse and elevated temperature. This stage may last from twenty- 
four hours to six days — according to the severity of the attack, nausea 
and vomiting are present and become more intense on the second or third 
day. The bowels are usually constipated. As early as the first morning, 
according to Guiteras, the face is decidedly flushed, more so than in any 
other infectious disease at such an early period. The second stage is 
characterized by the following symptoms : 

The Pulse. — One of the diagnostic signs is that with an ascending 
temperature, there will be a descending pulse. On the first day the pulse 
is rarely more than 100 or 110 ; on the second or third day while the 
temperature keeps up the pulse begins to fall and may become slower to 
the extent of twenty beats. On the evening of the third day there may 
be a temperature of 103 degrees and a pulse of 75 ; it may, during defer- 
vescence stage, go down as low as 30. 

The Fever — On the morning of the first day the temperature may 
vary from 103 degrees to 106 degrees ; during the evening of the first day 
and the morning of the second day the temperature keeps about the same. 
There is a slight diurnal variation in the second and third days. 

The Calm Stage — Third stage, the remission or stage of calm, as it 
has been called, is succeeded by a febrile reaction, or secondary fever 
which lasts one, two or three days, and in favorable cases falls by a short 
lysis. On the other hand, in fatal cases the temperature rises rapidly, 
becomes higher than in the initial fever and death follows shortly. The 



YELLOW FEVER. 299 

second stage is marked by depression of the nervous and muscular forces, 
and of the general and capillary circulations, slow and intermittent pulse, 
jaundice, urinary suppression, passive hemorrhages from the bowels, nose, 
gums, uterus and nearly all the organs lined with mucous membranes 
and, in cases of unusual severity, also from the eyes^ ears and skin. Black 
vomit, delirium and coma generally terminate in death. 

In more severe cases the symptoms resemble to a considerable extent 
those of relapsing fever, and it is impossible to foretell from any of these 
indications how serious these consequences may prove to be. In truth, 
these sequels constitute the most distinctive characteristics of yellow fever 
and comprise the "black vomit/' so well known and dreaded as a fatal 
symptom. The black vomit is frequently preceded by the white vomit, 
as it is called, which is a clear acid liquid, and at this time some pain is 
usually felt on pressure over the pit of the stomach. The occurrence of 
this black vomit is well known, even among sailors to West Indian ports, 
as a fatal sign in yellow fever, although occasionally a patient recovers 
after this gloomy harbinger of death has manifested itself. The yellow- 
jaundiced hue of the skin, when well marked, indicates a severe form of 
the disease, but has by no means the terribly fatal import of the black 
vomit. 

1. Prognosis. — There are epidemics in which all persons attacked 
are seriously ill or die. There are epidemics of medium intensity in 
which the progress of the disease is limited and the mortality low. Finally, 
there are mild epidemics in which nearly all the patients recover. The 
virulence of the epidemics seems to depend upon the month in which it is 
imported. The pathogenic bacillus increases in virulence in the months 
of May, June and July. On the other hand, the epidemics which are 
imported in the months of August, September and October are very 
mild, owing to the attenuation of the bacillus. 

2. The Individual Attacked — Should the patient prior to his attack 
have been addicted to the use of alcohol, should he be debilitated from 
overwork, sexual excesses or bad living, and lastly, if he be old, the prog- 
nosis is against his recovery. The younger, the healthier and stronger the 
patient the greater are his chances for recovery. When the fever reaches 
its maximum at the onset and defervescence is continuously noted at each 
visit, the disease is mild; even when the fever ranges between 103 and 
104.5 degrees Fahrenheit during the first three days, with a remission of 
at least a degree in the morning and the exacerbations are less and less 
pronounced each night, the patient always gets well. When the fever 



300 THE ERUPTIVE DISEASES. 

ranges between 104 and 105 degrees Fahrenheit, still with remissions of 
at least a degree, but with exacerbations above the degree of fever of the 
previous day, the disease is to be considered grave. The cases of recovery 
are more numerous than the fatal ones even here. But when the fever 
reaches 105 degrees Fahrenheit or above within the first twelve hours 
the disease is usually fatal, unless heroic treatment immediately produces 
a defervescence of two or three degrees. Copious urine is always a good 
augury, even should it contain five or ten per cent, of albumen. 

Scanty Urine with twenty to twenty-five per cent, of albumen on the 
second day, accompanying a fever about 104 degrees, indicates great 
danger. When the urine froms a complete coagulum on being heated 
death is certain. When anuria lasts twelve hours death is absolutely 
certain. 

Intense Jaundice on the third day, urine scanty and albuminous, with 
black vomit occurring at the same time, always results fatally. 

Black Vomit is less grave in children and in young women than in 
adults, particularly those over forty years of age ; the latter always die. 

Profuse Bleeding of the gums coming before or at the same time as 
the black vomit indicates an almost desperate state. Should it, however, 
occur on the fourth day and the gums being sound, the prognosis is less 
gloomy. 

Women having uterine hemorrhage on the fourth and fifth days with 
black vomit never recover. 

Treatment. — There are two great principles to be carried out in the 
treatment of yellow fever : 

1. To strengthen and sustain the organism by fortifying the nervous 
system, by arresting congestion and by increasing the blood pressure and 
diuresis. 

2. To consume, destroy and eliminate the toxin. 

First of Above — The first of the above is met by means of cold 
sponging or cold baths, administered not in a routine way, but by taking 
the virulence of the disease and the degree of the fever as a guide. 

Second of Above .^-The second indication is met by putting the pa- 
tient in a well aerated room, night and day, and making him drink in 
order to cleanse his blood and to dilute the toxin and eliminate them by 
way of the urine, two to four quarts of Yichy water in twenty-four hours. 

It is during the first three days of the disease that the physician 
must act. 

Absolute Rest. — Put the patient to bed, rest is essential and indis- 



BUBOXIC PLAGUE. 301 

pensable, walking, moving or the least muscular effort always increases 
the fever, and consequently the disease. 

Aeration of the Room. — The patient must be placed in the largest 
and best ventilated room in the house. Exposed to the rising sun if pos- 
sible. Keep the windows open night and day; do not let patient be in a 
draught, but let the outside air enter and circulate freely. 

Cleanliness. — The patient must be kept clean; should he be soiled 
by evacuation of the bowels or vomit, change the linen at once and plunge 
the soiled clothes in an antiseptic solution ; cleanse the patient's teeth twice 
a day with cooking soda and warm water. Administer morning and night 
an enema containing a pint of warm water and a tablespoonful of sul- 
phate of magnesia. 

The Urine should be examined each day to see how the kidneys are 
acting. 

Treatment of the Vomiting. — Let the patient eat small pieces of ice, 
but absolute rest for the stomach is the better plan. 

Nourishment. — None should be given for the first seventy-two hours, 
after that milk every four hours. Starve your patient whether he be 
child or adult, unless the fever be below 102 degrees Fahrenheit. Vichy 
water in large quantities should be given from the onset of the disease. 

Medicinal Treatment. — At the onset give one to three grains of calo- 
mel, depending on the age of the patient, but not enough to purge. In 
desperate cases enemas of strong black coffee to which is added two 
tablespoonfuls of brandy have been found beneficial. 



BUBONIC PLAGUE. 

Definition. — An acute infectious disease, which is identical with the 
pestilence of India and the black death of Europe in former ages, and is 
attended with buboes or boils of the lymphatic glands of the groins, as 
well as other glands and occasionally with carbuncles. It is very easily 
communicated by human intercourse and is probably the most fatal of all 
the eruptive fevers. 

Cause. — The specific bacillus which causes this disease was discovered 
by Kitasato, and occurs in the blood and in the organs of the body. It 
obtains entrance through the digestive and respiratory tracts. 

History. — The earliest positive accounts date from the second cen- 
tury of our era. From the great plague in the days of Justinian (sixth 



302 THE ERUPTIVE DISEASES. 

century) to the middle of the seventeenth century epidemics of varying 
severity occurred in Europe. Although the inhabitants of the United 
States have hitherto been spared any visitation from the plague, yet, as 
the shipments of rags from Italian ports with marble, for which they are 
used as wrapping, is carried on quite extensively, germs of this terrible 
malady may at any time be imported and planted within our borders. In 
the last great outbreak of plague in Astrakhan, a province of southeastern 
Russia, the starting-point of the whole epidemic was, it is said, traced 
to a shawl brought by a Cossack returning from the war in Afghanistan, 
as part of his booty, and presented to his sweetheart. The girl wore the 
fatal gift for a few days, when she sickened with all the symptoms of 
plague and died. During the following four days the rest of her family, 
six in number, sickened and died. From these poor people the disease 
spread rapidly, and proved very fatal, devastating nineteen villages in 
that district. Its deadly march was only checked by a double cordon of 
soldiers being placed around the infected towns, and absolute non-inter- 
course, on the plan of the shot-gun quarantines of our Southern States, 
enforced. 

Symptoms. — In the milder cases, patients are attacked with violent 
headache, transient shiverings, alternating with intense heat of skin, 
sometimes terminating in death from prostration. In the more severe 
form the persons affected are suddenly seized with palpitation of the 
heart, irregularity of the pulse, vomiting, difficulty of breathing, spitting 
of blood, and syncope or fainting. The face becomes pale, the expression 
apathetic, the eyes dull and the pupils dilated. The patients lie for three 
or four hours in a state of absolute prostration and then a violent accession 
of fever with delirium followed, in which the urine is suppressed and the 
bowels constipated. Dark purplish spots, from one-tenth of an inch to one 
inch in diameter, appear over the body, which exhale a peculiar odor 
somewhat resembling honey, and death is preceded by lethargy and col- 
lapse. The corpses become putrid in two or three hours after decease. 
Death sometimes occurs in twelve hours from the first onset. 

The fever may reach 104 degrees or 106 degrees Fahrenheit, and the 
tongue becomes brown. The inguinal glands are most often affected, then 
in order, the axillary, the cervical and the popliteal. Carbuncles also 
develop in different parts of the skin, particularly on the legs, buttocks 
or back. 

Treatment. — Free stimulation, nutritious food, as in the most adyna- 
mic forms of typhus and typhoid fever together with cool baths to 



BUBONIC PLAGUE. 303 

combat the fever, are the measures indicated. Antiseptic treatment of the 
abscesses should be practiced. 

Preventive Measures — In India, from 1896 to 1907, the number of 
cases of plague was 1,400,000, with 1,200,000 deaths. Owing to the filth 
and fanaticism of the people, neither curative nor preventive agencies 
were of much avail. It is evident that the greatest care is now demanded 
of every country to be watchful and to adopt all necessary measures to 
prevent a lodgment of the plague. Its introduction is due (1) to the 
arrival in a community of persons suffering from it, or who are in the 
incubative stage of the disease; and (2) through the instrumentality of 
rats, which are reagents of the plague. 

Precautions as to Persons. — As to persons, precautions against the 
plague resolve themselves into measures of quarantine observance. Every 
vessel, its crew and all passengers arriving from infected ports should 
undergo most critical scrutiny. Temperatures should be taken on arrival, 
and efforts made to distinguish between the mild, or amulant, cases and 
those of the croupous, or pneumatic type. The history of each individual 
with a mild case should be carefully looked up. Examination should be 
made of the glandular regions, the groins, the axillae, the neck, and if 
buboes are found they should be carefully distinguished from those due 
to venereal infection. For the detection of cases of the pneumatic type, 
the respiratory organs should be carefully examined, and the sputum 
subjected to microscopic or bacteriological tests to discover, if possible, 
the plague bacillus. 

Incubation. — The period of incubation of the plague for quarantine 
purposes should be regarded as seven days, and individuals from ports or 
places where plague is known to prevail should be detained for a period 
to complete seven days from the last exposure to infection, and should be 
subjected to critical inspection twice a day. 

Quarantine Against Rats. — To prevent the introduction of the disease 
through the agency of rats on vessels from infected ports, every part of the 
vessel should be disinfected by sulphur fumes for the destruction of the 
rodents, and their passage from vessel to shore should be prevented. The 
vessel should not be unloaded at a dock, but in mid-stream, by means of 
lighters. All rats found dead by the fumigation should be subjected to 
bacteriological examination, their bodies gathered and burned, and the 
places where they were found disinfected with a germicidal solution, or 
with boiling water. Eleas from the rats should be similarly guarded 
against, for they usually leave a dead rat, and thus help to spread the 



304: THE ERUPTIVE DISEASES. 

plague germs. All masters of vessels, agents and consular officers would 
do well to subject their vessels to disinfection for the destruction of rats 
at intervals of, say, three months. 

Procedure in Cities — When the plague has made its appearance in a 
city, the authorities should promptly pass anti-plague ordinances regu- 
lating garbage disposal, and placing all unsanitary buildings and places 
in sanitary condition. All garbage and kitchen waste should be collected 
and removed in covered, rat-proof cans; rat runs and burrows should be 
destroyed or filled in with broken glass ; house drains should be repaired ; 
all nuisances should be abated ; garbage should never be dumped in places 
accessible to rats, but should be burned; an active campaign against rats 
should be inaugurated, either by traps or by poisons, such as arsenic, 
phosphorus paste and carbonate of baryta. Eat poisons should be fre- 
quently changed, as well as the manner of displaying them. After the 
appearance of the plague in San Francisco in September, 1907, the 
campaign against rats resulted, in a few months, in the capture of 
278,000 rats, and the destruction by poison of 500,000. Perhaps no other 
agency was so potential in ridding the city of the plague. 

Plague in the House — The house or dwelling in which plague appears 
should be vacated. The house should be disinfected and fumigated, 
poison spread and trapping instituted to rid the premises of rats. Cellars 
and basements should be made rat-proof to prevent their return. Patients 
suffering with plague should be removed to a rat-proof hospital for treat- 
ment, and those who have been in contact with the dwelling should be 
isolated in some sanitary place for a time sufficient to cover the period of 
incubation of the disease. 

Serum Treatment. — While, as has been seen, the TJ. S. Bureau of 
Health relies chiefly on preventive measures for the extermination of 
bubonic plague, it by no means ignores the agencies which modern science 
places at its disposal for immunization from the disease or for dislodging 
it from the system. It has, therefore, experimented much with the 
prophylactic (preventive) fluid of Dr. Haffkine, by inoculating the system 
with it. In some cases it gave gratifying results, and in others proved 
disappointing. So also the antipest serum of Dr. Yersin has been tried 
and found to contain prophylactic qualities of a decided character, but 
the duration of the immunity offered is very uncertain; however, in the 
treatment of actual cases of plague this antipest serum has been found 
decidedly beneficial if used sufficiently early in the disease and in suffi- 



BUBONIC PLAGUE. 305 

ciently large doses. This serum is produced by the Pasteur Institute at 
Paris, Prance, and at the Bacteriological Institute at Lyon. 

Outgoing Quarantine. — If the city in which the plague has made its 
appearance is a seaport, all outgoing vessels should be subjected to careful 
scrutiny, and should be thoroughly fumigated with sulphur before taking 
on cargo to insure the destruction of rats. Wharves should be rendered 
rat-proof; gangways should be fended and guarded day and night, and all 
articles of cargo attractive to rats should be kept in rat-proof enclosures. 
Rags intended for export from a plague-infested city should be thoroughly 
sterilized, or else destroyed entirely, for it is quite possible that they may 
contain the dressings used in the treatment of plague cases. They may 
also contain the dejecta of plague-infected rats. 

Personal Protection Against Plague. — The following statement is made 
by Charles S. Braddock, Jr., M. D., of Haddonfield, KST. J., late chief 
medical inspector of the Boyal Siamese Government, in his "E"otes on 
Bubonic Plague as Seen in Siam :" 

"Personally in attending (plague) patients I always used plenty of 

coal oil on my shoes and stockings and on my leggings, as it has been shown 

that this kept the fleas away, a fact which was practically demonstrated 

in Bombay and Calcutta, where the coolie employees of the oil companies 

were found not to contract the disease which was raging all around them. 

The investigators in India found that on the death of a rat the infected 

fleas promptly left the dead rat, and if a non-infected rat was placed near 

them promptly attached themselves to him, and in a few days he was 

infected and died of plague. In the toAvn of Petchaburi I traced the 

great and excessive death rate among the children to the fact that after 

the rats died the infected fleas took up their habitat on the pariah dogs, 

and, these being petted and fed by the children, the children suffered 

proportionately. As the people are Buddhist in religion, and will not 

destroy life, my application to have the dogs killed was not granted. One 

of the most effective measures to stop the disease after all disinfection and 

sanitation was accomplished was to wash all floors and furniture with crude 

coal oil, and sprinkle it with a watering pot in large quantities under the 

houses and over the ground in the vicinity." 
20 






306 THE ERUPTIVE DISEASES. 

SLEEPING SICKNESS. 

{Human Trypanosomiasis.) 

Sleeping sickness is a disease affecting human beings, which is caused 
by the parasite — Trypanosoma Gambiense, getting into the blood, dne to 
the bite of the Tetse Fly. It is usually fatal. 

Sleeping sickness has occurred for the last hundred years on the 
West coast of Africa, and the disease includes the country between the 
Gambia and Congo rivers. 

In 1896 to 1901 this disease occurred in Uganda, Africa. It was 
evidently brought there by the natives who came from the Congo State 
where the disease prevailed. It was not recognized until 1901, when the 
cases became numerous. 

Race. — This disease can develop in any race of people if exposed to 
the bite of the Tetse Fly. 

Occupation. — Any work which leads a native or foreigner to spend 
much time on the shores of the rivers and lakes within the sleeping sickness 
territory, exposes himself to the disease. Native negroes contract sleeping 
sickness more than the whites, due to the fishermen, canoemen and other 
inhabitants being half naked and thus constantly bitten by the Tetse flies, 
30 to 80 per cent, of them having the parasite in their blood. 

Any person of any age or condition of health will develop sleeping 
sickness if bitten by a fly which has previously sucked the Trypanosoma 
from the blood of a sufferer from the disease. 

Cause. — The sleeping sickness is due to a minute, wriggling, worm- 
like parasite, called the Trypanosoma Gambiense, named by Doctor Dutton. 
of England, in 1901, who was sent to investigate this disease which was 
causing the slow death of thousands of negroes in Africa. This parasite 
is only seen when blood is drawn from a vein or lymphatic gland and 
examined under the microscope. It is very difficult to discover and often 
requires several examinations of the blood before it can be seen. When 
the Trypanosoma first is injected beneath the skin by the bite of the fly 
it passes to the lymphatic system, where it is found in great numbers, 
causing a swelling of the lymph glands, then passing in small numbers 
into the general circulation. 

These parasites only reproduce themselves within the human body. 
They do not pass out in the urine or stools, but only when the lymphatic 
duct blood fluids are withdrawn. 



SLEEPING SICKNESS. 307 

Sleeping sickness is not contagious, but is considered infectious. 
A delicate parasite which is incapable of living outside of the human 
body cannot be conveyed by drinking water, food, dust, etc., as other 
germs are. 

Entry of Germ into the Human Body. — The Trypanosoma is con- 
veyed from the sick to the well by the Tetse Fly (Glossina Palpalis), and 
it is the only species of fly known to harbor the parasite. Wherever 
sleeping sickness prevails, the Tetse Fly is correspondingly abundant upon 
the shores of the rivers, lakes, etc. This has been proven by taking flies 
which were caught in the sleeping sickness zones and alluring them to 
bite monkeys, the latter developing the symptoms of the sleeping sickness. 
The Tetse Fly cannot transmit the disease after three days have elapsed 
since biting a sufferer. The disease usually develops in a new case from 
eight to forty-eight hours after the fly has bitten a previous sufferer. 

The Tetse Fly is only found along the shores of rivers and lakes, 
where there is forest, which consists of high trees, thick jungles and 
dense undergrowth. They are never seen on open sandy beaches backed 
by grass plains, nor in the grass of the grassy plains even though long 
and tangled. 

Symptoms, First Stage. — After a person is bitten by a Tetse Fly, the 
trypanosoma is injected beneath the skin and then reaches the lymphatic 
and blood fluids of the body, wherein it multiplies. As far as is known 
they do not appear in the general circulation until twenty days have 
elapsed. The course of this stage of sleeping sickness is very slow and 
takes months and possibly years for the symptoms to develop. The 
average is between three months to three years or more. During this 
period the sufferer is attending to his ordinary work and feels well, but 
there is an enlargement of the glands of the back of the groins and armpits, 
which can be observed and felt as swellings bulging the skin in these parts 
of the body. If fluid is drawn from these swelling glands, after many 
careful searches the trypanosoma can be seen by the microscope. These 
glandular enlargements, with, of course, the finding of the parasites, and 
the history of a person having been in a sleeping sickness area, and bitten 
by the Tetse Fly are symptoms and facts which will prove that the 
patient is suffering from this disease. 

Second Stage. — During this period the patient is apparently lazy and 
inclined to lay around and sleep during the day. He becomes more 
sleepy as the disease advances, the expression of the face is sad and apa- 
thetic, he is mentally dull, the eyes are dull and heavy, the eyelids droop. 



308 THE ERUPTIVE DISEASES. 

The body is well nourished until late in the disease, if the patient is well 
fed. Headache is present, or there is complaint of dull pains in other 
parts of the body. The pulse is rapid and weak. The lymphatic glands 
are seen and on feeling, are about the size of a pea to that of a bean. 
There is never any eruption (rash) upon the skin. The patient walks with 
a weak gait, uncertain and shuffling. The hand grip is lost and the 
hands tremble when held out at right angles to the body. The tongue 
trembles when extended. The voice is mumbling, weak and monotonous. 
The fever during this time is from 101 to 102 degrees Erahenheit in 
the evening. These symptoms generally grow worse until after weeks 
or months the patient is unable to talk, walk, or feed himself. He is 
confined to bed, sleeps continually, is usually neglected and not fed by 
the ignorant relatives and friends, and becomes very thin. During the 
last two or three weeks the urine and stools pass without his knowledge 
and the temperature drops to 92 degrees Fahrenheit and he dies in a 
state of coma (stupor). 

Treatment — There is no known remedy which will kill the trypa- 
nosoma in the human body, nor any drug which will aid the patient in 
fighting the attack. It is a fatal disease and so far as is known every 
sufferer from sleeping sickness sooner or later dies from its effects. Iron, 
quinine and arsenic have been used as tonics, but with no results as to 
cure, simply prolonging life. Every known drug has been tried without 
success. 

Prevention. — Sleeping sickness is difficult to prevent owing to its oc- 
currence in a country which is inhabited by ignorant and superstitious 
savages, infested with the Tetse Ely, which alone spreads the disease. The 
fly cannot easily be destroyed owing to the dense jungles and forests which 
spread out from the shores of the lakes and rivers in the sleeping sickness 
areas. These cannot be burnt owing to their green and damp condition. If 
the natives were intelligent they might be urged to move from the infested 
region, but only the intelligent ones do this, the remainder would rather 
die than leave their shambles and their tribes. If removal does take place 
care must be taken to see that no species of Tetse Ely is present which 
might convey the disease to the new location. 

Among intelligent people the disease is preventable by not living 
in a sleeping sickness area, or if compelled to live there by wearing cloth- 
ing which covers the body completely and mosquito helmets for the face, 
and the screening of all doors and windows of houses, etc. Kill all flies 
seen indoors and remove all vegetation in the vicinity of the dwelling 



HOOKwoKzy: disease. 309 

and cultivate the ground if possible. Do not expose yourself in any way 
to the bite of the Tetse Fly. 

HOOKWORM DISEASE. 

The spread of hookworm disease is due chiefly to the lack of sani- 
tary privies in the Southern homes and schools of the people in the vil- 
lages, towns, etc. The depositing of bowel movements upon the soil and 
a poor sewage disposal is a means by which the parasite reaches the water 
supply. In some of the Southern colleges thirty per cent, of the students 
and as high as ninety-five per cent, of the pupils in the common schools 
showed the hookworm in the discharges from the bowels and the bladder, as 
proven when they were examined by the microscope. Those who had the 
disease were backward students as compared with the uninfected pupils, 
thus showing how the disease lowered their capacity for work and study. 

If one child has a case of hookworm disease in the home or school, 
and the latter have unsanitary privies, every child in them is liable and 
usually~does contract this dangerous, contagious disease. 

Cause of Hookworm Disease. — It is caused by a small, round worm 
about half an inch long and as thick as a pin. The forms occurring in 
man do not develop to maturity in the lower animals. The special variety 
discovered in this country has been named the "Xecator Americanus" or 
"American Murderer" by Dr. Stiles. Its color varies from a dead white 
to a dirty gray, sometimes red from the continued blood which it has 
sucked from its victim. 

How the Parasite Gets Into the Body. — The worms do not multiply in 
the body, but the adult females deposit great numbers of eggs in the small 
bowel, from a few hundred to three or four thousand every day, which are 
carried out with the normal bowel movement. The eggs hatch out the 
young worms called larva? in the course of twenty-four hours. Within a 
week the tiny organism has shed its skin twice, like a snake does. It lives 
in this cast-off skin, but takes no food after the first few days following its 
escape from the eggs. After shedding its skin, the young worm is capable 
of entering the human body of another person when passed out in the 
bowel movement of the person in which it is developed. It may enter the 
human body in one of three ways. First, it may be swallowed with con- 
taminated food, milk or water. Secondly, it gets into the body by boring- 
through the skin. Third, the eggs, larvae or young worms may be carried 
on the legs of flies. 



310 



THE EEUPTIVE DISEASES. 



In boring through the skin the young worms produce the condition 
known as "dew poison" or "ground itch" or "toe itch/ 7 which is usually 
the first symptom of hookworm disease. The "dew poison" occurs mostly 
about the feet and ankles, but in miners or farmers who work in infected 
or polluted ground, and sometimes in children, the "dew poison" appears 
in the hands and arms. After boring through the skin, the worm enters 
the blood stream and passes through the heart to the lungs, makes its way 
up to the windpipe or is coughed up and swallowed, and after its passage 
down the gullet to the stomach finally enters the small bowel. Having 




HOOKWORMS.— A, female; B, male. 



reached the bowel where it elects to remain, the tiny worm sheds its skin 
twice more, becomes fully developed and mates. The worms are provided 
with strong jaws and a hollow tooth somewhat like a snake. The worm 
hooks itself to the wall of the bowel by its strong jaws and sucks the blood 
of the child or adult in which it lives. Thus it wounds the wall of the 
bowel, sucks the red blood and weakens the patient. In addition the worm 
mixes the blood, after digesting it with its own poisonous bowel matter 
and injects or squirts it through this hollow tooth into the body of the 



HOOKWORM DISEASE. 



311 



patient. Thus the hookworm is first — a blood destroyer; and second — a 
blood poisoner. 

Symptoms. — If a child is infected with the parasite before puberty 
(adultage), the physical and mental condition is retarded. A boy or girl 
sixteen may present the body and mind of one of eight or ten years of age, 
and young men and women of twenty may appear to be not more than 
twelve or fifteen. The skin is pale, perspiration or sweat absent, cuts or 
bruises heal slowly. In the early stages of the disease "ground itch," 
"dew itch" or "toe itch" is often found upon the feet, ankles or hands. 

The hair may be normally developed upon the head, but on other 
parts of the body where it ought to be it is generally absent or scarce. 
The face, feet, ankles, and in extreme cases the entire body, may be swol- 
len. This swelling disappears rapidly after treatment. Body weight is 
reduced. The chest is thin, ribs prominent, the shoulder-blades stand out 
upon the back and the patient appears "round-shouldered." The expres- 
sion of the patient is anxious or very stupid. The appetite may be light or 
it may be ravenous, the child being unable to obtain enough food at an 
ordinary meal to satisfy its appetite. The patients often develop a desire 
for abnormal articles of food and this is why sufferers of hookworm dis- 
ease are called "dirt eaters:" They crave and eat lemons, pickles, salt, 
pepper, sour milk, chalk, clay, ashes, tobacco, mortar, plaster, sand, gravel, 
sticks, decayed wood, paper and cloth. Nausea and vomiting are frequent 
and there is tendency to heartburn and pain over the pit of the stomach. 

The blood is impoverished, the patient suffering from thin blood or 
anaemia as a result of the red cells of the blood being destroyed and the 
blood poisoned by the worms which suck it out and at the same time in- 
ject into it the poison from their bowel movements. 

The only sure way of diagnosing hookworm disease is to examine the 
bowel movements of the patient under the microscope and find the eggs, 
or to see the tiny worms, the size of an ordinary pin with the naked eye, 
which appear before or after treatment in the stools. 

Hookworm disease is termed the "lazy disease." This is due to the 
sufferers' muscles being very soft and weak. The shirking of w % ork and 
study is not due to laziness, but is nothing more or less than weakness or 
weariness because the hookworm is sucking their blood. They must be con- 
sidered ill and treated as such. 

Treatment. — In curing hookworm disease, we do not treat the pa- 
tient, but the worms. The remedies used either kill or cause the worm to 
loosen its hold on the wall of the small bowel. The treatment must always 



312 THE EKUPTIVE DISEASES. 

be given under the care of a physician. It is simple and usually very 
effective if directions are properly followed. It can be given to those who 
cannot afford to stay away from business or work by having them take 
the treatment on Saturday evening or Sunday morning. The best treat- 
ment is to give the drug thymol in capsule form. 

The bowels must be thoroughly emptied before the thymol is taken, 
so that all mucous and undigested food which surrounds the worm is re- 
moved, thus giving the thymol an opportunity to come in direct contact 
with the hookworm to properly affect a cure. 

Directions to Patient. — At bedtime for two nights before taking the 
capsules, take an ordinary dose of epsom salts and during the intervening 
day between the nightly doses of salts, eat only liquid foods, such as milk 
and soups. On the second morning after taking the first dose of salts, do 
not get lip, and eat nothing at all, and at 6 A. M. take one-half of all the 
capsules of thymol and at 8 A. M. the remaining half. The number of 
capsules to be taken and the amount of each one depends upon the age 
(not apparent age) of the patient. This must be judged by the physician 
in attendance. At ten o'clock the same day take a dose of epsom salts, but 
do not take oil, fats or alcohol while taking the capsules, as these sub- 
stances render the thymol absorbable by the digestive tract and poisonous 
symptoms occur. After the bowels have moved thoroughly following the 
ten o'clock dose of salts, the patient may eat an ordinary meal, and it will 
not be necessary to stay in bed. This treatment is recommended by Dr. 
Lock, Inspector of the State Board of Health of Kentucky. 

The Size of the Total Dose of Thymol. — 

Under 5 years old 7J grains. 

From 5 to 9 years old 15 grains. 

From 10 to 14 years old 30 grains. 

From 15 to 19 years old 40 grains. 

From 20 to 59 years old 60 grains. 

Above 60 years old 30 to 45 grains. 

(Recommended by Dr. Stiles.) 

It Jias been proven that after one treatment of thymol, as recom- 
mended by Dr. Lock and Dr. Stiles, ninety per cent, of the cases are 
cured. The bowel movements must be examined under the microscope 
two weeks after each treatment for the purpose of finding the pin-sized 
worms. If present, the thymol treatment must be repeated until all 
worms are absent from the bowel movements. 

The anaemia and debility of all sufferers from the hookworm disease 



HOOKWORM DISEASE. 313 

will soon disappear when the worms are destroyed and the food the patient 
takes is absorbed and used to make blood by the system, instead of being 
destroyed and poisoned by the hookworm. However, iron tonics and 
nourishing food must be given to build up the blood and aid recovery. 

Prevention of Hookworm Disease — Board of Health, state, county and 
city, in the Southern States, are spending thousands of dollars to wipe 
out the hookworm. It has been discovered that the worm develops as a 
result of "soil pollution." Not only can it be prevented, but at the same 
time the methods used are preventive of typhoid fever and other germ dis- 
eases, whose poisonous elements are carried in the bowels and urine from 
the infected person to the soil and water. 

Hookworm disease is spread as a result of the carelessness of persons 
who dispose of their bowel matter upon the soil and by the use of unsani- 
tary privies and toilets which drain upon the soil or a water supply. 

Shade and moisture are necessary for the eggs and larvse of the hook- 
worm to hatch and develop. Therefore, those who are infected with 
hookworm disease, and use the shaded spots where no privies are, to pollute 
the soil, are depositing and spreading their disease by their carelessness ; 
as shady spots are usually moist and make the best place for the hook- 
worm to develop. 

In some States even of this country many homes in villages outside 
of the towns and cities which have a sewage system and schoolhouses, etc., 
have no privies. (Think of it in the twentieth century in America.) 
Only the wealthier families have an occasional toilet on the premises, and 
these are absolutely unsanitary and are built apparently to only shield 
the user.. Is it any wonder that hookworm disease, typhoid fever, cholera 
infantum and dysentery thrive amid such surroundings ? 

Hookworm disease can be prevented from spreading by first curing 
the present sufferers with the thymol treatment, the building of sewage 
systems in the larger towns and villages with sanitary toilets, the build- 
ing of properly constructed fly-proof privies on farms, in schoolhouses, 
etc., the removal of all privies from a location where the waste matter can 
drain on to the soil which can be washed by rain or melting snow into a 
spring, creek, river or any other water supply of a house, camp, farm, 
dairy, etc. 

Children or adults in a region where hookworm disease is prevalent 
must wear shoes to protect their feet and ankles from the larva? upon the 
skin, as they will bore through and in this way get into the system. Boil 
all water and milk and cook vegetables. 



314 THE EKUPTIVE DISEASES. 

In the Southern States particularly, and others also, any child or 
adult who is apparently "lazy" and always tired with a puffy abdomen, 
tremendous appetite, swollen eyes, and loss of weight with anaemia, must be 
taken to a physician or public dispensary to ascertain whether or not he is 
suffering from the hookworm disease, and if a sufferer, receive treatment 
at once. Kill all flies about, screen doors and windows and construct a 
sanitary privy. 

PELLAGRA. 

Pellagra is a disease the cause of which is not definitely known. So 
far scientific investigation has not disclosed any germ as the cause, 
though some physicians believe it is an infectious disease and can be 
caught from a new case appearing in a community for the first time. It 
has been proven though that it is the result of a poison which exists in 
spoiled maize, Indian corn or corn products. This theory was first ex- 
plained by Ballardini, an Italian physician, in 1844, his theory being that 
the maize underwent a change by reason of the growth of a fungi on the 
grain, which acted as a poison to the system, and could be recognized in 
the grain as a greenish color. Another theory put forth by Dr. Scanlon, of 
the London School of Tropical Medicine, is that the "black-fly" or "sand- 
fly" (simulium repatans) causes it. Still another theory is that it is due 
to the stable-fly (Stomonys calcitrans) ; the mosquito is also considered 
as a carrier of pellagra. Others claim that no matter what the definite 
cause is, it is a disease which is being imported into this country by the 
hordes of immigrants from Italy. . 

Whatever its cause, pellagra is a serious disease and has been a na- 
tional scourge in Italy and other European countries for more than a hun- 
dred years. An epidemic occurred in Italy in 1907 during which 100,000 
cases occurred and at least 50,000 cases in Eoumania. Thus it can be seen 
how prevalent the disease may become during an epidemic and cause great 
mortality as well as loss of health and money to citizens and the State. 
Several cases have occurred in women who have washed the clothes of 
patients suffering from this disease, due to a poison being thrown off 
from the glands of the armpits which has been collected upon the clothing 
and may have caused the disease in the laundresses, showing that the 
disease is apparently infectious. 

People who eat spoiled maize or Indian corn have developed pellagra 
and from our present knowledge of the disease it would seem that this 
is the main cause of the symptoms. 



PELLAGRA. 



315 



The early symptoms of pellagra are marked enough to recognize the 
disease, but in cases seen where the patient has had it for some time, un- 
recognized, it is difficult to make the diagnosis. The first symptom com- 
pained of is an inability to walk straight. Persons can't step where they 
want to. They have an inclination to run forward, also a sudden contrac- 
tion of the muscles of the back which may almost throw the sufferer out 
of bed. Later on a reddish rash appears, and this is characteristic of 
pellagra in that it appears upon the same spot on both hands, arms or 
sides of the chest, etc. Another marked symptom is the salty taste in 
the mouth, the mouth also is inflamed, patient also complains of great 
wearines and expresses it as "leg tire." The patient is dull, cannot think 
quickly and dizziness is complained of. Pain occurs along the spinal 
column. 

Prevention of Pellagra. — Avoid eating corn bread or meal unless 
sure that the corn is fresh and has not undergone "heating." Avoid 
alcoholic drinks. All flies and mosquitoes must be killed, as they may 
carry the poison which causes the disease, and their breeding places must 
be removed. It is not necessary to isolate a patient from his family, 
but the ordinary precautions of disinfecting the hands after handling the 
patients, his or her clothes, etc., should be followed. A physician should 
be summoned, as the treatment requires such skillful handling that no 
layman can cure himself with any known remedy. A suiferer can only 
recover by following a course mapped by his physician, as to diet, mode of 
living and medicines to be taken. 

Pellagra and Corn — The scientists of Italy and Eoumania where 
pellagra has existed for upwards of one hundred years, state that when 
corn is harvested, while the ear is yet moist, because of not having been 
given time to dry out in the field, it is particularly apt to mildew in the 
barn. The same thing is true of even matured corn in particularly moist 
climates. When corn that is damp from any cause is placed in tight barns 
or cars for shipping, it is likely to mold. This mold is extremely danger- 
ous, regardless of what may be the cause of its development. The presence 
of the mold may be determined by any individual, for it is none other than 
the mustiness that we have all smelled in corn upon occasion. That musty 
odor is the warning of the presence of a danger that cannot be over- 
estimated. 



316 THE EKTJPTIVE DISEASES. 



MAXARIAL FEVERS. 

Under this group are included infectious diseases caused by a para- 
site plasmodia, which are spread from one person to another by the bite of 
the mosquito {anopheles maculopennis) which contains the parasite in 
its body. Malarial fevers are spoken of by the public as ague, swamp 
fever, chills and fever, etc. The malarial fevers occur in periodic at- 
tacks and are classified as: (1) regularly intermittent periodic fever of the 
tertian or quarter type; (2) irregular fever of remittent or continued 
type; (3) chronic malaria or a condition resulting from repeated attacks 
of malaria with ansemia and enlargement of the spleen. 

Etiology. — Influences predisposing to the spread of the disease. Con- 
ditions which favor the development of the mosquito as heat and moisture 
found in stagnant pools, lakes, rivers or any still body of water. Areas 
of special prevalence are found in tropical and subtropical countries — 
Panama, Central America, India, Northern Africa, especially along the 
coast and river basins. Malaria is prevalent along the shores of rivers in 
the Southern States of the United States, particularly along the Gulf 
States. Malarial fevers have almost disappeared from New England and 
New York. It is very infrequent in eastern Pennsylvania, New Jersey 
and Maryland. The Northwestern States, the Pacific coast, and the 
regions north of the St. Lawrence River are practically free from malaria. 

Season. — In the tropics malarial fevers are most prevalent during the 
rainy season. In temperate climates a few cases occur in the spring, the 
greater number of cases occur in the early autumn. 

Locality. — Malarial fevers occur more in the country or outlying dis- 
tricts of a large city. This is due to the fact that the anopheles maculo- 
pennis, the only species of mosquito which conveys the parasite, breed in 
small, shallow pools and stagnant waters. The culcinioc, the mosquito 
seen about the home in suburbs or cities free from marsh lands, etc., do 
not carry the parasite of malaria. They prefer human habitations and 
deposit their eggs in still water which is allowed to stand in rainpipes 
roof gutters, cesspools, barrels and other containers about the premises. 
Hence malaria is more prevalent outside of cities. 

The cause of malarial fevers was discovered in 1880 by Doctor 
Laveran, a French army surgeon in Algiers. He examined the blood of 
patients suffering from chills and fever and found the parasite which 
caused the symptoms was present in every case. This tiny parasite has 



MALARIAL FEVERS. 317 

been termed the Plasmodium Malaria. It has been discovered and proven 
that the parasites causing malarial fever have a definite course and de- 
velopment in the blood of man and the body of the mosquito. 

The Parasite in Man — Three species of parasites are recognized as 
causing the different types of fevers in sufferers from malaria: (a) the 
tertian is caused by the Plasmodium Vivax ; (b) the quartan by the Plas- 
modium Malaria; (c) the estivo-autumnal (Perincenis) by the Plas- 
modium Immaculatum. 

The Tertian Parasite (Plasmodium Vivax). — This species when in- 
jected into the blood of a person by the bite of a mosquito — the anopheles 
maculopennis — causes a fever which occurs every forty-eight hours. The 
fever results from the parasite undergoing a development in the red cells 
of the blood, in which new parasites are developed at the same time, de- 
stroying the cells, then they attack fresh cells, at which times the fever 
develops and they repeat this until treatment is instituted. But the ter- 
tian parasite never causes chills or fever until its period of development is 
Completed — forty-eight hours. 

The Quartan Type (Plasmodium Malaria). — This species also carried 
by the mosquito is the cause of quartan fever. Its cycle of development 
in the red blood cells of man is seventy-two hours, when the new parasites 
are liberated and attack fresh blood cells, thus causing chills and fever 
once every seventy-two hours. 

The Estivo-Autumnal Parasite (Plasmodium Immaculatum). — This 
parasite is the cause of estivo-autumnal fever (Perincenis) , which is the 
most malignant type of malarial fever. It is conveyed by the bite of the 
mosquito — anopheles maculopennis. Its development takes place in the 
red cells of the blood in the liver, spleen and bone-marrow, and usually 
requires forty-eight hours to develop. This parasite will not cause a great 
deal of fever, but a continuous one which lasts for some time and goes up 
very high and remains up until recovery occurs, when it drops suddenly. 

The parasites of tertian fevers can only be seen by withdrawing the 
blood from a finger or lobe of the ear and examining it under the micro- 
scope. The estivo-autumnal parasite is not often found in the peripheral 
blood of the body. Each parasite causes its own type of fever and no other. 

The Parasite in the Mosquito. — The common species of mosquito which 
carries and spreads malaria is the anopheles maculopennis. There are 
many species, but wherever malaria is found the anopheles is always in 
the neighborhood. The anopheles cannot convey malaria unless it has 
sucked the blood of a patient suffering from malaria. Its bite alone does 



318 THE ERUPTIVE DISEASES. 

not cause the disease unless it has the parasite in its body, and the para- 
site does not develop in cold climates. Thus the anopheles can live in 
regions not malarious and still be harmless, but should one of this species 
bite a sufferer of malaria, who recently arrived and had the parasite in his 
blood, then the mosquito could spread the disease by biting another person. 

Persons living in malarious countries should be familiar with the 
habits and appearance of the mosquitoes seen within the house or about 
the premises. The culex or ordinary mosquito which is not a carrier of 
malaria can be recognized by its position from the anopheles maculo- 
pennis. The former rests upon the ceiling or wall with its posterior pair 
of legs turned up over its back, and the body, if not dragged down by the 
weight of blood, is nearly parallel with the wall. Its wings show no spe- 
cial marking. The anopheles maculopennls, when resting, places the 
posterior pair of legs upon the wall or ceiling or allows them to hang down, 
and the body is held at an angle of 45 degrees with the surface upon which 
it rests. The wings of this species show distinct markings. 

Part Played by Mosquito in Spreading Malaria. — Let us take, for 
example, a man suffering from the tertian type of malarial fever. In 
forty-eight hours the malaria j:>arasite nas undergone a development, 
sexual and non-sexual, in the man's red blood cells, thus forming new 
parasites. The non-sexual developments have formed spores, these spores 
find their way into a red cell and begin the sexual development, which 
progresses until the cell develops into a different shape, called Gametocyte, 
now the mosquito bites this patient and takes into his stomach these 
Gametocytes, which are at this time of both sexes — male, the Microgamiti, 
female, Macrogamet. The cells reproduced by the Macrogameti penetrat- 
ing the body of the Macrogamet, a single cell resulting — called the Zygote, 
the latter passes into the wall of the stomach of the mosquito, when 
it develops in an oocyst containing sporeblasts which develop into sporo- 
zoites. The mature oocyst bursts and these accumulated sporozoites reach- 
ing the circulation of the mosquito are carried to the salivary glands, and 
when the mosquito bites a fresh victim, he injects the young sporozoites 
into his blood through his proboscis as he sucks the blood, and the develop- 
ment of the parasite is repeated, as in the first patient. 

Symptoms. — Malaria usually develops in a person in from a few 
days to two weeks after being bitten by a mosquito. The symptoms of the 
tertian and quartan types are practically the same, and are spoken of as 
the paroxysm. 



MALARIAL FEVERS. 319 

The paroxysm is known as the chill or "ague fit," and is described 
under three stages : cold, hot and sweating. 

Cold Stage. — During this period the patient at first complains of 
loss of energy, yawning, pain in the pit of the stomach, sometimes nausea 
and vomiting with headache. Shivering commences which develops into 
a chill. The teeth chatter, there is violent shaking of the whole body, and 
distressing sensations of extreme cold. The face is blue, the body is cov- 
ered with goose-flesh, the temperature of the surface of the skin is sub- 
normal. This stage lasts from fifteen minutes to an hour or more. The 
danger of the attack lies in how long the cold stage has progressed. 

Hot Stage. — The cold sensations are replaced by those of heat. The 
face becomes flushed and the fever is high, 101 to 104 degrees Fahren- 
heit, the pulse is free and strong, headache is present and delirium occurs 
in some cases. The patient complains of urgent thirst and is distressed by 
the sensations of extreme heat which he feels within the body. The dura- 
tion of this stage usually lasts from thirty minutes to three or four hours. 

Sweating Stage. — Perspiration appears upon the forehead and face, 
later the entire body is drenched. The duration of this stage is variable. 
The patient finally falls into a sleep from which he awakes, very weak 
but refreshed. 

The entire paroxysm may last from two to six hours depending upon 
the severity of the attack. Between the paroxysms the patient feels well 
and considers himself in normal health. The paroxysms are due to the 
breaking down of the red cells and the liberation of a poison from the 
parasites, produced during the maturity of the parasites in the red blood 
cells of the sufferer; also the liberation of the new parasites (Sporozoites). 
A paroxysm which occurs every forty-eight hours in malaria is due to 
the presence in the blood of the tertian parasite, and it is called tertian 
fever. A paroxysm occurring every seventy-two hours is due to the 
presence in the blood of the quartan parasite ; then we speak of this as 
quartan fever. In some cases of malaria, a paroxysm occurs every day 
(quotidian fever). Then it is due to the fact that two groups of parasites 
are present, which undergo segmentation on alternate days. This is 
spoken of as a double tertian period. 

If two groups of the quartan parasite are present in the blood, the 
paroxysms occur every seventy-two hours on alternate days, thus there 
will be two days of chills, fever and sweats, with a day in between, free 
from an attack. This is spoken of as a double quartan ; if three group* 



320 THE ERUPTIVE DISEASES. 

are present there will be a daily attack (Quotidian Fever), this is called 
a triple quartan. 

The Estivo-Autumnal, or Perincenis Malarial Fever. — This type of 
fever prevails in southern Italy and Russia, tropical countries and the 
Gulf section of the United States. It usually develops in the last part 
of the summer or early autumn. It is characterized by irregularity due 
to the parasites in the blood, which have a cycle of development of about 
forty-eight hours, being in numbers or groups and does not mature upon 
certain definite days. The intensity is clue to the dangerous nature of 
the poison produced by the parasite at the time of the sporulation of the 
numerous groups. 

Symptoms. — The sufferer from the estivo-autumnal type of malarial 
fever does not have a paroxysm occurring at regular intervals, but suffers 
from a high fever, which begins and stays high until recovery. There 
may be no chills but fever and sweats are symptoms. The face is flushed, 
severe headache is present, the pulse is bounding and enlargement of 
the spleen occurs. Jaundice of the skin is seen. This fever may be 
very mild, or the patient may suffer from a severe form. The most 
dangerous types of estivo-autumnal fever are grouped under the Perincenis 
fevers. These are characterized by grave symptoms and unless properly 
treated and protected against reinfection may result in death. These 
types of perincenis malaria are called (1) Algid form, (2) comatose form, 
(3) hemorrhagic form. 

Malarial Cachenia- or Chronic Malaria — This is a condition of health 
occurring in patients who have had and been exposed to malaria numbers 
of times and did not receive proper treatment and protection from the 
bite of the mosquito which carries the parasite. It is characterized by 
an anaemia (thinning of the blood), with enlargement of the spleen. 
The patients are very thin and lose weight, the complexion is muddy 
with brown spots in the skin. Shortness of breath occurs upon slight 
exertion, and the ankles are usually swollen. The spleen becomes so 
large that it resembles a tumor known in the Southern states as "Ague 
Cake." Vomiting of blood may occur and is usually fatal if a symptom. 

Treatment. — In the tertian and quartan types quinine is given in 
15 to 30 grain doses (preferably in solution), at the time the temperature 
declines and repeated if necessary upon the following day. The treatment 
should be continued for at least a month, but the dose must be gradually 
reduced. Keep this up however if the paroxysms occur or the parasite 
is seen in the blood of a patient when examined under a microscope. 



MALARIAL FEVERS. 321 

In tke estivo-autumnal type quinine should be given in five-grain 
doses every four hours until the active symptoms have cleared up, then 
five grains every six hours for the next three days. During the following 
week the patient must receive 15 grains once a day every other day, and 
for two months, following give 15 grains every sixth day until all danger 
is passed. In this way the disease can be cured. Also be sure that the 
patient is protected from reinfection or moves away from the malarious 
country until cured. Do not stop quinine treatment until parasites cannot 
be found in blood, and chills and fever and enlarged spleen, etc., are 
absent. 

Treatment of Malarial Cachenia, or Chronic Malaria. — Quinine, iron, 
arsenic and various tonics have been used, but the best treatment is to 
remove to a non-malarious country with a high altitude and avoid living 
again in a malarious country. Sufferers from malarial fevers will recover 
more quickly if confined to bed. Quinine acts in curing malaria by 
directly destroying the malarial parasite. 

Prevention of Malarial Fevers. — As malaria parasites are carried 
from one person to another by the mosquito (Anopheles Maculopennis) 
its spread can be prevented by destroying the mosquito, screening all 
doors and windows, etc., wearing clothing which protects the body com- 
pletely, wearing a mosquito helmet over the head and face, or smearing 
oil of citronella over the face and hands at intervals. 

If choosing a site for a house or camp, or any building, high, dry 
ground should be selected, away from all still bodies of water, if possible 
drain all stagnant pools, etc., fill in with earth water which cannot be 
drained and prevent mosquitoes from laying their eggs in these hiding 
places. Kerosene freely used about the premises upon any still body 
of water will prevent the development of the anopheles and thus destroy 
the common carrier of malaria. 

Persons living or traveling and exposed to malaria can oftentimes 
protect themselves from contracting the disease, even though exposed to 
the bites of the mosquito,- by taking five to ten grains of quinine once a 
day, two or three days a week. Of course some people contract the 
disease regardless of this precaution. See Part I of Book II (Preventive 
Medicine) for further habits of the mosquito and methods of destruction. 
21 



322 THE EKUPTIVE DISEASES. 



AGUE OR INTERMITTENT FEVER. 



Ague or intermittent fever is invariably prevalent in swampy conn- 
tries. In olden times it was attributed to the insects rising at night-time 
from the swampy ground, bnt now it is known that it is obtained only by 
means of the mosquito, which finds its best breeding place in swamps and 
still waters. It is to be observed that it is only the female mosquito which 
is able to impregnate malaria in the human victim. 

Symptoms. — Characterized by three distinct stages of fever, chill and 
sweat. The paroxysm is usually preceded by a feeling of uneasiness and 
discomfort, sometimes langour and yawning, which forewarns the patient 
of its coming. 

1. The Chill or Cold Stage. — Begins gradually ; first there is a creep, 
then another, a little more severe, then another, each growing in severity 
until the teeth chatter and the body shakes violently. ~Nbt only does the 
patient look cold, but a surface thermometer will indicate a reduction of 
the skin temperature. The rectal temperature during the chill may be 
greatly increased. It lasts from fifteen minutes to an hour. 

2. The Hot Stage. — iNext comes the hot stage, in which all the 
symptoms of fever are manifested, comprising headache, nausea or vomit- 
ing, heat of skin, which may attain an elevation of 105 degrees, full, 
strong, rapid pulse and occasionally delirium lasting from a half hour 
to four hours. After this follows the sweating stage, during which pro- 
fuse perspiration takes place and the temperature is reduced, as a con- 
sequence, nearly or quite to the natural standard. The paroxysms, thus 
constituted, generally recur with considerable regularity, but may vary 
a good deal in different cases in regard to the interval between each par- 
oxysm. 

Varieties of Ague. — The varieties of ague designated in accordance 
with this difference are, first, the quotidian or daily ague, in which the fit 
comes on usually at the same hour every day; second, the tertian ague, 
the most common form, when the paroxysm returns every forty-eight 
hours whilst the disease continues ; third, the quartan, where the fit occurs 
every seventy-two hours, or on every fourth day ; and fourth, the irregular 
ague, in which the fits are not distinctly periodical. Under this head is 
included the kind of periodical neuralgia affecting the forehead, and hence 
denominated brow-ague. In the quotidian form the paroxysm is apt to be 



INTERMITTENT FEVER. 323 

the most prolonged and may last for sixteen hours out of the twenty-four, 
leaving of course only eight hours between its termination and the com- 
mencement of a new chill; in the tertian form, the fit is less protracted, 
lasting on an average about ten hours ; and in the quartan it is still shorter, 
having an average duration of only six hours. In a fit of tertian ague 
continuing ten hours, we may expect to find the chill lasting from half! 
an hour to an hour, the febrile stage, during which the patient often de- 
clares he feels as though he were burning up, extending over from three 
to iiye hours and the sweating stage occupying the remainder of the time. 

Complications — The most common secondary affection which occurs 
in the course of intermittent fever, and appears to be directly dependent 
upon it, is the chronic enlargement of the spleen, called "ague-cake." 
During the cold stage of the fit, it is probable that the spleen is always 
more or less distended with blood, which, being driven from the surface 
of the body whilst the chill lasts, finds its way to the internal organs and 
especially the spleen, in unusual quantity. Such congestion, if frequently 
repeated, seems to lead, in a majority of cases, to a real increase in amount 
of the structure of the spleen, and consequent enlargement of the organ. 

The Ague-Cake — The "ague-cake," when fully developed, may attain 
a magnitude of a foot or more in length by ten inches in breadth, and even 
when much smaller than this may be felt as a hard, painful and movable 
tumor, on the left side of the abdomen, a few inches below the heart. 
Such increase in size of the spleen generally indicates a rather profound 
impression of the malarial poison upon the system, and renders the pros- 
pect of speedy cure far less hopeful. 

Lack of Blood. — Another serious complication of prolonged ague is 
the intense anemia, which so many persons who suffer from malarial, 
poisoning often exhibit to a marked degree. The absence of the natural 
supply of good, rich, red blood gives to the skin, and especially that of the 
face, a dull, yellowish tint, which in malarious regions is displayed by 
most of the inhabitants, even the children exhibiting a pallid sallowness 
pitiful to behold. There is also a peculiar dejected, woe-begone expres- 
sion of countenance, which is almost characteristic of malarial poisoning, 
and feelings of muscular weakness and fatigue on the slightest exertion are 
very common. 

Diagnosis. — The diagnosis of ague is seldom difficult after the first 
paroxysm, as the regular recurrence at the same hour of the day is a 
feature which is so characteristic that it has given the name of "periodical 
fevers" to the febrile affections caused by malaria. At the first onset, it 



324 THE ERUPTIVE DISEASES. 

is impossible to distinguish the chill from the initial symptom of a great 
number of diseases, but a microscopical examination of the blood will 
quickly decide. The plasmodium of malaria is found in the blood during 
the paroxysms. 

Treatment. — In the medical treatment of all the periodical fevers, we 
fortunately possess a specific of wonderful power in quinine and the other 
alkaloids of Peruvian bark, which have a direct control over the malarial 
poison, by checking the development of the bacillus malarice, which has 
been already referred to as being the cause of ague. 

Quinine Treatment. — It is the custom to prepare the system for the 
administration of quinine, by the purgative action of full doses of blue- 
pill or other active cathartic. Give quinine in sufficient doses, during 
the sweating stage, to produce the slight deafness and ringing in the ears 
which mark the occurrence of cinchonism, as it is denominated. As a 
general rule, it is quite possible to do this before the time for another 
paroxysm, even with an attack of intermittent fever of the quotidian type. 
The antiperiodic must, however, in order to effect a cure, be continued 
in full doses of from ten to thirty grains daily, for three or four, days, then 
reduced to half or one-third this quantity for a few days, and so per- 
severed in for three weeks. 

Preventing Fever Recurrence. — For the purpose of counteracting the 
tendency which intermittent fever possesses of recurring in its original 
violence at intervals of exactly one week, it is advisable to take the full 
dose of from ten to thirty grains, or whatever amount has been found 
to produce slight buzzing in the ears, on the sixth and seventh, the thir- 
teenth and fourteenth, and the twentieth and twenty-first days from that 
on which the last chill was experienced. In this way not only the peri- 
odicity of single ague-fits, but also the periodicity of groups of the inter- 
mittent fever paroxysms, appears to be most effectually extinguished. 

An East Indian Cure. — In case quinine fails or is not tolerated, other 
alkaloids of Peruvian bark, and preparations of the bark itself, should 
be fairly tried. A famous East Indian mixture for the cure of ague is 
Warburg's tincture, and it may be resorted to when ill-success with other 
forms has been met with. 

Use of Peruvian Bark — The alkaloids of Peruvian bark are, as a rule, 
much more efficacious in solution with some mineral acid, such as the 
dilute sulphuric acid. 

Other Treatments. — Where for any reason Peruvian bark and its 
preparations fail to cure ague, the best substitute, although a far inferior 



REMITTENT OK CONTINUED EEVERS. 32£ 

one, is probably arsenic, particularly in the form of Fowler's solution, 
administered in quantities of five drops thrice daily, and formerly well 
known under the name of the tasteless ague-drop. For the cold stage, 
wrap the patient up well in blankets and apply hot-water bags, besides 
giving hot drinks. For the fever, cool sponging will relieve the patient. 

Diet. — No particular care of the diet is requisite in intermittent fever, 
except to counteract as far as possible the tendency to anemia and general 
debility, by a liberal supply of the most nutritious food which the diges- 
tive powers are able to assimilate. In like manner, as the patient is not 
confined to bed, directions about nursing are unnecessary. 

Prevention of Ague. — The remedy to be used in preventing an attack 
of malarial poisoning, when temporary residence in a fever and ague 
district is unavoidable, is quinine used internally, as already suggested, 
in doses of six or eight grains daily. 

THE MORE IRREGULAR, REMITTENT OR CONTINUED FEVERS. 

Place and Seasons. — This type of fever occurs in temperate climates, 
chiefly in the later summer and fall ; therefore it is sometimes called 
estivo-autumnal fever. The severer forms of it prevail in the Southern 
States, where it is known as the bilious remittent fever. The entire 
group of cases included under the term remittent fever are bilious, re- 
mittent and typho-malarial fevers. 

Symptoms. — These, as to be expected, are often irregular. In some 
instances there may be regular intermittent fever, occuring at uncertain 
intervals of from twenty-four to forty-eight hours, or even more. In the 
cases with longer remissions the paroxysms are longer. Commonly, how- 
ever, the paroxysms show material differences ; their length averages over 
twenty hours, instead of ten or twelve; the onset occurs often without 
chills and even without chilly sensations. The rise in temperature is 
usually gradual and slow, instead of sudden, while the fall may occur by 
lysis instead of by crisis. There is a marked tendency to anticipation, 
while frequently from anticipation of one paroxysm and retardation of 
another more or less continuous fever may result. In the cases of con- 
tinuous and remittent fever the patient, when seen early in the disease, 
has a flushed face and looks ill, the tongue is furred, the pulse full and 
bounding, but rarely dicrotic. The temperature may range from 102 
degrees to 103 degrees or go even higher. 

Diagnosis. — The diagnosis of remittent malarial fever may be def- 



326 THE ERUPTIVE DISEASES. 

initely made by an examination of the blood. The small, actively, motile, 
hyaline forms of the estivo-antumnal parasite are to be found, while if 
the case has lasted over a week, the larger cresentic and ovoid bodies are 
usually seen. 

Treatment. — The treatment of remittent fever is essentially that of 
intermittent fever. The continued nature of the fever and the tendency 
to a typhoid state demands a liquid diet, with the careful addition of 
stimulants. 

PERNICIOUS MALARIAL FEVER OR CONGESTIVE CHILL. 

Character. — Pernicious malarial fever differs in no respect from or- 
dinary ague and bilious remittent, except in its greater severity. The 
disease is observed under three forms: First, the comatose or apoplectic 
form, the patient speedily loses consciousness, as though the chief force 
of the poison was expended upon the brain, disturbing its functions to 
such an extent as almost to abolish them. The fever is usually high and 
the skin hot and dry. Should the patient regain consciousness a second 
attack may come on and prove fatal. 

Second Form — In the second or algid form the symptoms of intense 
chill are prolonged, it may be for some hours, and death occurs in fatal 
cases from pure debility or asthenia, without reaction coming on. Al- 
though the patient is apathetic, the mind remains clear to the last. Vom- 
iting and purging are the prominent symptoms, and the disease might 
readily be mistaken for Asiatic cholera, if it happened to occur whilst an 
epidemic of that malady was raging, were it not that the urine is never 
albuminous. 

The Hemorrhagic Form. — In the third group of cases, denominated 
jhemorrhagic malarial fever, the prominent peculiarity is bleeding, gen- 
erally from the kidneys, but sometimes from the stomach, bowels, nose 
and mouth. 

Diagnosis. — As one might expect, the blood shows marked changes in 
malarial fever. In the regular intermittent type there is a loss in the 
red corpuscle after each paroxysm, which may be considerable, but which 
is rapidly compensated for during the intermissions. In the estivo- 
autumnal fever the losses are often greater and more permanent. 

Treatment. — As in the other kinds, give quinine, but in larger doses. 
In the case of the pernicious disease to get the effect more rapidly give 
quinine hypodermically as much as thirty grains at a time. Excessive 
care must be used to avoid abscesses. 



CHOLERA MORBUS. 327 

Quinine sulphate '. 60 drops 

Saturated solution tartaric acid 68 drops 

Distilled water to make 2 drachms. 
Take 30 drops three times daily. 

In addition to the use of quinine, stimulants must be given for the 
asthenia, artificial heat for the low temperature. Morphine hypoder- 
mically to relieve pain and allay nausea. 

CHOLERA MORBUS. 

Definition. — An acute gastro-intestinal catarrh, characterized by pro- 
fuse vomiting, purging and painful cramp. 

Causes. — This malady, which is not contagious, occurs at times almost 
as an epidemic, and is occasionally fatal, so that no instance of it, however 
mild at first, ought to be allowed to run on without treatment. Although 
generally, induced by indulgence in indigestible food, especially unripe 
fruits, there seems to be at certain seasons of the year some external in- 
fluence promoting the tendency to disorder of the bowels, which is atmos- 
pheric. Especially frequent are these attacks in July and August. Cold 
and dampness are also regarded as predisposing agents. 

Symptoms. — The primary symptoms are uneasiness at the pit of the 
stomach, nausea, retching and then vomiting, followed by severe watery 
diarrhoea, consisting of a large amount of the watery portions of the blood, 
and containing only a little albumen. The whole system is thus affected, 
in part by sympathy, but also to some extent, it is probable, by the change 
in the specific gravity and constitution of the blood. The attack is often 
abrupt, a patient being awakened out of sleep by a sudden seizure during 
the night. This is, however, no doubt because the preliminary uneasi- 
ness, nausea and slight colicky pains, which manifest themselves in a 
diurnal onset of the malady, are unfelt in the unconsciousness of profound 
slumber. The vomiting and purging, when once commenced, recur in 
rapid succession, and sometimes even simultaneously, and enormous quan- 
tities of fluid are evacuated from the system, often with the result of 
producing intense thirst. This thirst cannot, however, be gratified for 
some time, because the irritable stomach refuses to retain the smallest 
amount of fluid. Collapse may supervene and the skin become cold, 
clammy and ashen hued, the eyes sunken and the pulse frequent and 
feeble. 

Diagnosis. — The only difficulty about the diagnosis of cholera morbus 
or sporadic cholera is when true Asiatic cholera is epidemic, then, if a 



328 



THE ERUPTIVE DISEASES. 



microscopical examination of the dejecta be made, will, if it be Asiatic 
cholera, reveal the comma-shaped bacillus. 

Treatment. — For the pain in the abdomen hot applications, morphine, 
one-quarter grain, hypodermically ; to be repeated when necessary. When 
the pain is less severe opium may be given by the mouth or rectum in the 
form of laudanum — ten drops by the mouth or twenty-five drops in a 
tablespoonful of thin starch by the rectum. When vomiting is the most 
troublesome symptom the following is beneficial : 



Creosote 6 drops 

Bismuth subnitrate 2 drachms 

Mix and put into 12 papers. Take one every hour. 

The prostration requires stimulants like aromatic spirits of ammonia, 
thirty to sixty drops at a dose or whiskey. 

ASIATIC CHOLERA. 

Definition. — An acute infectious disease, due to the implantation of 
the comma bacillus of Koch, characterized by vomiting, purging, rice- 
water evacuations and suppression of urine. 

History. — It first made its appearance in the United States in 1832. 
Since that time there have been several epidemics, all of which are 
traceable to immigration. The most serious epidemic of recent time 
started in India in the spring 

of 1892, passing from thence to ,~, 

Persia, Austria, Germany and 
Holland. A few cases reached 
London and l^ew York. 

Causes. — The disease- 
poison of cholera 
reproduces and multipli 
during the course of the com- 
plaint, being propagated by a 

contagion, given off mainly, if §ff Jfi ^SM^Sh 

not entirely, by the evacuations ®||b ^^13^?X^& > 

from the bowels, in which the %%*§^\\ K ^^W)^ 

germs of disease propagate \D^*^tS 

themselves, even after their dis- C'* # ** ^'^%| 

charge, so that the stools be- The Cholera Ge rm. 




undoubtedly 9gWM /fcE^ * 

tiplies itself &%m ^}li$kt< 




ASIATIC CHOLERA. 329 

come more virulent after they are passed, especially when mixed with 
water. The extended researches of Dr. Koch have proved beyond all ques- 
tion the existence of the cholera germ (comma bacillus) in drinking water, 
and traced its development in the intestines of persons who had died of the 
disease. The illustration shows the appearance of this cholera germ, 
which it is so important for every one at the peril of his life to avoid. 
When magnified about six hundred diameters one of the minute intestinal 
glands may be found to contain, as shown at a, b and c, minute bacteria 
or bacilli, as they are technically called, which, from their resemblance 
to the curved portion of a comma, but without the head of that punctuation 
mark, have been named the Comma bacilli. Sometimes these bacilli 
unite at their ends with their curves turned in opposite directions, so as 
to produce an S shape, or even a spiral formation. 

This Comma Bacillus is the direct cause of cholera by its lodgment in 
the intestines, where it has been proved, by examination of nearly one 
hundred cases, to develop with great rapidity. It is easiest to detect in 
the earlier stages of the disease, because later on it is obscured by the 
development of a great many other forms of bacteria. It is distinctive 
of the mildest as well as of the most severe attacks, and has therefore 
an important diagnostic value. It is capable of successful cultivation in 
meat broth, in milk, on slices of potato, and especially on gelatine, in 
which it grows in a singular manner, producing a gradual liquefaction of 
the stiff gelatine around the growing colony, which sinks down into the 
jelly in a peculiar way. The comma bacillus thrives best at temperatures 
between 70 degrees and 135 degrees Fahrenheit, but is not destroyed and 
only has its growth checked by a cold of 18 degrees below the freezing 
point. It is, however, readily killed by drying, by the removal of all ani- 
mal material upon which it can feed, or by acidifying the medium in which 
it is growing with a mineral acid. Under ordinary circumstances the 
bacillus when swallowed is destroyed by the gastric juice being digested 
in the stomach, but when there is any derangement of the stomach, from 
errors of diet or any other cause, so that the acid digestive liquid is de- 
ficient or absent, the bacillus escapes destruction, and may pass on into 
the intestine where the fluids are alkaline and it is able to develop witli 
great rapidity. This fact in regard to the growth of the bacillus in 
alkaline fluids solely is one of great importance, not only in regard to the 
treatment of cholera, but also in connection with the subject of diet, since 
it is obviously highly necessary to avoid everything which, by producing 



330 THE ERUPTIVE DISEASES. 

indigestion, could interfere with the production of the precious gastric 
juice. 

Modes of Infection. — In cholera epidemics we have, says Dr. Koch, 
instances amounting to actual experimental infection of man, as, for 
example, in the infection of those engaged in washing linen soiled with the 
discharges from the bowels of patients affected with cholera. An event 
of this kind is reported in the first outbreak of cholera in this country, 
when it was introduced into Quebec forty-two years ago. 

Infection by Clothing. — Linen or other clothing soiled with choleraic 
discharges contains the bacilli often in a pure form, and if infection occurs 
through this medium it must be by the comma bacilli, frequently the only 
microscopic organism present, except those which are known to be inno- 
cent. 

Infection by the Hands. — The hands of a person washing or handling 
such clothes may be soiled, and the bacilli introduced into the mouth by 
direct contact, or through the food which thus becomes contaminated, or 
the washing water may come in contact with the lips, and thus in some 
way the human being be fed with an extremely minute quantity of a pure 
culture of the comma bacillus. 

Infection by Water — When Dr. Koch was investigating the disease 
in India he observed an instance in which a certain tank furnished the 
water for drinking and other purposes to many people among whom the 
cholera was raging. He found the comma bacilli in this tank, and learned 
on inquiry that the clothes of the patients were washed in it. Around the 
tank were some thirty or forty huts inhabited by upward of two hundred 
people, and of .these persons seventeen died, whilst the number of those 
taken sick was not ascertained. The tank in this case also received the 
refuse from the dwellings. In fact, it is common in India for the Hindoos 
to bathe in the tank which affords their water-supply, to wash their uten- 
sils in it, to deposit their excrement upon its bank, and if a hut has a 
latrine, or substitute for one, its outflow is apt to be into the tank. In 
this particular instance it was found, after a time, that the bacilli became 
less abundant in the tank-water, and coincidently the cholera declined 
among the inhabitants of the huts along its shore. Here, if the epidemic 
had been the cause of the bacilli, instead of the result of their develop- 
ment, the number of these minute organisms ought to have been aug- 
mented after the disease began to be less violent. For further dissemina- 
tion of the disease, the cholera discharge must be retained in a moist 
state, since complete drying seems to destroy the poisonous property of 



CHOLERA. 331 

the virus; and this view is sustained by what we have long known in 
regard to the spreading of cholera by contaminated water-supply, or more 
directly by soiled hands, or even conveyance by insects, as, for example, 
by blow-flies alighting upon meat and other food. Drains may be infected, 
and through them the drinking water polluted; but as the virus cannot 
preserve its activity in a dry state little can be hoped for from aerial dis- 
infection, nor does it seem probable that, except under certain conditions 
of unusual moisture can cholera be transmitted by merchandise or by 
letters, even if the latter are not disinfected, but only by human inter- 
course. 

Symptoms. — Period of incubation ranges from two to five days. The 
symptoms of cholera commonly present themselves sufficiently gradual to 
admit of arrangement into three distinct groups or stages: 

1. Preliminary Diarrhoea. — This may set in abruptly without any 
previous indications. More commonly there are for one or two days 
colicky pains in the abdomen, with looseness of the bowels, perhaps vomit- 
ing, with headache and depression of spirits. As a rule the temperature 
is not elevated. 

2. The Stage of Collapse. — Spasmodic griping pains are felt and de- 
pression of the powers of circulation and respiration come on, attended 
with a sense of faintness and oppression over the heart, whose beat at 
times is hardly discernible, and the pulse at the wrist may be absent. 
Copious purging, at first of the contents of the intestines, and afterward 
of a thin, watery fluid, resembling water in which rice has been washed, 
having an alkaline reaction, and sometimes tinged red with blood, soon 
commences, and is usually accompanied with violent vomiting and a 
sensation of burning heat in the stomach. In a short time, perhaps 
within a few hours, there results from this excessive drain upon the circu- 
lation, coldness and dampness of the whole surface of the body, lividity 
of the lips, cold breath, an unquenchable thirst, a feeble, rapid pulse, 
difficult respiration, with extreme restlessness, and suppression of the 
secretion of the kidneys. 

Symptoms in Fatal Cases. — In fatal cases are noticed blueness of the 
whole body, the sunken and horror-stricken countenance denominated the 
Hipprocratic face, popularly known as the appearance of being struck 
with death, and a peculiarly suppressed voice, this condition ending either 
immediately in fatal collapse or in reaction followed by violent secondary 
fever. 

3. Stage of Reaction. — This is characterized by return of warmth 



332 THE ERUPTIVE DISEASES. 

and colds, the latter more slowly and the re-establishment of secretions. 
Especially favorable is the return of the urinary secretion. Along with 
these changes the vomiting and purging occur at longer intervals. The 
heart's action becomes stronger, and there are no abdominal pains. jSTot 
infrequently this favorable condition is interrupted by a recurrence of a 
severe diarrhoea, and the patient is carried off in a collapse. Other cases 
pass into a condition of what has been called cholera-typhoid, a state in 
which the patient is delirious, the pulse rapid and feeble and the tongue 
dry. Death finally occurs with coma. These symptoms have been at- 
tributed to uremia. 

Diagnosis. — The only affection with which Asiatic cholera could be 
confounded is the cholera morbus, which occurs as a rule during the sum- 
mer months, of which mention has been made. 

Preventive Measures. — Preventive measures are all-important, and 
isolation of the sick with thorough disinfection have effectually prevented 
the disease from obtaining a foothold in either the United States or in 
England. 

The course of cholera during the last epidemic which visited the 
United States, and ravaged the Mississippi Valley in 1873, reaffirmed the 
lessons of previous outbreaks of this disease abroad. This was especially 
the case as regards the supreme importance of pure water-supplies in 
cities and villages, all of which should be boiled before using, and of hav- 
ing all wells and water-springs which are used by the people effectually 
guarded against any possible soakage and contamination from privies and 
other sources of defilement by excrement. It must be admitted that the 
history of outbreaks of cholera, in all parts of the world, conspicuously 
illustrates the vital importance of procuring all supplies of drinking-water 
from sources which cannot become polluted by the soakage into them of 
intestinal discharges, or from outflowing^ in any such way as to be carriers 
of bowel-diseases, particularly not of cholera and typhoid fever. The 
story of the Broad street pump in London, which killed fixe hundred peo- 
ple in one week during the last great cholera epidemic, and was found to 
have its water contaminated by soakage of cholera evacuations from an 
adjoining cess-pool, has already been related, but it should be retold to 
every one as a terrible warning against the almost universal dangers of 
water-pollution. An item in the London Lancet, printed in 1882, states 
that a recent analysis of the water of the Holy Well of Mecca, which is 
so eagerly drunk by the pilgrims, as a part of their religious rites, shows 
the water to be sewage, about ten times stronger than the average London 



CHOLERA. 333 

sewage. And during the same month that this report was given, came 
the news that the cholera had made its usual annual appearance among 
the pilgrims to the shrine of Mahomet in the Holy City of Mecca. It 
therefore appears extremely probable that by suitable investigation of the 
water of the Holy Well, there might be found in it a perennial supply of 
the cholera germs, and such a demonstration of the true origin of the 
frightful cholera epidemics which, spread by the caravans of returning 
Moslem pilgrims, have so often devastated large sections of Europe and 
Asia, would be a triumph for experimental hygiene of which the whole 
world of science might be proud. 

The impurity of the local atmosphere of a dwelling, a village, or a 
particular district, is proved to be a matter also of public concern, and 
environed in a polluted atmosphere, the palatial mansions of wealth and 
gayety may suffer equally with the tenements of the humblest classes. 
The specific migratory power of cholera, whatever its nature, has the 
faculty of infecting districts in a manner most detrimental to health only 
when the atmosphere is fraught with certain products, susceptible under 
its influence of undergoing poisonous transformations. Through the un- 
polluted atmosphere of cleanly districts it migrates perhaps without a 
blow because that which it can kindle into poison is not there. 

Disinfection. — 1. The vomited matter and the discharges from the 
bowels are to be gathered and put in a carbolic solution one to twenty, or 
chlorinated lime one to ten, some of which should be in the vessel before 
it is used. In the country where the excreta can be thrown in a pit, 
"whitewash" is a cheap disinfectant. 

2. After vomiting, the mouth of the patient should be rinsed with a 
solution of hydronapthol one to five thousand, care being taken that 
none of it is swallowed. After each evacuation from the anus the but- 
tocks and thighs should be washed with soap and water. 

3. All body and bed linen soiled with the discharges should be im- 
mediately moistened with a carbolic solution one to sixty, removed from 
the apartment in a covered vessel and boiled for one-half hour in a one 
per cent, solution of washing soda, or 1 to 2000 of bichloride of mercury. 

4. Napkins, towels, and so forth, should be treated in like manner. 

5. All dishes, knives, forks, spoons, and so forth, after each meal, 
should be boiled for the same length of time in the same medium. 

6. The remains of meals should be thrown in whitewash and removed 
at the end of each day. 



334 THE ERUPTIVE DISEASES. 

7. Door knobs are liable to be soiled by the hands of one carrying 
out the excreta and should be carefully watched. 

8. In cases of death the body, without being washed, should be 
wrapped in sheets wet in a solution of bichloride of mercury and should 
be buried promptly. 

Directions for Nurses. — 1. Nurses should not hold any direct com- 
munication with others while in attendance on the case. 

2. They should under no conditions take their meals in the same 
room with the patient. After touching the patient her hands should be 
washed in bichloride of mercury one to one thousand. 

3. The teeth should be cleansed after each meal, as the mouth affords 
a peculiar favorable nidus for decomposing matter and would therefore 
be favorable for the growth of the cholera bacillus. 

Treatment. — The successful treatment of cholera depends largely 
upon how promptly remedial measures are commenced, for if the first 
sign of relaxation of the bowels is met at once by an energetic astringent 
and opiate, such as the mixture of a teaspoonful of syrup of galls, ten drops 
of laudanum, and one drop of chloroform, repeated every hour if neces- 
sary, or a compound of ten drops each of spirits of camphor, tincture of 
capsicum and laudanum, to which, if there is any vomiting, five grains of 
bismuth should be added, it is certain that many lives might be directly 
saved by medical treatment. External applications of heat should be 
made, warm applications to the abdomen will be found grateful to the 
patient. Sometimes a pill of opium and acetate of lead, with a little 
capsicum, using, for example, one-half of a grain of opium, two grains of 
the sugar of lead, and a quarter of a grain of cayenne pepper, is singularly 
serviceable, and being carried in small compass is especially convenient 
for travelers. 

Pain Treatment — Should the pain be great control it with one-fourth 
grain injections of morphine hypodermically. As owing to the profuse 
discharges the blood is very much concentrated, subcutaneous injections of 
normal salt solution should be given. 

The following well-known cholera or diarrhoea mixture is of great 
value in the early stages: 

Tincture opium I ounce 

Spirits of camphor I " 

Tincture capsicum i " 

Pure chloroform 3 drachms 

Alcohol sufficient to make 5 ounces. 

Mix and take one teaspoonful every one or two hours. 



DIPHTHERIA. 335 



DIPHTHERIA. 



Definition. — An acute infectious disease due to Klebs-Loener bacillus, 
characterized by a local fibrinous exudate usually upon the mucous mem- 
brane of the throat, with a moderate fever, glandular enlargements and 
great prostration. 

Cause. — The disease is endemic in all large cities, and becomes 
epidemic at times ; while other contagious diseases have diminished in the 
past decade, diphtheria has increased, particularly in cities. 

Contagiousness. — Diphtheria is a highly contagious disease, and is 
readily transmitted from person to person. The bacilli may be received 
from (1) discharges of diphtheria patients, (2) from the secretions of the 
nose and throat of convalescent cases, in which the virulent bacilli per- 
sists, (3) from the throats of healthy individuals who have acquired the 
bacilli from being in contact with others having the virulent bacilli on 
their persons or clothing. 

Dangers of the Disease. — No disease of temperate regions proves more 
fatal to physicians and nurses. There seems to be particular danger in 
examining and swabbing out the throat; for in the gagging, spluttering 
and coughing efforts the patient may cough mucus and flakes of mem- 
brane into the physician's throat. The bacillus attaches itself to the 
bedding, clothes and room of the patient with great tenacity. 

Attack Upon Children. — Very young children are rarely attacked, the 
age of predilection being from the second to the fifteenth year. The great- 
est number of deaths occur between two and ^.Ye years of age. Girls are 
attacked in larger numbers than boys. Adults are frequently affected. 

Symptoms — Period of incubation is from two to seven days ; oftener 
two (Tyson). 

According to the location we may speak of the pharyngeal, laryngeal 
and nasal varieties. 

1. Pharyngeal. — The symptoms are those of an ordinary febrile at- 
tack. Slight chilliness, fever and aching pains in the back and limbs, 
usually the temperature rises in the first twenty-four hours from 102 
to 103 degrees Fahrenheit. There is a slight redness and feeling of sore- 
ness in the throat, generally upon one or both tonsils, and on careful exam- 
ination the tonsils and adjacent portions of the fauces are found to be a 
little swelled. A whitish-gray patch of false membrane, looking at first 
like a small ulcer in the mucous surface, next makes its appearance, and 
this may spread until, by the third day, it has covered the tonsils, fauces 
and perhaps the uvula. 



336 THE ERUPTIVE DISEASES. 

The False Membrane. — If this false membrane is forcibly torn away, 
as, for example, by some of the various forceps which were at first invented 
for the purpose, a raw bleeding surface is exposed, which in a few hours 
is again covered with a new growth of the layer of membrane. This 
structure, which is partly composed of an exudation of lymph and partly 
of a fungoid growth, the ^micrococcus diphtheriticus, quickly undergoes 
putrefactive changes, together with the outer layer of mucous membrane 
lying immediately beneath it, so that there is often a superficial ulcera- 
tion, from which an unhealthy discharge flows, and a putrid odor fre- 
quently emanates constantly, in severe cases of diphtheria. 

Thickness of the Membrane. — The thickness and density of the false 
membrane varies greatly in different cases, and in different epidemics. 
Sometimes it is scarcely thicker than writing-paper, and has hardly more 
consistence than thick cream. At other times it is firm and tough, almost 
like leather, and may even attain the thickness of a quarter of an inch. 
Although in mild cases and those of moderate severity, its color is grayish- 
white, in debilitated states of the system, and when there is a tendency 
to bleeding from the throat and other mucous surfaces, it may be tinged, 
probably by the altered blood elements of a yellow, yellowish-brown, or 
dark-brown hue. 

Diagnosis. — (a) There may be no local manifestation of the mem- 
brane, but a simple catarrhal angina, associated sometimes with a croupy 
congh. The detection in these cases of the Klebs-Loener bacillus can 
alone determine the diagnosis. 

(b) There are cases in which the tonsils are covered with a pulta- 
ceous exudate, not a consistent membrane. 

(c) Cases which begin and often run their entire course with the 
local picture of a typical lacunar amygdalitis, they may be mild, but in 
other cases there is a rapid development of membrane and extension of 
the disease to the pharynx and nose with septic and constitutional 
symptoms. 

2. Nasal Diphtheria. — In membranous or fibrinous rhinitis, a very 
remarkable affection seen usually in children, the nares are occupied by 
thick membranes, but there is entire absence of constitutional disturb- 
ances. Eavenel collected seventy-seven cases, all of which ran a benign 
course, and in all but a few the membrane was limited to the nose and the 
constitutional symptoms were slight or absent. On the other hand, nasal 
diphtheria is apt to present a most malignant type of the disease, high 



DIPHTHERIA. 337 

\ . 

fever, marked glandular evolvement and great prostration by epistaxis 
and by excoriation of the lips. 

3. Laryngeal Diphtheria — The affection begins like an acute laryn- 
gitis, with a slight hoarseness and rough cough, to which the term croupy 
has been applied. After these symptoms have lasted a day or two, with 
varying intensity, the child suddenly .becomes worse, usually at night, and 
there are signs of impeded respiration. These cases are always serious. 

Difficulty of Breathing — At first the difficulty in breathing is paroxys- 
mal, owing probably to a spasm of the muscles of the glottis. Soon the 
dyspnoea becomes continuous, inspiration and expiration become difficult, 
particularly the latter. The voice is husky and is reduced to a whisper. 
The color gradually changes and the imperfect aeration of the blood is 
shown in the lividity of the lips and finger tips. Restlessness comes on 
and the child tosses from side to side, vainly trying to get breath. Oc- 
casionally in severer paroxysms portions of the membrane are coughed up. 

The Fever. — The fever is rarely very high, and the condition of the 
child at the onset is good. The pulse is always increased in frequency. 
In -favorable cases the dyspnoea is not very urgent, and the color of the 
face remains good. In unfavorable cases the dyspnoea becomes more and 
more urgent, the cyanosis deepens, and the child, after a period of rest- 
lessness, sinks into a semi-comatose state, and death finally occurs from 
poisoning of the nerve centres by carbon dioxide. 

1. Complications. — Hemorrhages from the nose or throat may occur 
in severe ulcerative cases. Skin rashes are not infrequent. In very bad 
cases, with extensive sloughing, the septic particles may reach the bronchi 
and excite gangrenous processes, which may lead to severe and fatal 
hemorrhages. 

2. Renal Complications. — These are common, albuminura is present 
in all severe cases ; nephritis may set in quite early in the disease ; it sets 
in at times with complete suppression of the urine. 

3. Paralysis. — This is rather frequent, occurring in from ten to even 
twenty per cent, of cases. 

Diagnosis. — The onset is more sudden than in scarlet fever, the fever 
higher, the pulse more rapid and the tongue presents a strawberry appear- 
ance. For the rest of the diseases it is sufficient to state that, for the 
purpose of insuring proper sanitary precautions, it is advisable to con- 
sider all cases of sore throat, with fever and prostration of strength, in 
which patches of false membrane, however small, appear upon the tonsils 
99 



33 S THE EBEPTIVE DISEASES. 

or fauces, as diphtheritic in their character. All cases should be treated 
as diphtheria until the contrary is proven by a culture. 

Preventive Measures. — Recent investigations having proved that the 
poison of diphtheria is portable, communicable by infection, and capable 
of reproducing itself outside of the human body, diphtheria must now be 
ranked as both a contagious and infectious disease. The following rules 
are therefore more imperative than ever before: 

1. When a child or young person has a sore throat, a bad odor to its 
breath, and especially if it has fever, it should immediately be separated 
and kept secluded from all other persons, except necessary attendants, 
until it be ascertained whether or not it has diphtheria, or some other 
communicable disease. 

2. Every person known to be sick with diphtheria should be promptly 
and effectually isolated from the public. Only those persons who are act- 
ually necessary should have charge of or visit the patient, and these visi- 
tors should be restricted in their intercourse with other individuals. 
Children residing in a house where there is a case of diphtheria should 
not be permitted to attend school. 

3. When a case of diphtheria is fully developed, the same precautions 
in regard to free ventilation, disposal and disinfection of discharges, bed 
or body linen, and so forth, isolation during convalescence (or manage- 
ment of the corpse should death unfortunately occur), and so forth, ought 
to be enforced which have already been recommended in regard to small- 
pox and cholera. 

4. It is particularly important that persons whose throats are tender 
or sore from any cause, should avoid possible exposure to the contagion of 
diphtheria. Children under ten years of age are in much greater danger 
of taking the disease, and after they do take it of dying from it, than are 
grown persons. But adults are not exempt, and mild cases in them may 
cause whole series of fatal attacks among children. 

5. Numerous instances are recorded where the contagion of diph- 
theria has retained its virulence for weeks or months, in cesspools, heaps 
of decaying vegetable matter, damp walls, and so forth, and been carried 
for long distances in clothing, in sewers, in waste pipes from stationary 
washstands, and in other conduits. Hence all sewer connections and other 
carriers of filth should be well ventilated and disinfected, and children 
particularly should not be allowed to breathe the air of any water-closet, 
cesspool, or sewer into which discharges from patients sick with diphtheria 



DIPHTHERIA. 339 

have entered, nor drink water or milk which has been exposed to such 
air or the atmosphere of the sick-room. 

6. Beware of any person who has a sore throat; do not kiss such 
a person or take his or her breath ; do not drink from the same cup, blow 
the same whistle, nor put his pencil or pen into your mouth. 

2. Treatment. — Local treatment — germicides and disinfectants are 
best applied when possible by the spraying apparatus at intervals of an 
hour, or at most every two hours. If the spray cannot be used, as is 
often the case with children, a soft sponge may be used. The most satis- 
factory solution for this purpose is equal parts of peroxide of hydrogen 
and Dobell's solution. Carbolic acid may be used in the proportion of 
fifteen drops to an ounce of glycerine and water. Boric acid in saturated 
solution is fairly good. Where there is the laryngeal form the patient 
should breathe an atmosphere saturated with the vapor of slacked lime. 
In all cases antitoxin should be given. 

2. Constitutional Treatment. — For checking the growth of the mem- 
brane the preparations of mercury are good. The bichloride of mercury 
in dose of one-forty-eighth to one-twelfth (Tyson) for an adult, in con- 
junction with the tincture of the chloride of iron and chlorate of potas- 
sium every two hours. Early in the cases calomel in small doses every 
hour. These doses are given to adults, and they need not be much re- 
duced for children. Quinine should form part of the medical treatment 
in doses from ten to twenty-four grains in twenty-four hours. 

Other prescriptions are: 
1. 

Bichloride of Mercury 1 grain 

Tincture Chloride of Iron 1 ounce 

Two to six drops every three hours in water. 



Chloride of Potash 1 drachm 

Tincture Chloride of Iron l 1 /^ drachms 

Syrup of Lemon 1 ounce 

Spirits of Mindererus 4 ounces 

Mix. Dose : one teaspoonful every two hours. 

If this prescription cannot readily be filled a fairly good substitute 
is the Tincture of Chloride of Iron. Get about one ounce of this and take 
ten drops in a wineglassful of water three times a day. This is a valu- 



340 THE ERUPTIVE DISEASES. 

able tonic, but if there is much failure of strength, use the following 
in addition to the chloride of iron : 

z. 

Sulphate Quinine (Powder) . . . . , 1 drachm 

Best Brandy 1 pint 

Mix and dissolve. Dose : two teaspoonf uls every three hours in half 
a glass of water. 

Diet. — Stimulating, nourishing and easily assimilated food is neces- 
sary. Milk is preferred to all else, fortified with full doses of whiskey, 
two drachms to an ounce being required in all severe cases. Milk may 
be alternated with animal broths. When deglutition is difficult nutrient 
enematas may be given. For this peptonized milk is best. 

Opening the Windpipe. — When laryngeal obstruction is imminent 
intubation or tracheotomy should be performed. This is rarely necessary 
when antitoxin is used. Lives have been saved by both these operations. 
Such cases should breathe air charged with vapor of lime. 

3. Serum Treatment. — It has been fully demonstrated that antitoxin 
or the serum of immunized animals, is the best therapeutic agent in 
diphtheria. The investigation conducted by the American Pediatric 
Society has shown that the mortality under the serum treatment in 5,794 
cases was only 12.3 per cent. The strength of the serum is measured in 
units, the latter being equal to 1 c.cm. of "normal serum," which is the 
blood serum of an immunized animal so active that one-tenth of a c.cm. 
will antagonize ten times the minimum of diphtheria poison fatal to a 
guinea pig weighing 300 grams. For children over two years old the 
initial dose should be from 1,500 to 2,000 units in all severe cases, in- 
cluding those of laryngeal stenosis; this dose to be repeated in from 
eighteen to twenty-four hours if there is no improvement seen, and again 
in twenty-four hours if the course of the disease is unfavorable. The 
third dose is rarely necessary. Mild cases should receive 1,000 units for 
the first injection, a second is rarely necessary. In cases injected during 
the first two days the mortality is less than 5 per cent. The question of 
immunizing those exposed to the disease is a very practical one. It has 
been carried out on a very large scale in some institutions with satisfactory 
results. The immunity is only transient and only persists a few weeks. 

Diphtheria antitoxin is injected beneath the skin and is not a pain- 
ful procedure and rarely has ill-effects if properly given and the pre- 
cautions of cleanliness are followed as to the skin of the patient, the 



DIPHTHERIA. 341 

needle used and hands of the nurse and physician. Every adult case 
should receive a dose of antitoxin of 3,000 units immediately upon the 
physician being sure that the patient has diphtheria. In severe cases 
as high as 20,000 or more units have been given in repeated doses with- 
out ill effects and the child has recovered. Those in attendance, as 
nurses, physicians and all persons who have come in contact with the 
patient, must receive at least 500 units as a preventive measure against 
taking the disease. 

Those who cannot afford to purchase antitoxin can secure it from 
the authorities of the local Boards of Health in most States. In large 
cities it can be procured from the police stations. 

Every parent or guardian should submit to the early use of anti- 
toxin and thereby save human life. Those exposed to it should also sub- 
mit and protect themselves and prevent the spread of this highly dan- 
gerous and contagious disease. Public funerals cannot be held in case 
of death from diphtheria. Cremation d* burial in a sealed casket is 
necessary. 

General Remarks. — Diphtheria is a highly contagious disease, occur- 
ring mostly in children between the ages of two and fifteen years. In- 
fants in the first year of life are rarely affected. Death is most frequent 
between children of two to frve years of age. It occurs mostly during the 
winter. It can be caught by persons of all walks of life by coming in 
contact with a patient or his or her clothing, bed linen, etc., which has 
not been disinfected. It can be carried in water, milk, by the dried 
discharges from the patient's nose and throat, being blown about in the 
air, dirty streets, gutters, alleys, cesspools, etc. 

It requires from two to seven days for a person to develop diphtheria 
after being exposed to it. Its early symptoms consist of slight chilliness, 
in young children convulsions, older children and adults complain of a 
sore throat. There may be vomiting. Examine the throat at once. The 
tonsils and arches of the soft palate appear reddened, swollen and a whit- 
ish membrane in spots or as a solid layer will be seen covering the tonsils 
and later on this spreads to the nose, throat, larynx, etc., depending on 
the severity of the attack. The child will complain of a tightness in the 
throat, pain or swelling and if the attack is sudden and severe, the face 
and lips become bluish and breathing is difficult, and there may be a 
whistling sound upon taking each breath, due to the membrane filling the 
larynx and throat. The germs of this disease are present in the nose and 



342 THE ERUPTIVE DISEASES. 

throat of the patient. Summon a physician at once. The guardian or 
physician must notify the local Board of Health. 

The sick person must be placed, whenever possible, in a room away 
from the rest of the family, all unnecessary furnishing removed, a nurse 
or attendant placed in charge and no one permitted to enter or leave 
the room but the nurse and physician until disinfection is completed by 
the Board of Health. Cats, dogs and all the family pets must be removed 
from the room and quarantined outside of the house. The physician 
should wear a cotton gown and cover his head with a cloth of suitable 
texture. The nurse must wear a similar gown and cover the hair with a 
cloth. On leaving the room, the physician and nurse must leave the 
head covering and gown in the room, also disinfect their hands in a 
disinfectant of 5 per cent, carbolic acid solution or bichloride of mercury 
(1 tablet to a pint of water). 

Persons living in a house where diphtheria has developed should not 
leave until they have taken a bath in water containing bichloride of mer- 
cury, washed their hair and had their clothing disinfected by the Bureau 
of Health. A sheet must be hung across the door leading to fhe sick 
room and this sheet dipped in and kept moist by a solution of chloride 
of lime (1 tablespoonful to a pail of cold water). The knob of the door 
should be washed off dailv with the chloride of lime solution. 



INFLUENZA OR LA GRIPPE. 

Definition. — An acute infectious disease, appearing at irregular inter- 
vals, characterized by extraordinary rapidity of extension and the large 
number of people attacked. 

Causes. — It is caused by the bacillus of PfeifTer. It spreads with 
remarkable rapidity. In the large pandemic of 1889-1890 some of the 
large prisons escaped entirely. The outbreaks of the epidemics are in- 
dependent of all seasons and meteorological conditions, though the worst 
epidemics have been in the colder seasons of the year. One attack does 
not protect. A few persons do not appear liable to the disease. 

Symptoms — Incubation is from one to four days. The onset is usu- 
ally abrupt, with fever and its associated phenomena. Usually there is 
coryza and sneezing, with or without watering of the eyes and headache. 
No age is exempt, as it attacks with impunity the infant as well as the 
old man. There is generally a cough, to which is added very soon profuse 
expectorations. 



GLANDERS OR FARCY. 343 

Expectorations — The cough may he paroxysmal, with prostration at 
the end of the spell. It often persists, while the bronchitis may pass into 
broncho-pneumonia, or a croupous-pneumonia may supervene. Another 
mode of onset is by extreme and sudden prostration. This prostration is 
apt to be prolonged even in mild cases far beyond what seems reasonable. 

Mental Depression. — This is a frequent symptom, and suicide has been 
its terminal act. There is always more or less fever, ranging from 101 
degrees to 106 degrees Fahrenheit. Delirium is nearly always associated 
with a high fever. 

Nausea and Vomiting. — With the onset of the fever there may be 
nausea and vomiting, or the attack may set in with abdominal pains, pro- 
fuse diarrhoea and collapse. 

Diagnosis. — During a pandemic the cases offer but slight difficulty. 
The profoundness of the prostration, out of all proportion to intensity of 
the disease, is one of the most characteristic features. 

Treatment. — Isolation should be practiced if possible. Old people 
should be guarded against all sources of infection. The secretions, nasal 
and bronchal, should be disinfected. In every case the disease should be 
regarded as serious and the patient kept in bed until the fever has com- 
pletely disappeared. From the onset the treatment should be supporting, 
and the patient should be well fed and nursed. At night ten grains of 
Dover's powder may be given. At the onset a warm bath is sometimes 
grateful in relieving the pains in the back and limbs. If there is much 
fever and delirium small doses of antipyrin or phenacetin may be given 
and an ice-cap applied to the head. In cases with great cardiac weakness 
stimulants should be given freely and during convalescence. Strychnia 
in full doses and good, nutritious diet, cheerful surroundings and change 
of air are essential. The depression of spirits following this disease is 
one of its most unpleasant and obstinate features. 

GLANDERS OR FARCY. 

Definition. — An acute infectious disease, usually commencing with a 
specific inflammation of the mucous membranes of the nose and throat, and 
originating in contagion derived from a glandered horse, ass or mule, and 
characterized by the appearnce of vesicles in the mucous membrane of 
the mouth and between the toes and nodules beneath the skin ; in the latter 
it is called farcy. 

Cause — The disease belongs to the infective granulomata. The local 



344 THE ERUPTIVE DISEASES. 

manifestations in the nostrils and skin of the horse are due to one and 
the same cause. Man becomes infected by contact with diseased animals, 
and usually by inoculation on an abraded surface of the skin. The con- 
tagion may also be received on the mucous membrane. 

Symptoms. — The disease has an incubation of from three to five days. 
At this time there is a febrile movement, with malaise and loss of appetite. 
On the mucous membrane of the lips and tongue and sometimes on the 
hard palate come vesicles containing a yellowish serum. There is a 
sensation of heat and burning through the mouth, and the swelling may 
be so great as to make speech difficult and swallowing painful. There is 
copious salivation. Almost simultaneously appear vesicles between the 
fingers and toes and around the nails. 

Treatment. — If seen early the wound should be either cut out or 
thoroughly destroyed by caustics and an antiseptic dressing applied. In 
the acute cases there is very little hope. In chronic cases recovery is 
possible, though often tedious. 

ANTHRAX OR MALIGNANT PUSTULE. 

Definition. — An acute infectious disease of animals, due to the bacillus 
anthracis, especially affecting cattle and sheep, but transmissible to man. 

Causes. — It is very prevalent in Europe and Asia, but is rare in this 
country. A protective inoculation, with a mitigating virus, has been in- 
troduced by Pasteur. In animals the disease is conveyed sometimes by 
direct inoculation, as by the bites and stings of insects, by feeding on the 
carcasses of animals which have died of the disease, but more commonly by 
feeding in pastures in which the germs have been preserved. Pasteur 
believes that the earth worm plays an important part in bringing to the 
surface and distributing the bacilli which have been propagated in the 
buried carcass of an infected animal. Certain fields or even farms may 
thus be infected for an indefinite period of time. 

Symptoms. — Anthrax has a period of incubation of about one week, 
after which there are a number of modes of manifestation of the disease. 

1. External Anthrax or Malignant Pustule. — This occurs most fre- 
quently on the exposed surfaces, the arms, face or hands, and. produces 
in a few hours a slight redness like that from a mosquito bite, and after- 
ward a little blister. This is soon succeeded by a spreading hardness of 
the surrounding tissues, which mortify and turn black. Crops of sec- 
ondary vesicle? appear, the neighboring lymphatic glands become in- 



MALIGNANT PUSTULE. 345 

flamed, the breath grows fetid, and there is thirst, high temperature and 
frequent pulse, and death may take place in from twelve to forty-eight 
hours, with all the symptoms of profound blood-poisoning. Occasionally 
recovery takes place, but it is only in mild cases, in which all the symp- 
toms, local and general, are less severe ; the vesicles dry up into scabs and 
the hardness passes away. 

2. Malignant Anthrax, Edema — This form begins in the eyelid, and 
from thence passes into- the head, arms and hands. It is characterized by 
the absence of the vesicles and by the most extensive oedema, which may 
follow, rather than precede, the constitutional symptoms. The most fatal 
cases are seen when inoculation takes place about the head and face. A 
feature in both these forms of malignant pustule, to which many writers 
refer, is the absence of feelings of distress or anxiety on the part of the 
patient, whose mental condition may be perfectly clear. He may be with- 
out apprehension, even though his condition is very critical. 

Diagnosis. — Diagnosis can be readily made from the character of the 
lesion and the occupation of the patient. When in doubt a microscopical 
examination of the fluid from the pustule may show the presence of the 
bacillus. 

3. Intestinal Form — In these cases the infection is usually through 
the stomach and intestines and results from eating the flesh or drinking 
the milk of diseased animals. It may, however, follow an external in- 
fection if the germs are carried to the mouth. In acute cases there are 
dyspnoea, cyanosis, great anxiety and restlessness, and toward the end con- 
vulsions or spasms of the muscles. 

4. Wool Sorters' Disease. — This important form of anthrax is found 
in large establishments in which wool or hair is sorted and cleansed. The 
hair and wool imported into Europe from Russia and South America ap- 
pear to have induced the largest number of cases. Many of these show 
no external lesion. The infected material being swallowed or inhaled 
with the dust. 

Symptoms. — There are rarely any preliminary symptoms. The pa- 
tient is seized with a chill, becomes faint and prostrated, has pains in th ; 
back and legs and the temperature rises to 102 degrees or 103 degrees 
Fahrenheit. The breathing is rapid, and there is much pain in the chest. 
There may be a cough and signs of bronchitis. There may be vomiting, 
and death may occur within twenty-four hours. In more protracted 
cases there may be diarrhoea, delirium and unconsciousness. 

Treatment. — In malignant pustule, the site of inoculation should 



346 THE ERUPTIVE DISEASES. 

be destroyed by the caustic or hot iron and a little powdered bichloride of 
mercury sprinkled over the exposed surface. The local development of 
the bacilli about the site of inoculation may be prevented by the sub- 
cutaneous injections of carbolic acid or bichloride of mercury. The in- 
jections should be made at various points around the pustle, and may be 
repeated two or three times a day. 

Internal Treatment. — The internal treatment should be confined to 
the administration of stimulants and plenty of nutritious food. Davies- 
Colley advises ipecacuanha powder in doses of five to ten grains every 
three or four hours. In the malignant form, particularly the intestinal 
variety, little can be done. Keep the bowels active. 

ERYSIPELAS OR ST. ANTHONY'S FIRE. 

Definition. — This is a specific, contagious inflammation of the skin, 
tending to spread over large portions of the cutaneous surface with the 
usual signs of inflammation — pain, heat, redness and swelling. 

Causes. — This complaint has, as a rule, for its starting point some 
slight wound or abrasion of the skin, although occasionally it seems to arise 
spontaneously, affecting the head and face in such instances more fre- 
quently than any other portion of the body. It is particularly prevalent 
in the spring of the year. It can be conveyed by a third person. The 
poison certainly attaches itself to clothing, furniture and bed-room walls. 
Recently delivered women and persons who have been the subjects of 
surgical operations are particularly susceptible to it. 

Predisposing Causes. — Predisposing causes are Bright's disease, alco- 
holism and debility. The specific agent of the disease is a streptococcus 
growing in long chains, the streptococcus erysipelatous. 

Symptoms. — Period of incubation is variable from one to eight days. 
The stage of invasions is often marked with a rigor and followed by a 
rapid rise in temperature and other signs of an acute fever, when there 
is a local abrasion, the spot is slightly reddened, but if the disease is idio- 
pathic there is seen within a few hours a slight redness over the bridge of 
the nose and on the cheeks. The swelling and tension of the skin increase 
and within twenty-four hours the external symptoms are well marked. 

The Skin. — The skin is smooth, tense and oedematous. It looks red, 
feels hot and the superficial layers of the skin may be lifted as small blebs. 
The swelling increases rapidly, and during the second day the eyes are 
usually closed. 



BLOOD POISON. 347 

Further Symptoms. — The first affected parts gradually become pale 
and less swollen as the disease extends. When it reaches the forehead 
it progresses as an advancing ridge, perfectly well defined and raised; 
and often on palpation hardened extensions can be felt beneath the skin, 
which is not yet reddened. Even in cases of moderate severity the face 
is enormously swollen, the eyes closed and the lips oedematous, the ears 
thickened, the scalp is swollen and the patient's features quite unrecog- 
nizable. 

Blood Poisoning. — The lymphatic vessels and glands, especially the 
cervical, are almost always more or less affected, and poisoning of the 
blood as in pyemia not infrequently occurs. One attack of the disease, 
so far from affording any protection, generally leaves the patient par- 
ticularly susceptible to the malady for a long time, perhaps for life. 
Delirium is present, the tongue becomes dry, the pulse feeble and there 
is marked tendency to death from toxemia. In the majority of cases, 
however, even with extensive lesions the constitutional disturbances, con- 
sidering the height of the fever range, are slight. 

Treatment. — Isolation must be carried out. A practitioner in attend- 
ance on a case of this disease should not attend a woman in confinement. 
The disease is self -limited, and a large majority of cases get well without 
any internal medication. 

Diet. — The diet should be nutritious and light. Stimulants are not 
required, except in the old and feeble. For sleeplessness, restlessness and 
delirium chloral and the bromides may be given, or if these fail, opium ; 
when the fever is high the patient may be bathed or sponged. Of the 
internal remedies the tincture of the perchloride of iron has been highly 
recommended. 

Local Treatment. — For the local treatment, two per cent, solutions of 
carbolic acid, the corrosive sublimate solution 1 to 2,000. In the Poly- 
clinic Hospital in Philadelphia the application of ichthyol ointment over 
the reddened area, and should there be a wound, washing it out with 
normal salt solution have proved very efficacious. To prevent spreading, 
paint the margin of the inflammation with tincture of iron. 

SEPTICEMIA OR BLOOD POISON. 

Definition. — It is a condition in which, with or without a local site 
of infection, there is a microbic invasion of the blood and tissues, but 
in which there are no foci of suppuration. 



348 * THE ERUPTIVE DISEASES. 

Symptoms. — Illustrative cases of the more usual form of septicemia 
are puerperal fever, following a retained placenta, infection by scarlet 
fever, or difficult labor involving lacerations and the poisoning by a dis- 
secting wound. The symptoms set in from three hours to four days, 
usually twenty-four hours. 

Initial Symptoms. — The usual initial symptom is a chill varying in 
severity; it may, however, be preceded by a headache and malaise and is 
always followed by a high fever. In bad cases the chill is repeated daily 
and the temperature rises high. I have known of one instance in which 
it went to 106.7 degrees Fahrenheit. The patient is restless, the tongue 
at first red and glazed becomes dry and leathery, the pulse at first full and 
bounding becomes weak and compressible with a rate of 130 or more. 
Prostration is marked. 

The Fever. — The fever is subject to remissions which give rise to the 
inexperienced to delusive hope. The chill is followed by profuse sweating 
and further prostration, the mind early begins to wander and delirium 
of the low muttering kind is soon established. There is a tenderness over 
the abdomen in puerperal cases and in all a tendency to enlargement of 
the spleen with hypostatic congestion of the lungs and often broncho- 
pneumonia will result. 

Diagnosis. — This is usually easy, the resemblance of the more serious 
form to intermittent fever has been referred to. In this disease the 
remissions are not so total and the patient remains very ill. 

Treatment. — In treatment all possible infecting foci should be re- 
moved by surgical methods; after this the strength should be supported 
by quinine, strychnine and stimulants. The food should be liquid and 
of the most nourishing kind. The fever should be reduced with cold 
sponging and quinine. 

PYEMIA OR PUS BLOOD POISON. 

Definition. — Pyemia is a general febrile affection due to sepsis, char- 
acterized by recurring chills and profuse sweats with remissions or inter- 
missions in the fever, also by abscesses variously disseminated in the 
different tissues and organs of the body. 

Causes.— The same essential cause lies at the bottom of pyemia as 
of septicemia, but associated with this disease are the important etio- 
logical factors, thrombosis and embolism. Fragments of a venous throm- 
bus, due to a phlebitis at the seat of putrid inflammation, are broken 
off and carried in the circulation until a lodgment is effected. These 



PUS BLOOD POISON. 349 

fragments swarm with bacteria and the embolus excites intense inflam- 
mation, which goes on to abscess formation. The emboli may be multiple, 
and there will be as many abscesses as there are emboli. The seats of 
election are lungs, liver, spleen, kidneys, brain and joints and the various 
connective tissues in the order above given. 

Other Causes. — Other causes are gunshot injuries of bone and com- 
pound fractures, gonorrhoea and prostatic abscesses. 

Symptoms — A rapidly rising fever, often so closely followed by- a 
chill that its previous existence is often not suspected. The severity of 
the chill is proportionate to the intensity of the infection. The tempera- 
ture during the chill reaches 103 degrees to 105 degrees Fahrenheit, and 
is followed. by a sweat and fall in temperature, after which the latter 
rises again to a point even righer than was at first attained. The tempera- 
ture may rise and fall several times, but as a rule each one goes higher 
than the preceding one. 

Other Symptoms. — The other symptoms of fever are also present, 
thirst, loss of appetite and nausea. The strength of the patient rapidly 
wanes and he soon sinks into a condition of exhaustion and semi-conscious- 
ness from which he may be aroused to take medicine and nourishment. 

Diagnosis is not usually difficult ; a careful study of the case will show 
marked differences in history to typhoid fever and malarial fever. There 
are no rigors followed by sweats in typhoid, and finding the plasmodium 
malaria? in the blood of suspected patient will settle the case should it be 
malaria. 

Treatment is like that of septicemia. Remove the foci of infection 
surgically, and after that the symptoms are to be combated and the 
strength supported to the utmost. 



# 






PART II OF BOOK IV 

Treats of the constitutional diseases, their causes, 
diagnoses, prognoses and treatments. 



Acute Bright's Disease 395 

Acute General Dropsy 393 

Acute Rheumatism 353 

Causes of 354 

Symptoms of 353 

Treatment of 356 

Anemia 389 

Causes of 389 

Diet in 390 

Symptoms of 389 

Treatment of 390 

Arthritic Rheumatism 361 

Beri-Beri 39* 

Causes of 39 1 

Symptoms of 39 1 

Treatment of 391 

Bright's Disease 395, 

Acute 395 

Causes of 395 

Chronic 395 

Diet in 395 

Symptoms of 395 

Treatment of 395 

Cancer 363 

of Bones 373 

of Brain 371 

Causes of 3&7 

Colloid 372 

Diet in 374 

of Duodenum 371 

of Kidney 37i 

of Liver 371 

Membranous 373 

Prevention of : 364 

Skin 373 

Soft 373 

of Spleen 371 

Symptoms of 369 

Transmission of 3^7 

Treatment of 374 

of Uterus 37* 

3 



Cancerous Dropsy 372 

Carcinoma 363 

Chronic Bright's Disease 395 

Diet in 397 

Symptoms of 396 

Treatment of 396 

Chronic Gout 362 

Chronic Rheumatism 359 

Symptoms of 359 

Treatment of 360 

Colloid 378 

Cancer 372 

Constitutional Diseases, The 353 

Cretinism 384 

Causes of 384 

Symptoms of 384 

Treatment of 385 

Diabetes 385 

Causes of 385 

Diet in 386 

Mellitus 385 

Symptoms of 385 

Treatment of 386 

Dropsy, Acute General 393 

Cancerous 372 

Diet in 394 

General 392 

Local 392 

Symptoms of 392 

Treatment of 393 

Dry Leprosy 379 

Elephantiasis '. ... 3 79 

Fever, Rheumatic ^53 

General Dropsy 391 

Gonorrheal Rheumatism 361 

Gout 361 

Causes of 362 

Chronic 362 

Hereditary 362 

Symptoms of 361 

Treatment of 362 



51 



352 



LXDEX TO PART II OF BOOK IV. 



Hereditary Gout 362 

Land Scurvy 386 

Causes of 386 

Symptoms of 38° 

Treatment of 3§7 

Leprosy 379 

Causes of , 379 

Dry 379 

Symptoms of 379 

Treatment of 380 

Local Dropsy . 392 

Lumbago 358 

Treatment of 358 

Lupus 373 

Symptoms of 378 

Treatment of 3/8 

Malignant Disease 363 

Melanosis 373 

Membranous Cancer 3/3 

Muscular Rheumatism 358 

Neck. Stiff 358 

Noli MeTangere 37^> 

Ophthalmia 382 

Diet in 32-2 

Symptoms of 382 

Treatment of 382 

Pain in the Side 358 

Treatment of • -359 

Pleurodynia 358 

Podagra 361 

Purpura 386 

Rheumatic Fever .353 



Rheumatism, Acute 353 

Arthritic 361 

Chronic 359 

Gonorrheal 361 

Muscular 358 

Syphilitic 361 

Rickets 383 

Causes of 38) 

Diet in 38 \ 

Symptoms of 383 

Treatment of 384 

Scorbutus 38.I 

Scrofula 3S 1 

Causes of 381 

Symptoms of 38 1 

Treatment of 38 T 

Scurvy 388 

Causes of 388 

Diet in 389 

Land 38C 

Symptoms of 388 

Treatment of 388 

Skin Cancer 373 

Soft Cancer 373 

Stiff Neck 358 

Treatment of 358 

Syphilitic Rheumatism 361 

Uraemia 397 

Uraemic Poisoning 397 

Causes of 397 

Symptoms of 397 

Treatment of 398 



CURATIVE MEDICINE 



PART II. 



THE CONSTITUTIONAL DISEASES 

Meaning of Constitutional Diseases. — By constitutional or organic dis- 
ease is generally meant a visible disorder of structure; that disease and 
disorder are, however, essentially the same thing, is clear from the cir- 
cumstance that function and organism are united. The state of the organ 
will always influence the function, just as a power applied to any ma- 
chinery will produce effects according to the nature of the machine and 
the materials acted upon. The power and function of the machine are 
dependent on its intrinsic mechanism, though set to work by an extrinsic 
influence. The mode of working is not visible in the vital organs, nor 
are the functions of life mechanical, except so far as they act in time and 
space. 

ACUTE RHEUMATISM OR RHEUMATIC FEVER. 

Symptoms. — Acute rheumatism is an inflammation of the joints, 
characterized by general fever, by pain, heat, redness and swelling of the 
joints affected, and by a tendency to leave one joint suddenly and fasten 
upon another. The affection sometimes commences by chills and fever, 
and general uneasiness ; and these symptoms (rheumatic fever) may last 
for twenty-four hours or more before the local manifestations show them- 
selves. More frequently the local symptoms make their appearance at the 
same time with the fever, and occasionally they are present some little 
time before it supervenes. 

The Pain — The pain in the joint or joints affected, commonly but 
little felt while the patient is perfectly quiet, becomes intense on the 
slightest motion, so that he is rendered completely helpless. The super- 
ficial joints become swollen and tense, they are hotter than natural, and 
the skin covering them is generally more or less reddened. 

The Swelling. — The swelling is sometimes mainly caused by effusion 
within the capsular ligament of the joint itself, at others by the inflamma- 

(353) 
23 



351 CONSTITUTIONAL DISEASES. 

tion and thickening of the fibrous tissues external to the joint. The pulse 
is generally full, strong and moderately frequent, rarely rising over 100 
beats in a minute; the skin is warm and copious sour perspirations are 
commonly present; the tongue is thickly coated, the bowels somewhat 
constipated and the appetite completely lost. 

Freaks of Inflammation — The inflammation at first affects one or two 
joints, rarely three; after a variable time it commonly leaves the joints 
first affected as suddenly as it attacked them, and fastens on some other 
articulation; often, however, new points are attacked without the disease 
leaving its original seat. As a rule the larger joints are the ones most 
liable to be attacked, the knees, elbows, ankles, wrists and hips; more 
rarely the smaller joints of the toes and fingers become affected. 

Heart Attack. — Besides the articulations, acute rheumatism fre- 
quently attacks the heart, not by metastasis or transferrence of the inflam- 
mation from one part to another, but by seizing on the fibrous textures of 
the heart as in one of the series of textures liable to the disease. Some- 
times the pericardium is attacked (pericarditis), sometimes the lining 
membrane of the heart's cavities (endocarditis). The younger the patient 
the more liable is the heart to be affected; so that when rheumatism 
occurs previous to the adult age the heart is attacked in a large majority 
of cases. 

Rheumatism Hereditary. — The rheumatic constitution is frequently 
hereditary, and rheumatism is peculiarly a complaint of cold, damp sea- 
sons and climates. 

Causes. — The cause of rheumatism has provoked more thought and 
research than any of the commoner diseases; at least one type of the 
disease is due to excess of fibrin in the blood. There is an exudation of 
this fibrinous material into the sheaths of nerves about tendons, especially 
where inserted into the bone, the fasciae of muscles, the serous capsules 
of organs, their ligamentous attachments, in joints, heart valves, and so 
forth, wherever fibrous tissue is found normally. This fibrinous exudate 
organizes into bands, fungus, nodules, and so forth, of cicatricial tissue, 
obstructing circulation and movement of parts and modifying cell nutri- 
tion. The presence of this fibrinous exudate makes the muscles hard and 
stiff, so that they contract with difficulty and pain, yet appear large and 
strong. Impinging upon nerves it causes pain and perverted nerve action. 
Especially is this the case where the deposit occurs near the bony opening 
whence the nerves emerge. 

The Fibrous Exudation. — This fibrinous exudate is precisely like the 



ACUTE RHEUMATISM. . 355 

membrane of diphtheria, of membranous dysmenorrhea, colitis and croup, 
the exudate in lobar pneumonia, and so forth. Its appearance in the mus- 
cles and other structures is also preceded by a similar weakening of the 
vaso-motor nerves. When the blood gets into this hyperplastic state it 
must get rid of the excess of fibrin-forming materials in some way, or it 
would finally solidify, organize like a clot, and the individual turn to stone. 
So nature sounds the alarm, and sacrifices a part to save the organism. 
But sometimes her warnings are not heeded. 

A Chief Cause. — The chief exciting cause, we know, is the application 
of cold to the body when unusually heated. Cold is more liable to pro- 
duce this effect when combined with moisture, whence a cold and humid' 
atmosphere and wet or damp clothes are the most frequent sources to 
which rheumatism can be traced. Partial cold, as when parts of the body 
are subjected to currents of cold air, is very apt to give rise to rheumatism ; 
when the body is predisposed a very transitory exposure of this kind will 
suffice to bring on an attack ; if the current be sustained for any time, few 
will wholly escape some contingent suffering. Of the fact that rheuma- 
tism is so excited there can be no doubt. When it is reflected, however, 
that for every instance of rheumatism so induced, numbers continually 
endure as much or greater exposure to the alleged cause without any 
disease ensuing, too much importance should not be attached to it. 

Diagnosis. — The only disease with which it is liable to be confounded 
is gout. Formerly discrimination in this respect was deemed of high 
importance, the prevailing theories of gout demanding a course of treat- 
ment very different from that to which rheumatism was subjected. In the 
present day a juster pathology of gout assimilates the treatment of both 
diseases sufficiently to render extreme accuracy of discrimination of very 
slight moment. 

Prognosis — The prognosis is dependent on the promptitude with 
which suitable treatment is resorted to. Generally speaking, there is little 
immediate danger to life, there being no inflammatory disease of equal 
intensity which so little deranges the vital functions. This, most proba- 
bly, is owing to the disease expending its violence in the joints and other 
external parts, and being little prone to attack the viscera. The peculiar 
character of the inflammatory action, too, and the little liability which 
it has to pass into suppuration, or undergo the other changes consequent 
to phlegmonous inflammation, may account for the safety with which 
even the metastasis of rheumatism to internal parts is borne. It is certain 



350 CONSTITUTIONAL DISEASES. 

tliat such metastasis is not attended with so much danger as the severity of 
the symptoms would seem to denote. 

Management of Acute Rheumatism. — One of the most important points 
in the management of acute rheumatism is to watch the supervention of 
the morbid action in the fibro-serous tissues of the heart. It is not neces- 
sary to repeat here the symptoms of pericarditis and endocarditis, but the 
occurrence of dyspnoea, with more or less anxiety, jerking or feeble and 
rapid pulse and tumultous action of the heart ought to direct the atten- 
tion of the practitioner to that viscus, and if he discovers by the physical 
signs and functional phenomena the existence of inflammatory action 
there, it must be treated as if the disease were unconnected with rheuma- 
tism, for no truth is better established than that, although acute rheuma- 
tism, seated in the fibrous and muscular tissues around the joints, is 
remarkable for its great and rapid change of location; chronic rheuma- 
tism loses this mobility when it fixes upon a serous membrane. 

Treatment. — 1. Acute rheumatism produces, we have seen, diseases of 
the heart; it is, therefore, incumbent on the practitioner to prevent the 
continuance of the rheumatic inflammation of the serous membrane of the 
heart. The indications are to subdue fever and remove inflammation. 
The promptitude with which the local inflammation in its earliest stage 
yields to the treatment by which a plethoric state of constitution is cor- 
rected, and febrile action allayed, and the obstinacy of the local ailments, 
whenever the constitutional state is overlooked or inadequately treated, 
furnish the best proofs of the correctness of this pathology. 

2. The treatment has been pursued in various ways — bleeding, mer- 
curials, mercurials with purgatives, opium, sulphate of quinine and nitrate 
of potassa in large doses have been at various times resorted to. Of these 
methods, those by large doses of sulphate of quinine and by nitrate of 
potassa have seemed to have an influence in controlling and cutting short 
the disease, and the treatment by quinine appears to be successful in the 
acutest and most violent attacks; but they are both subject to incon- 
venience and dangers which counterbalance their advantages. 

3. The treatment which is most generally relied on is the alka- 
line. Our aim being to liquefy and eliminate the fibrinous deposit. 
The iodides, ammonia preparations, jaborandi, hot vapor baths, massage, 
and counter-irritation have all been employed; overfeeding, especially 
with meats and highly concentrated foods, should be rigorously avoided. 
Persons having this fibrous diathesis should employ a resolvent treatment 
at intervals, for weeks at a time. Exercise must be systematic, and too 



ACUTE RHEUMATISM. 357 

much cannot be said of the value of hot vapor baths, massage and joint 
movements. 

4. If the heart shows signs of being affected,, and embolism or phle- 
bitis occur, use ammonia, carbonate and acetate with nitro-grycerine, 
warmth to and rubbing of extremities with mercury to move the bowels. 
The old custom of venesection and cups, in vigorous subjects, was very fair 
practice. It made the patient thirsty and so called for diluents to thin 
the viscid blood. The cups relieved engorged parts, and paved the way 
for a better circulation through them. 

5. The fibrous diathesis varies from that of the uric acid, and 
the same treatment will not always relieve the rheumatic pains of both. 
In the former, there is a tendency to congestion of the brain, the liver 
and kidneys are apt to be sluggish. In the uric acid type of rheuma- 
tism irritability is contrasted with the torpor which characterizes the 
fibrous. Enlarged joints are common, and storms of disease sweep over the 
system. Muscular development is slight, and the powers of endurance 
small. In the fibrous diathesis the patient is well developed, tough and 
resisting. 

As rheumatism is invariably accompanied by loss of appetite and 
embarrassed metabolism, it is naturally the result of accumulated secre- 
tions and imperfect excretion, hence it is best treated by freeing the 
bodily outlets and carefully measuring the supplies. While recognizing 
the necessity of salicylate treatment, we would advise that such be com- 
bined with mild cholagogues, diaphoretics and diuretics. The salicylate 
appears to exert a general action on all the excretions in the exact pro- 
portion in which such is needed. 

6. If any organ requires but little correction, it receives no more, 
and on that account sufficient force is retained to exercise itself where it 
is more in demand. As a result, the beneficial effects of the salicylic acid 
treatment are utilized to their fullest extent without being followed by bad 
reactionary conditions. 

Treatment. — Rest in bed and the parts kept warm. The affected 
parts should be wrapped in cotton. Give freely alkaline mineral waters. 
In the strong frequent doses of salicylic acid or the salicylates. 

R. — Acid Salicylic I % drachms 

Sodii Bicarb 2 drachms 

Tr. Card. Co 6 drachms 

Syrup i % ounces 

Water q. s. to make four ounces. 

Two teaspoonfuls every three or four hours. 



358 CONSTITUTIONAL DISEASES. 

Or, 

R. — Sodii Salicylate 3 drachms 

Syrup 2 ounces 

Water of peppermint 2 ounces 

Two teaspoonfuls every three or four hours until relieved. 

Or five-grain doses of aspirin every three or four hours. The alka- 
line treatment can be used by giving the following: 

R. — Potass. Bicarb I drachm 

Lemon juice 2 drachms 

Water I ounce 

After the acute symptoms and pain have subsided, Basham's Mix- 
ture in dessertspoonful doses three or four times a day. Oil of winter- 
green applied to the affected joint will often relieve the pain. 

MUSCULAR RHEUMATISM. 

Of the minor painful maladies this is, perhaps, the most common in 
many parts of the country. It may attack any muscle, but its three most 
decided and painful phases are lumbago, stiff neck and pain in the side 
(pleurodynia), all of which yield to the same or analogous treatments. 

Lumbago. — This affects the large muscles of the back and loins, 
sometimes extending to the lowest parts of the spine. The pain is severe 
and often of sudden occurrence, very much as if one had sprained his 
back. 

Treatment. — Apply locally chloroform liniment on hot flannel. A 
porous plaster is often effective. Assume and hold a restful position. 
Take internally two grains each of quinine and phenacetin, with one 
twelfth of a grain of belladonna every three hours until relieved. 

Stiff Neck. — This is also called cervical rheumatism. It affects the 
large muscle at the side of the head behind the ear, extending down to the 
collar or even the breast bone. 

Treatment — Apply locally chloroform liniment on hot flannel. As- 
sume and keep a restful position. Take internally two grains each of 
quinine and phenacetin, with one-twelfth of a grain of belladonna every 
three hours until relieved. 

Pain in the Side (Pleurodynia) arises from a rheumatic affection of 
the muscles concerned in breathing, especially the short, flat muscles 



CHRONIC RHEUMATISM. 359 

between the ribs, called intercostal muscles. It is also called intercostal 
rheumatism. The pain produced resembles that of pleurisy, and some- 
times excites alarm lest some more serious disease is present. A test of 
the lungs with the stethoscope will determine whether the condition is 
pleuritic or not. Absence of cough or fever, and soreness, upon touch, 
of the muscles on the side affected, also show that pleurisy is not present. 
Treatment. — 1. As in all cases of muscular rheumatism, put the 
affected muscles at rest as far as possibile. Of course this will be hard 
to do, because these muscles are engaged as helps in respiration, but the 
object may be aided by applying strips of adhesive plaster, overlapping 
each other, around the affected side, so as to compress it tightly. 

2. Apply an ordinary porous plaster to the side affected. 

3. Treat internally by taking every three hours, until relieved, a 
dose consisting of two grains each of quinine and phenacetin, with two 
grains of Dover's powder. 

4. Fifteen drops of wine of colchicum, with a quarter of a grain of 
opium, used in very small but often repeated doses, is often beneficial in 
all the above forms of muscular rheumatism. 

5. In all of the above forms of muscular rheumatism — lumbago, 
stiff neck and pleurodynia — where the suffering is intense, a hypodermic 
injection of a quarter of grain of morphia will afford prompt relief. 

CHRONIC RHEUMATISM. 

Character. — The distinctive characters of this malady are a febrile 
state of the general system, with more or less pain and swelling in certain 
tissues and joints. And in this, precisely as in acute rheumatism, the con- 
tinuance of febrile action undermines the general health, while the local 
inflammation, however indolent, disorganizes the joints, occasioning even- 
tual decrepitude. The pain and swelling of joints with progressive 
thickening of the ligaments and effusion in the several bursa? sufficiently 
evince the morbid actions from which such effects result. But coincident 
with these will generally be found a quickened pulse, some increased heat 
of skin and a furred tongue. 

Symptoms. — Chronic rheumatism presents itself under two forms. In 
one of the joints are swollen and painful, the pain being aggravated by 
motion; there is no general fever and the appetite may be good and the 
digestion sound. The affection is exceedingly obstinate, attacking new 
joints without leaving those first affected ; it frequently attacks the smaller 



360 CONSTITUTIONAL DISEASES. 

joints, rendering them permanently swollen and deformed, while the 
immobility to which the joints are sometimes reduced may cause atrophy 
of the muscles connected with them. 

Gout. — When the type is precise and definite it presents sharply- 
drawn distinctive characters which distinguish it from gout; but it must 
be admitted that there are many cases in which it exhibits so great a 
resemblance to chronic gout that it is almost impossible to establish an 
absolute distinction between the two diseases. Mobility is the primordial 
character of rheumatism ; this character at once presents itself. In gout — 
on the other hand — mobility does not show itself until the malady has 
become inveterate, until the attacks, which at first were strictly local, have 
frequently recurred, or the progress of the regular manifestations has been 
interfered with. 

Treatment. — 1. In the treatment alkalies and diuretics are of service, 
also the iodide of potassa, while the different mineral waters are frequently 
of great service. Warm salt water baths, the use of flannel and stimulat- 
ing liniments afford relief. 

2. It would be vain to enumerate the various stimulants which 
have obtained character for the cure or relief of this disease. The prin- 
cipal are the different essential oils ; various balsams and gum resins ; 
sudorific decoctions; electricity. Any of these may benefit according as 
the general constitution is prepared for their operation, or as the special 
ailment may require. If there be no plethoric or febrile state present, 
their use will at least be harmless, if not beneficial ; but should the case be 
such as to need depletory treatment and the operation of mercury, then 
must the use of such stimulants as are now named be watched with great 
caution. Warm bathing and active exercise are among the unexception- 
able and most powerful means of relieving chronic rheumatism. 

Local Treatment. — 1. The local treatment as directed for the regular 
or acute rheumatism also requires to be assiduously employed. For this 
various liniments are useful; none are better than those containing oil of 
turpentine, oil of wintergreen, oil of sassafras, ammonia and laudanum, 
diluted with soap liniment, or where pain is considerable, chloroform or 
aconite liniment. Blisters may be applied in obstinate cases. Dry cup- 
ping to the back, leaving a number of cups on for twenty or thirty minutes 
at a time makes a more pervading favorable impression sometimes than 
might have been expected. 

2. For rigidity of the joints and even for pain in them or in the 
muscles, pouring lint water continuously over the parts does great service. 



GOUT OR PODAGRA. 361 

The hot bath or vapor bath, or, as some prefer, the hot dry-air bath (130 
degrees to 200 degrees) will be powerful for relief in many cases. 

Electric Treatment. — Electricity also will aid in hastening the restora- 
tion of use to the stiffened parts. 

SYPHILITIC RHEUMATISM. 

This affects the long and flat bones chiefly, and mostly between the 
joints, not at them. Generally there is nodosity upon the bones affected, 
or some degree of periosteal inflammation at least. Our main reliance in 
this affection is the iodide of potassium. 

ARTHRITIC RHEUMATISM. 

This designation is applied to a form of subacute or chronic inflam- 
mation of one or more large joints of greater severity than ordinary 
chronic rheumatism. Effusion into the joints, with deformity and perma- 
nent lameness may occur. The treatment pursued in chronic rheumatism 
has proved beneficial. 

GONORRHEAL RHEUMATISM. 

A peculiar inflammation of one or more joints occasionally commenc- 
ing in the course of gonorrhea or even of urethral inflammation from 
forced catheterism. The local affection may be severe, with suppuration 
in a few cases and anchylosis of the joint in many. It appears to be an 
ichorgemic affection; the result of absorption into the blood of morbid 
matter effused into the membrane of the urethra. 

GOUT OR PODAGRA. 

Character — A painful disease affecting principally the fibrous tissues 
about the smaller joints and intimately connected with an excess of uric 
acid and its compounds in the blood. Various names have been given 
according to the part affected, as podagra when in the feet, chiragra when 
in the hands, and so forth, but all such and probably many cases of neu- 
ralgia, accompanied by oxalic deposits in the urine, are mere forms of 
one disease. 

Symptoms. — A common attack of acute gout is generally preceded 
by uneasiness, indigestion, loss of appetite, nausea and vomiting, biliary 
derangement, dull pains or numbness in the parts affected, often with 



36'2 CONSTITUTIONAL DISEASES. 

feverish symptoms; but in some cases, on the contrary, the disease comes 
on in the midst of apparent health and well-being, and occasionally at 
night during refreshing sleep. In most cases it makes itself known by 
an acute pain in the joint of the great toe. 

Further Symptoms. — This is accompanied by feverish symptoms, 
urinary sediment, extreme tenderness, restlessness, involuntary muscular 
contractions, sleeplessness and perspiration; the affected joint is swollen, 
red and hot. This series of symptoms may last four or five days, to be 
followed after a day or two by three or four others, continuing in all 
from two to three weeks; the severity of the attack, its persistence, its 
seat and its metastases vary according to circumstances. 

Chronic Gout. — When gout becomes chronic the attacks are more 
irregular, less severe, more frequent and sudden, leaving one joint for 
another after slight exposure to cold and moisture, excess at table or vivid 
emotions; in this form the continuance of the pain and the fear of in- 
juring the gouty joints render its subjects cross, fretful and disagreeable. 

Chalky Deposits. — Toward the end of the spell chalk-like deposits 
are thrown out about the joint in some, but not in all cases. The suffer- 
ing with the gouty inflammation is often very intense. 

Hereditary Gout — Hereditary gout is sometimes podagra or foot- 
gout, but more often is of the hardening kind. Neuralgia, indigestion, 
palpitation and urticaria or eczema upon the skin are its most common 
manifestations. In such a system rheumatism and other affections are 
to a considerable degree modified by the "gouty tendency." 

Causes. — High living with indolent habits generates gout. Even 
excess of animal food, with scanty exercise, has been known to produce it. 
But strong wines and malt liquors much increase the tendency. Weak 
wines do not seem to have the same effect. 

Diagnosis — Between gout and rheumatism there is great resemblance. 
In gout the small joints are chiefly affected; in rheumatism the larger 
joints. Repetition of attacks is much more frequent in gout ; their dura- 
tion is greater in rheumatism. In gout the heart is seldom attacked and 
spasmodically; in rheumatism the heart is often subject to inflammation. 
In gout the stomach is sometimes spasmodically affected with violent 
symptoms ; in rheumatism, almost never. In gout, and not in rheumatism, 
uric acid is in excess in the blood. In pure gout, colchicum does good ; in 
rheumatism, hardly ever. 

Treatment. — 1. There are few diseases which have more empirical 
remedies extolled for their cure than gout ; almost every drastic purgative, 



CANCER, OR MALIGXAXT DISEASE. 363 

diuretic, tonic and narcotic has been pressed into the service either for 
external or internal use. To say nothing here of soothing topical appli- 
cations, colchicum has enjoyed, and deservedly, a great reputation in the 
treatment of gout and neuralgia between the attacks and in their chronic 
forms ; it is most efficacious when it acts upon the skin and bowels. The 
acetate of potash and other alkalies are in favor both for their diuretic 
property and as alkalizing the acid in the blood and urine. 

2. During the attack colchicum and the alkalies are the remedies. 
Wine of the root of colchicum may be given in ten- or twenty-drop doses 
several times daily. The stomach and bowels are sometimes irritated by 
large doses ; but for a few days most patients will bear fifteen drops thrice 
daily. It should be stopped when relief has been obtained. Carbonate 
of potassium — ten to thirty grains at once with half -drachm doses of 
rochelle salts will be important in addition. Opiates or other anodynes 
may be craved by the patient during the extremity of his pain. 

3. Gouty attacks affecting the stomach or heart spasmodically are 
usually sudden, violent and prostrating, requiring prompt stimulation, 
as brandy, laudanum, Hoffman's anodyne or chloroform. Small or mod- 
erate doses of one or another of these should be given at short intervals. 
Mustard plasters to the epigastrium or chest and back will be important, 
and the feet may be placed in hot mustard water for revulsion. 

Diet. — Regulation of the diet is of primary importance. But it 
should not be too low, especially when the patient's habits have been 
those of free living. Nourishment must be full, while the digestive power 
is economized and positive stimulation avoided. Attention to hygienic 
rules and avoiding exposure to dampness, cold and fatigue of body or 
mind are absolutely necessary as aids in the treatment of this disease. 
To promote all this adequate exercise is the natural agent, the use of 
which cannot be superseded by any medicines however valuable or how- 
ever lauded. 

CANCER, OR MALIGNANT DISEASE. 

Cancer is a disease the cause and method of spreading of which is 
not definitely known. It starts by the growth of cells in an organ or skin 
of the body which are exactly like normal body tissue, but differ from the 
cells which are normal for the organ in which it develops. These ab- 
normal cells constituting cancer, renew themselves and encroach upon the 
normal cells of the organ involved, so that its function is interfered with 
and ultimately destroyed. Cancer of the stomach, liver, etc., grow until 



364 CONSTITUTIONAL DISEASES. 

the j encroach upon adjoining organs and practically eats its way into the 
vitals of the patient until removal or death occurs. Cancer can spread 
to other parts of the body by the poisonous cells, from the original seat 
of the growth, getting into the blood and lymphatic channels. As soon as 
the wall of a blood or lymph channel becomes eaten through these cells 
are washed to other organs, and wherever they happen to be checked start 
a secondary growth. This habit of cancer cells traveling by the former 
method and starting up secondary tumors resembling the primary growth 
is spoken of as "metastasis." Do you know that after thirty-five years 
of age one in every eight females and one in every eleven males die of 
cancer, that the death rate from cancer between the ages of fifty and sixty 
is not surpassed by any other disease as a cause of death in women, and 
only slightly by tuberculosis in men. 

What are the early signs or danger signals of this scourge, which, 
if recognized by the sufferer, may save his life ? 

According to Dr. Childe, the eminent English surgeon, the suscep- 
tible localities for cancer are: 

(1) Cancer of the breast. Here the danger signal is a small lump 
or thickening of any kind. In women over forty years old, this lump is 
a cancer from the start in at least 90 per cent, of the cases. In a woman 
of any age, the finding of a lump in the breast should be immediately 
followed by its removal by operation. 

(2) Cancer of the uterus (womb). The danger signal here is any 
irregular bleeding, especially after menopause (change of life), or the 
onset of a discharge in a woman who has been free from it previously, or 
the change in character of a previously present discharge, so that it be- 
comes more profuse, more foul or more irritating. 

(3) Cancer of the lip, mouth and tongue. The danger signal here 
is a little wart or sore that will not heal. 

(4) Cancer of the skin. The danger signal here is any sore that 
will not promptly heal or any wart or mole which suddenly begins to grow 
rapidly. 

(5) Cancer of the stomach and intestines. Here the danger signals 
are not so apparent as on the surface of the body. After forty years of 
age, the onset of obstinate indigestion, persistent colicky pains in the ab- 
domen, persistent diarrhoea and especially the vomiting of blood or the 
pasage of blood in the stools. Loss of weight. 

Prevention. — The cause of cancer is unknown, and whether contagious 
or not is unsettled. Therefore, we cannot prevent its spread by isolating 



CANCER, OR MALIGNANT DISEASE. 365 

the person in quarantine. If the disease were known to be due to a germ or 
parasite, insects, etc., then it could easily be cured, as other contagious dis- 
eases, by destroying the cause and preventing others from contracting the 
disease by coming in contact with sufferers from cancer. . However, any 
sufferer from cancer in a family should be kept in a separate room, and all 
doors, windows, etc., screened to keep flies and mosquitoes out, and kill 
all insects seen that may alight upon the dressings or any exposed surface 
of the body. Disinfectants should be at hand for the nurse, attendant and 
physician to disinfect their hands a#ter attending to the patient. All dis- 
charges, bedclothing, wearing apparel, dishes, etc., used by the patient 
should be disinfected with chloride of lime solution (one ounce to half a 
pail of water) as a precaution. 

Treatment. — There is only one way of preventing the spread of this 
disease, and that is by immediately consulting your physician and inform- 
ing him of a growth or mole, etc., or any distressing pain or symptoms 
which affect any portion of your body. Do not wait. Cancer spreads 
slowly and treacherously until it has gained a hold, and then it may be too 
late. When the surgeon sees your case, submit to an operation at once. If 
the stomach or womb, etc., are involved, you will be saved a slow and pain- 
ful death. Complete and early removal of a cancer by operation is the 
safest cure. Even then it will return, but these cases are rare where the 
patient has acted promptly. 

No Medicine Will Cure Cancer — Avoid Patent Medicines. — They are 
fakes; your money will be wasted, while your tumor will grow. There 
have been numerous cures recommended in the treatment of cancer where 
operations cannot be made. The best of these is the Eadium Treatment. 
This is very expensive, but in time the government and our wealthy 
citizens will see that the poor can receive treatment according to their 
station in life with a nominal charge or fee. It has cured some cases, but 
others have succumbed. 

Dr. Seelye, of Daytona, Florida, IT. S. A., recommends the treat- 
ment of cancer (epithelioma) by direct sunlight, by concentrating the 
rays of the sun upon the growth, early, by means of a magnifying glass 
such as may be purchased under the name of a "reading glass" for half a 
dollar or less. He claims permanent cures in mild cases so treated. 

Common Form of Cancer — The most familiar and characteristic form 
of cancer is that which attacks the female breast or womb, usually past 
the middle period of life. It first appears as a local induration situated 



366 CONSTITUTIONAL DISEASES. 

beneath the skin, in the glandular tissue of the organ, for the most part in 
the neighborhood of the nipple. It increases slowly in size, becomes ad- 
herent to the skin and involves more and more of the substance of the 
breast. 

Cancer Pains. — In most cases sharp lancinating pains are experienced 
at this time, sometimes causing much distress. When the glandular sub- 
stance of the breast has become fully affected, it is also found to be adher- 
ent to the walls of the chest, so that it can no longer be moved from side to 
side, and the skin over its whole surface is discolored. Smooth in texture, 
raised in irregular knobs or eminences and in spots red and tender. 

The Ulceration. — The early hardness now yields to local softening, 
the skin gives way at some prominent point, and the ulcer thus formed 
shows no tendency to heal, but constantly enlarges and discharges a dark- 
colored and fetid exudation. Subsequently the morbid growth involves 
the subjacent muscles, the ribs and even the substance of the lungs. In- 
ternal cancer, however, is often developed as a secondary affection with- 
out being directly continuous with the external growth. The patient may 
be gradually exhausted by the pain, discharge and constitutional irritation 
dependent upon external cancer alone, or the fatal termination may be 
principally due to the secondary affection of the internal organs. 

Course of Cancer — The course of cancer is for the most part slow, 
requiring several years to pass through its successive stages. This is gen- 
erally the case in cancer of the breast. In other forms, particularly where 
the morbid growth is softer and more vascular at the outset it often 
terminates fatally in a few months or even weeks. 

Train of Cancerous Symptoms — The cancerous humor possesses these 
characteristics : 

1. The peculiar power of infiltrating every tissue as it encroaches 
upon it. 

2. It spreads to the lymphatic glands of the neighborhood through 
the absorbents. 

3. It affects the body generally through the vascular system, thus giv- 
ing rise to secondary deposits, that is to say, to the development of similar 
growths in the viscera or remote parts, the lungs and liver being particu- 
larly prone to its attack. 

4. It is liable to recur after removal. 

The stroma is abundant, tough and resisting, giving a tuberoid cir- 
cumscribed appearance to the mass when superficial. It is of great hard- 
ness, and when fully developed is firmly adherent to the adjacent parts. 



so: 

Upon sections it presents a bluish-white, glistening appearance and yields a 
creamy, oily fluid known as cancer juice. When situated subcutaneously, 
as in the mamma, the tumor commonly assumes a dark purple or livid 
color, and is subject to darting, stinging or neuralgic pains. It is apt to 
ulcerate, when the sore will present hard and everted edges and the neigh- 
boring lymphatics will become indurated and enlarged. It is found most 
frequently in the mamma, liver, stomach and rectum. It is more frequent 
in women than in men. It is of slow growth, and rarely occurs before 
forty or forty-five years of age. 

Causes. — The observations which we have made on the relative fre- 
quency of cancer as to age, sex-temperament and condition of life contain 
the greatest part of what we have to say on the predisposing causes of the 
disease. Among these have long been enumerated the frequent and direct 
operation of irritating substances ; external injuries, especially blows ; the 
abuse of stimulating potions; immoderate indulgence in venery; the de- 
pressing influence of moral afflictions; bad food, conjoined with the de- 
bilitating effects of cold and otherwise unhealthy habitations; the inju- 
rious influence of one or more of these predisposing causes on particular 
organs being determined or modified by the individual or accidental cir- 
cumstances of the case. 

Cancer May be Hereditary. — The frequent occurrence, however, of 
cancer in individuals in whom none of these predisposing causes seem to 
have cooperated in the production of the disease has led many pathologists 
to consider it as having an hereditary origin. 

Transmission of Cancer Germ. — The germ of the disease, or cancerous 
virus, is transmitted from the parent to his offspring. The evidence on 
which this opinion rests is shown in the fact that the material element of 
the disease is contained in the blood, and is separated from this fluid after 
the manner of nutrition and secretion, either in the molecular structure 
or on the free surface of organs; and that, while the formation of the 
disease is thus going on, there may be no appreciable physical or physi- 
ological modification of the part in which it is observed. It is thus that 
we meet with carcinomatous tumors in the brain, which, from their bulk 
and other characters, must have existed long before the functional disturb- 
ance of the organ gave signs of their presence; and we have an equally 
striking example of the silent development of these tumors in the eye, 
until acting simply as a foreign body, they obstruct the rays of light and 
render vision more or less imperfect. 

Cancer Pimple. — In persons, too, apparently in the enjoyment of the 



36R CONSTITUTIONAL DISEASES. 

most perfect health, we often see the disease making its appearance in the 
form of a small pimple, proceeding more or less rapidly in its course, 
extending in breadth and depth and terminating ultimately in death, in 
spite of all the means which art has devised. In others, a similar pimple 
arises under similar or even unfavorable circumstances, proceeds like the 
former to ulceration, and although it may have been neglected, irritated 
and excited from time to time, disappears and leaves the patient in perfect 
health. 

Diagnosis. — It is not until carcinoma has made some progress that we 
are sometimes able to recognize its presence in internal organs by means of 
a careful consideration of the local and general symptoms which we have 
enumerated. Little importance in general is to be attached to any one of 
them taken individually. But when the local signs, viz., the changes 
in the bulk, form and situation of organs, occasioned by the disease, its 
relative frequency in different organs and in particular portions of the 
same organ are taken in connection with the special and general modifi- 
cation of function which may be present in individual cases, the greatest 
possible assistance is afforded us in establishing the diagnosis. Thus it is 
more easy to detect cancer of the stomach than of the lungs, of the latter 
than of the brain; because of our being able to ascertain the presence of 
the greater number of the local signs of the disease in the first case, only 
a few of them in the second and none at all in the third. 

Further Diagnosis. — And when the sense of sight can be applied with 
that of touch and hearing the diagnosis seldom presents much difficulty, 
as in the case of carcinoma of the os uteri and rectum. It is necessary to 
observe that too much reliance is not to be placed on the presence of these 
general symptoms which constitute the cancerous cachexia, for there are 
morbid conditions of the stomach and duodenum associated with the de- 
rangements of the biliary secretion which give rise to a state of debility 
and emaciation, accompanied with discoloration of the skin, which so 
closely resembles this cachexia that the one is not to be distinguished 
from the other. 

Difficulty of Diagnosis — The difficulty of establishing the diagnosis in 
such cases is likewise increased by the circumstance that the same chronic 
character prevails in both. It is hardly necessary to remark that the pres- 
ence of carcinoma in an external part of the body is to be regarded as a 
diagnostic sign of great importance in all cases of a doubtful character 
in which functional derangement of an internal organ has existed for some 
time. In such a case we should regard the frequent occurrence of vomit- 



CANCEE, OR MALIGXAXT DISEASE. 369 

ing after meals as indicating the existence of carcinoma of the pylorus, 
even should no tumor be felt in this situation or dilatation of the stomach. 

Abdominal Tumor. — If the presence of a tumor were detected in any 
part of the abdominal cavity we should not hestitate to say that it was of 
the same nature as the external affection, and the occurrence of paralysis, 
under the same circumstances, would justify us in attributing • it to car- 
cinoma of the brain or spinal cord. 

Possibility of Cure. — In no disease is a fatal determination so uni- 
versally admitted as in carcinoma. The possibility of the cure of cancer 
of the internal organs has never been supported by substantial evidence, 
and the examples are few indeed in which we are disposed to believe that 
the disease has been removed from an external part by surgical or other 
means, without its recurrence in the same or some other part of the body 
at some other future period. 

Symptoms. — Changes in the color, temperature, circulation and nutri- 
tion of the affected organ cannot be detected by direct observation, and 
those of bulk consistence and form can be determined only in certain 
organs, and at a more or less advanced period of the disease, such as the 
stomach and intestines, liver, spleen, kidneys, ovaries and uterus, lungs 
and mesenteric glands, in all of which organs these changes may be recog- 
nized either by the touch, percussion or auscultation. But it is more 
particularly the change of bulk which is detected by these means, and 
which, as a local symptom of the presence of cancer, is that to which the 
greatest importance is to be attached. The increase of bulk which ac- 
companies the presence of cancer is not perceptible until the disease has 
made some progress. It is most considerable in solid organs, such as the 
liver, kidney, ovaries and so forth, and is seldom very marked in hollow 
organs, such as the stomach or intestines. 

Further Symptoms. — Considerable increase of bulk may, however, 
have taken place in the walls of the stomach and intestines without our 
being able to detect its presence, which happens when cancerous matter 
accumulates in the direction of the internal surface of these organs. In 
such cases an increase of bulk of a different kind is produced, viz., dilata- 
tion, in consequence of the obstacle presented by the carcinomatous matter 
to the passage of the food or feces. When dilatation of the stomach is 
thus produced, the obstacle is situated at the pylorus; when of the small 
intestines, it is, in the great majority of cases, situated at the termination 
of the duodenum or commencement of the jejunum and caput cecum coli : 
24 



370 CONSTITUTIONAL DISEASES. 

and at the sigmoid flexure of the colon and rectum when the dilatation 
occupies the larger intestines. 

Bulk of Stomach. — The increase of bulk which the stomach and intes- 
tines acquire in consequence of an obstacle of this kind is sometimes very 
great. In some cases of scirrhus pylorus the stomach has been found to 
occupy the greater part of the abdominal cavity, stretching down to the 
symphysis of the pubis and from one lumbar region to another; and the 
large intestines sometimes measure from four to six inches in diameter 
when similarly affected. We have seen the small intestines equal in 
size to the ordinary dimensions of the stomach. It is important to know 
that the extent of the dilatation is not to be taken as the measure of the 
extent of the disease. The greater the dilatation the greater we may 
infer is the obstacle by which it is occasioned, but this obstacle may con- 
sist in a slight scirrhus enlargement, which prevents the passage of the 
food or feces as effectually as when it is occasioned by one or more tumors 
of considerable size or great thickening occupying several inches in length 
of the whole circumference of the walls of the stomach and intestines. 

Pain of Cancer — The only modification of the sensibility which as a 
local symptom accompanies cancer is that of pain. There is, however, no 
symptom of carcinoma more deceptive than pain. Of all varieties of car- 
cinoma it is that of scirrhus which is most frequently accompanied with 
pain, and it is also in this variety that the pain is most severe, acute and 
lancinating. Vomiting is an invariable consequence of carcinoma of the 
pylorus, accompanied with a diminution of bulk of the orifice of this part 
sufficient to interrupt or impede the exit of the chyme or indigested food. 

Vomiting in Cancer. — Perhaps the most frequent cause of vomiting is 
the mechanical obstacle occasioned by the carcinomatous substance in the 
pyloric portion of the stomach. The quantity and quality of the matters 
vomited are variable. Both will be modified by the quantity and quality 
of the food and drink ; the former by the capacity of the stomach and the 
absence or presence of irritation; the latter by the nature of the ingesta, 
the state of digestion and the stage and variety of the disease. It is only 
at the early stage of carcinoma, or at least before softening and ulceration 
have taken place, that the vomiting consists of a watery or mucous secre- 
tion. In the great majority of cases, and always toward the termination 
of the disease, the contents of the stomach ejected by vomiting contain a 
substance resembling the lees of wine, a mixture of chocolate or soot and 
water. The substance may appear in the form of little particles, patches 
or streaks, and indicates the effusion of the blood into the cavity of the 



CANCER, OR MALIGNANT DISEASE. 371 

stomach from hemorrhage, either in consequence of the softening of the 
carcinomatous matter or the sloughing of this substance and of the con- 
tiguous parts. 

Cancer of Liver — Carcinoma of the liver may occur without any 
appreciable derangement of the special function of the organ being ob- 
served. There is often no apparent alteration in the quantity or quality 
of the bile, even in the most extensive forms of cancer of the liver. 

Cancer of Kidney. — There is no apparent modification of the secre- 
tion of urine in cancer of one of the kidneys, although the disease may be 
so extensive as to leave no trace of the natural structure of the organ. 

Cancer of Uterus — The much more frequent occurrence of cancer 
after than before the cessation of the menstrual discharge, prevents us, 
from estimating accurately the influence which this disease exercises 
on the special function of the uterus and ovaries. Impregnation, however, 
has been known to have taken place in carcinoma of the os uteri, and of 
one of the ovaries. 

Cancer of Spleen — As regards the spleen, its cellular organization may 
be completely effaced by the presence of the carcinomatous matter, and 
consequently it is rendered incapable of receiving more blood than is 
necessary for the nutrition of its solid parts and the growth of the disease. 

Cancer of Duodenum. — Cancer of the duodenal extremity of the pan- 
creas, in consequence of the compression of the duct which passes in this 
direction, gives rise to an accumulation of the secretion of this organ, and 
great dilatation of the duct throughout its whole extent. Diminished or 
suspended absorption are the occasional consequences of cancer of the 
mesenteric and lymphatic glands. 

Cancer of Brain. — The functional lesions which accompany cancer of 
the brain, cerebellum and spinal cord vary considerably with the seat of 
the disease relative to these organs individually, as well as to particular 
portions of them. But in neither of these respects does it give rise to any 
symptoms which can be regarded as pathognomonic of its presence. As a 
foreign body it gives rise sometimes to a degree of compression sufficient 
to produce partial or complete paralysis, loss of memory or difficulty of 
speech and derangement of the intellectual faculties. 

Symptoms. — But these latter changes depend principally on the irrita- 
tion and softening of the substance of the brain in contact with the car- 
cinomatous mass. Even paralysis is more frequently produced by these 
subsequent changes than by compression. 

The Spinal Cord. — Paralysis of the superior and inferior extremities 



372 CONSTITUTIONAL DISEASES. 

of the muscles of respiration, and of the bladder and rectum take place in 
carcinoma of the spinal cord, the seat and extent of the paralysis depend- 
ing on the portion of the spinal cord occupied by the disease. 

General Symptoms. — The general symptoms of carcinoma do not make 
their appearance before the last stage of the disease. Their severity de- 
pends much on the nature of the organ and the extent to which it is af- 
fected, but it is principally the irritation produced by the presence of 
the cancerous substance during the period of softening, sloughing and 
ulceration that determines the gravity of these symptoms. It is in this, 
the last stage of the disease, that the circulation and innervation become 
deranged, and that fever and a diminution of the nutritive function are 
first observed. It is likewise at this period, but more frequently a few 
days or weeks before death, that the skin assumes a pale earthy or dull 
ochrey tint ; the debility and emaciation make rapid progress, and all the 
functions of the economy become implicated in the deteriorating influence 
of the disease. It is this group of the general symptoms which constitute 
what is called the cancerous cachexia. 

Fever Symptoms. — The febrile symptoms, as well as the diminution of 
nutrition in general, are greatest when the seat of cancer is the uterus or 
stomach, and least in those organs as the brain and lungs, in the former of 
which softening and in the latter compression may terminate in death 
before either of these symptoms has become conspicuous. General dropsy 
does not often occur and is never great. Ascites frequently accompanies 
carcinoma of the liver. 

Cancerous Dropsy. — Dropsy of the inferior extremities occurs more 
frequently in cancer of the ovaries and uterus than of any other organ. It 
is the consequence of compression of the iliac veins, but it may also be 
occasioned by the extension of the inflammation which accompanies the 
ulcerative stage of the disease to these vessels. Compression of the vena 
cava by tumors in the liver, or by the enlarged mesenteric glands, may 
also give rise to the same state of the inferior extremities. 

Colloid Cancer. — Colloid or alveolar carcinoma is characterized by the 
stroma being tolerably thick and so arranged as to divide the mass into a 
number of cystiform chambers, or alveoli, which are occupied by a jelly- 
like substance. Generally pale and transparent this may be firm as the 
white of a hard-boiled egg in the older cells, or of the consistency of half 
dissolved glue or currant jelly. In any form it is non-adherent to the 
walls of the cells, and may be readily removed. The disease assumes two 
forms, the circumscribed and infiltrated. The former is met with in 



CANCER, OR MALIGNANT DISEASE. 373 

subcutaneous tissue and in the bones of the extremities, constituting the 
osteo-sarcoma and spina ventosa. The latter is seen in the walls of the 
alimentary canal. It is of much slower growth than either of the above 
varieties, and rarely or never ulcerates or softens. 

Black Pigment. — Melanosis is a form either of scirrhus or encephaloid, 
in which a deposit of black pigment has taken place. 

Soft Cancer. — Encephaloid or soft carcinoma possesses a matrix less 
abundant and firm than in the preceding variety. So deficient is this that 
the mass is of jelly or brain-like consistency. Its cells are for the most 
part large, with a tendency to assume the caudate form. The growth may 
be circumscribed (forming tumors often of immense- size), or it may occur 
in the tissues as an infiltration. It is elastic, occasionally fluctuating un- 
der pressure, as though pus was present. When opened it shows a 
whitish-yellow surface, dotted with pinkish spots during life. It is very 
vascular, giving a purplish-red tinge to the contiguous skin- and possessing 
oftentimes a distinct fruit. Hemorrhage resulting from the spontaneous 
rupture of some of these vessels is not infrequent, forming apoplectic clots 
in the interior if confined, but constituting frightful loss of blood if rup- 
turing the matrix. When ulcerated the surface of the tumor assumes a 
dark, sanguineous appearance, in which condition it is often described as 
fungus hematodes. From the first the peculiar cancerous cachexia is 
better marked in this than in any other kind of malignant growth. Its 
most frequent sites are the eye, cavities of face, articular ends of bones, 
the testicles, uterus and breast. The disease runs its course rapidly. 

Skin Cancer — Epithelioma or epithelial cancer differs from the above 
in having an imperfectly defined matrix which possesses a tendency to 
form concentric laminae around the cellular elements. These are gen- 
erally mixed up with altered epithelial cells of the parts, and are more 
constant in their outline than other cancerous growths. Epithelioma is 
found chiefly at the margin of the mouth and at the anus, though it is 
occasionally seen on the hands and feet. 

Cancer of Bones. — Osteoid cancer is defined as a malignant tumor, 
usually commencing in the bones, consisting almost entirely of bone and 
followed by similar growths in the glands and viscera. 

Membranous Cancer. — Villous cancer is the name given to cancer in 
a mucous membrane when covered with a villous or velvet-like growth. 

A host of remedies have been proposed for the cure of cancer; the 
greater number of them have been tried in almost every form of the 



374- CONSTITUTIONAL DISEASES. 

disease, but they have nearly all failed to justify the high praises bestowed 
on their curative virtues. 

Remedies. — 1. The remedies which retard or arrest the progress of 
cancer consist of those which exercise a direct or indirect influence on the 
nutritive function of the affected organ. Among the former are those 
which operate directly — the local abstraction of blood by means of leeches 
and compression hold the first rank. The first of these means should be 
employed for a considerable length of time, at intervals of one, two or 
three days, and the quantity of blood taken should be regulated chiefly by 
the strength of the patient. The diminution of bulk of the original 
tumor which follows this mode of treatment is sometimes very consider- 
able. 

2. In the great majority of cases the tumor is not entirely removed. 
It may be reduced from the size of a hen's egg to that of a nut, and 
in this state remain stationary for years without giving rise to pain or 
any inconvenience whatever. The alternate use of local bleeding and 
compression effect more rapidly the reduction of bulk just noticed than 
when either is employed separately. 

3. Although compression and local bleeding are employed benefi- 
cially they are by no means to be altogether relied upon. In consequence 
of a modification of nutrition in general, and consequently of that of the 
affected organ, the beneficial effects of some general remedies in car- 
cinoma of external organs are chiefly to be attributed. Some of these 
remedies appear to modify nutrition by effecting some unknown change in 
the composition of the blood, as aconitum, conium and arsenic ; others, by 
acting on the capillary circulation and absorption, as mercury, in altera- 
tive doses, and various preparations of iodine. 

4. The beneficial effects of tonics, as preparations of iron, the fixed 
and volatile alkalies, mineral waters and all other remedies which in- 
crease the vital energies, invigorate digestion and promote absorption and 
secretion, may also be referred to a favorable change induced in the 
nutritive function of the affected organ by the introduction of these 
remedies into the circulating system. 

5. The salutary operation of these local and general remedies is 
much increased by a judicious combination of both, regulated according 
to the circumstances of individual cases. 

Diet. — But while employing any of these remedies it is of the utmost 
importance to regulate the diet and regimen of the patient in such a 



CANCER, OH MALIGNANT DISEASE. 375 

manner that neither of them may interfere with the operation of the 
remedy employed. 

Virtues of Conium — For example, the curative virtues of conium 
depend greatly on the quantity of food consumed by the patient, that is 
to say, the operation of this remedy is more or less powerful when only a 
small quantity of food was allowed and hardly perceptible when the 
quantity was considerable. 

The following has been our experience with the use of conium in 
this disease: 

1. The patient takes a dose of the extract of conium, morning and 
evening, two hours before each meal. The amount of the first dose is half 
a grain, which is gradually increased to six grains each time. This dose 
is continued for about three weeks in order that the organs may become 
habituated to its operation, and is afterward increased to twelve grains 
each time, beyond which it is not necessary to carry the remedy, because 
of its influence being sufficient. The twelve-grain dose is continued from 
two to four weeks. 

2. After each dose of conium, as well as at meals, the patient uses a 
glass of the decoction of sarsaparilla. 

3. Only the third of the ordinary quantity of food is allowed, which 
ought to be very simple and divided into three small meals. 

4. If the conium disagrees in one form it should be given in another 
or the aconitum may be used instead, but in lesser quantity than the 
conium. Toward the end of the treatment the dose of the conium is 
gradually diminished and the diet gradually increased. 

Further Remedies. — The only class of remedies which can be expected 
to afford any essential benefit are those that are capable of inducing a 
new condition in the system by modifying the function of nutrition, such 
as the various preparations of iodine, combined with a thorough change 
of everything surrounding the individual. The cachexia is the real mor- 
bid condition and the cancerous affections in particular organs are but so 
many evidences of it, as tubercles in the lungs are mere expressions or 
indications of another form of cachexia, equally possessing the whole 
system. Hence it is that cancerous tumors on the external parts of the 
body are so apt to recur after they have been removed by the surgeon. 

Removal of Tumors. — Still it must be admitted that in cases of scir- 
rhus tumors, when they have been removed early, there has very fre- 
quently been no return of the disease. In such cases the cachexia has been 
less strongly marked and time, apparently, has not been permitted for the 



376' CONSTITUTIONAL DISEASES. 

local mischief to increase the morbid disposition. It would seem, too, that 
the particular species of cancer influences the probability of recovery. 
There are a few examples of permanent recovery after the removal of 
encephaloid tumors. 

Remedies for Cancerous Fevers — The remedies best calculated to pre- 
vent, remove or mitigate the local and general effects of carcinoma of 
internal organs vary with the nature of these effects and the seat of the 
disease. The state of irritation and fever and pain, at whatever period of 
the disease they may occur, may be greatly moderated by the use of 
conium, aconitum, opium, hyoscyamus, the acetate or muriate of morphia, 
while at the same time the use of all kinds of stimuli is to be avoided, par- 
ticularly if the digestive organs be the seat of the disease, and the patient 
himself kept as much as possible in a state of quiet of body and mind. 

Treatment. — When cessation of pain and a. return of strength and ap- 
petite take place, treatment is suspended for a month. It is then resumed 
for two consecutive months, then suspended for two months, and recom- 
menced, continuing during a month. This plan is pursued for at least 
two years, which by pursuing the patient is not only greatly benefited, 
but frequently cured. 

Ferruginous preparations must not be omitted when there is great 
anemia caused by profuse hemorrhage or imperfect nutrition. 

Hemorrhages. — Hemorrhages are treated by rhatamy, sulphuric acid 
and ice. When they have been arrested, and when the pain is subdued, 
bitters, such as the decoction of cinchona, infusion of quassia, or of Col- 
umbo root, are given; sometimes also certain remedies which combine 
bitter with slightly purgative properties, such as rhubarb, are used; and 
finally the preparations of iron. 

Classes of Remedies — The only class of remedies that can be expected 
to afford any essential benefit are those that are capable of inducing a new 
condition in the system, by modifying the function of nutrition, such as 
the various preparations of iodine, combined with a thorough change of 
everything surrounding the individual. The cachexia is the real morbid 
condition, and the cancerous affections in particular organs are but so 
many evidences of it, as tubercles in the lungs are mere expressions or 
indications of another form of cachexia, equally possessing the whole sys- 
tem. Hence it is that cancerous tumors on the external parts of the body 
are so apt to recur after they have been removed by the surgeon. Still it 
must be admitted that in cases of cancerous tumors, when they have been 
removed early, there has been frequently no return of the disease. In 






cancer, or malignant disease. 377 

such cases the cachexia has been less strongly marked, and time, ap- 
parently, has not been permitted for the local mischief to increase the 
morbid disposition. 

Mitigation of Pain — When the carcinoma or cancerous disease has 
arrived at that period when the cancerous cachexia announces the exten- 
sive and fatal termination of the disease, the efforts of the physician must 
be directed solely to the mitigation of the sufferings of the patient. If 
this symptom were removed, there are many cases in which carcinoma 
would run- a much longer course, and give rise to comparatively little 
functional derangement. 

Termination of Cancer. — With regard to the termination of cancerous 
affections of the hollow organs, it takes place frequently in the uterus and 
stomach, the rectum and urinary bladder, the transverse arch of the colon 
and jejunum, and the peritoneum. The perforation of the rectum, blad- 
der and peritoneum is the consequence of the extension of the disease from 
the uterus ; that of the transverse arch of the colon, the consequence of its 
extension from the stomach. 

If the os uteri be the seat of the disease additional benefit may be 
derived from the use of leeches applied to this part, and also sedative in- 
jections. It is only in this latter situation that sloughing and ulceration 
can be detected, and local remedies applied to remove some of the dis- 
agreeable effects of the one, or retard the progress of the other. Anti- 
septic disinfectants are perhaps the best remedies we can employ in this 
case, as they not only destroy the disgusting odor which accompanies this 
stage of the disease but remove the putrid and irritating fluids which are 
then discharged. The retention of the contents of hollow organs from 
compression or obstruction is an occurrence to be guarded against by regu- 
lating the quantity and quality of food, for negligence in this respect may 
be followed by fatal consequences if the obstacle be situated in the in- 
testines. 

Further General Treatment. — The same general treatment is applic- 
able to all forms of cancer. If the growth be well defined, as in carcinoma 
of the breast, of not very long standing and not involving neighboring 
lymphatic glands, it may be removed, but severe hemorrhage from a large 
encephaloid cancer or the complication of important structures in any 
variety having deep attachments will preclude any operative procedure. 
Even when extirpated under favorable conditions it is very apt to return, 
eventually to destroy the patient. The removal of epithelial growths by 
the knife, or their destruction by caustic applications before glandular 



378 CONSTITUTIONAL DISEASES. 

evolvement has supervened, in many instances may effect a permanent 
cure. In the last few years the X-ray has been used in the treatment 
of cancer with marked benefit, especially the external variety. In fact, 
many cures are reported. 

Care in Removing Cancerous Growths. — When a cancerous tumor has 
been removed all surrounding parts should be carefully examined, because 
it is not uncommon to find small cancerous tubercles in the connective 
tissue, fascia or muscular sheaths, which, if passed by unheeded, would 
soon increase and give rise to a recurrent growth. 

COLLOID. 

Characteristics. — This new growth, formerly called colloid cancer, 
gelatinous or gum cancer, is no longer considered to be malignant, in the 
sense of its having the power to infect other and distant portions of the 
system. Its great characteristic is the formation of a new growth in the 
large open meshes of which it exists a glue-like, gelatinous, transparent 
substance like half dissolved gum arabic. This matter is strikingly trans- 
parent. Greenish-yellow is. its predominant hue. This jelly-like matter 
is exceedingly soft; a colloid mass is, however, firm and resisting; al- 
though not aj3t to be produced elsewhere, these growths may obtain an 
immense size and even prove fatal by the disturbances which they cause 
in the system. Fortunately they are quite rare in this country. 

LUPUS OR NOLI ME TANGERE. 

Character. — This is a spreading, tuberculosis inflammation of the 
skin, usually of the face, tending to destructive ulceration. Its name is 
supposed to be derived from a fancied resemblance which the sores left 
in the progress of the disease have to the bite of a wolf. 

Symptoms. — 1. The "lupus erythematosus" occurs chiefly upon the 
face, and is symmetrical; each patch has well-defined edges and a red, 
scaly surface with small horny points upon it, due to accumulation in the 
dilated mouths of sebaceous ducts. 

2. The "lupus vulgaris" has its origin in a skin tubercle, or tubercles, 
of a flat form, fleshy consistence and pink, shining appearance, and these 
at times ulcerate. This lupus ulceration, when once originated, progresses 
steadily, destroying every tissue it attacks, and when it reaches the nose, 
its favorite seat, it simulates cancer. 

Treatment. — In the treatment of lupus, although the disease has 



ELEPHANTIASIS OK TRUE LEPROSY. : >~D 

probably a constitutional origin and requires tonic treatment, both by 
medicine and regimen, there is no disease that derives more benefit from 
local treatment. Quinine, with vegetable tonics; cod-liver oil and iodide 
of potassium are all useful in this respect. When the ulceration is super- 
ficial and the skin is not deeply infiltrated, the local application of cod- 
liver oil on lint and the covering up of the part with cotton to keep it 
warm has in some cases worked wonders. 

ELEPHANTIASIS OR TRUE LEPROSY. 

Symptoms. — This is a constitutional, hereditary affection, essentially 
chronic in its nature, showing itself mainly as shining tubercles of differ- 
ent sizes, of a dusky red or livid color, on the face, the ears and often on 
the legs, the skin being thickened, wrinkled, rough, unctuous, devoid of 
hair, and the perspiration from it highly offensive. After a time there is 
a circular margin enclosing the central red part free from scales and quite 
resembling the irregular scaliness of psoriasis. 

When the local disease has reached its highest degree a remarkable 
constitutional affection appears. The patient then becomes very languid, 
asthmatic, particularly at night time ; smothering fits seize him, he coughs 
violently and spasmodically, and spends the night in perfect sleepless- 
ness, falling into excessive, colliquative, clammy sweats, which give an 
intolerably fetid odor. His voice becomes weaker and hoarser, the ap- 
petite for food and drink is preternaturally increased, and the temper 
becomes gloomy. Finally, various nervous symptoms arise — fainting, 
convulsions, paralysis of some parts — and death arrives, preceded by the 
highest degree of exhaustion. 

Causes — Its origin has been ascribed to want of cleanliness and to 
unwholesome diet, especially the constant use of bad fish, to long-con- 
tinued exposure to the heat of a tropical sun, to dampness of situation or 
occupations requiring the frequent immersion of the limbs in cold water. 

Where Occurs. — The disease occurs chiefly in warm climates — Arabia, 
China, India and some of the West India Islands. 

Dry Leprosy — In this the wasting of the disease is circumscribed, and 
limited to all the muscles of the hand. The skin is thick, reddened, and 
completely anesthetic; the fleshy masses have entirely disappeared, and 
the fingers assume the shape of claws. This disease rarely attacks women. 
It is accompanied with great torpor of mind and sluggishness of body. 
Mental depression amounting to extreme melancholy is the natural con- 



380 CONSTITUTIONAL DISEASES. 

sequence of so hopeless a malady. Yet the general health, for a length of 
time suffers infinitely less than could have been anticipated, the actions 
of the respiratory and digestive organs continue longer unaffected, and 
even the cutaneous functions are still tolerably performed, as is evidenced 
by abundant perspiration. 

Progress of the Disease is very slow, and its termination, though it 
may be deferred for many years, is almost always fatal, the unfortunate 
patient being in the meantime dreadfully deformed and mutilated, and 
literally dying by inches. The patches spread slowly till the surface of 
the whole body may be at length inflicted, and its sensibility lost. There 
is neither pain nor itching, and usually no swelling. After a few months 
the internal functions become deranged, the pulse gets very slow and 
heavy, "as if moving through mud," the bowels grow costive, and there 
is much sluggishness of mind, and tendency to somnolency. The skin 
of the extremities becomes fissured and rough, and ulcers appear under 
the metatarsal or metacarpal joints — the integuments seeming to be 
simply absorbed — or sloughing off in successive layers of about half an 
inch in diameter, without any previous tumor, suppuration or, pain. A 
serous discharge ensues and there is loss of sensation and a tendency to 
ulceration and death of the parts. In the advanced stage of the disease 
the eyes are fierce and staring, and the voice hoarse and nasal. 

Character. — Leprosy is not a contagious disease, but is propagated by 
inheritance, depending on some specific taint transmitted from parents 
to children. The two forms of this horrible disorder are the tuberculated 
and the non-tuber cul at ed or anesthetic. 

Treatment. — The only hope of exterminating this dreadful disease 
appears to lie in the adoption of hygienic measures tending to improve 
the general condition, both physical and moral, of the leprous poor. 
"Without this medical treatment is of little or no avail, but, with the aid 
of improved sanitary surroundings, tonics and alteratives, especially prep- 
arations of iron and iodine, have a very beneficial effect. Much may be 
hoped also from the systematic employment of baths, either saline or 
sulphureted, in this affection. 

Leprosy Germ. — A bacteria claimed to be the cause of leprosy, and 
named the bacillus leprar, was discovered in Norway in 1874, and its 
existence in the tubercles of this disease has been confirmed, although its 
causative power has not yet been completely demonstrated. 

An internal and external remedy is as follows: 



SCROFULA. 381 

Corrosive sublimate 2 grains 

Bismuth subnitrate ................ ..._._._... 1 drachm 

Amylum % drachm 

Arsenious acid 20 grains 

Cosmoline 1 ounce 

Make ointment. Over a patch of skin three or four inches 
square rub the ointment in well once daily for about two weeks, 
then treat a fresh portion until the body is covered. 



SCROFULA. 

Causes. — A blood disease manifesting itself in a great variety of 
organs and characterized when fully developed by the presence of a pecu- 
liar unorganized matter termed scrofulous. The causes are chiefly her- 
editary transmission and deprivation of pure air. It is closely allied to 
pulmonary consumption. 

Symptoms. — The scrofulous habit, when strongly marked, is easily 
recognized. The skin is usually delicate and irritable ; the patient suffers 
very readily from chilblains, and in childhood is more liable than others 
to cutaneous diseases. The mucous membranes partake the delicacy and 
irritability of the skin. The edges of the eyelids are apt to be red and 
swollen; the eye is very liable to be attacked by inflammations; hemor- 
rhages from the nose, cold in the head and enlarged tonsils are frequent. 
The muscles commonly want firmness, and the whole system is deficient 
in stamina. 

Diagnosis. — Scrofula is eminently a disease of childhood, while con- 
sumption belongs to a later period, but neither is confined to any age. 
One of the forms in which scrofula most commonly and earliest shows 
itself is swelling of the lymphatic glands in various parts of the body, 
more particularly about the neck. These become enlarged and firmer, 
and after a time a deposition of the peculiar curd-Jike matter is found to 
have taken place in their interior. After a time suppuration occurs, the 
swellings become softer and the skin over them assumes a dusky red hue, 
gradually becomes thinner and finally bursts, giving outlet to an un- 
healthy pus mixed with the curd-like deposit of the disease. The ulcers 
left heal slowly and with difficulty, and unless great care is exercised pro- 
duce deformed cicatrices. 

Treatment. — 1. In the constitutional treatment of these cases of stru- 
mous adenitis, nutritious food, suitable warm clothing, attention to clean- 
liness and residence in pure air are the most important requisites. Iodine 
in its different forms, especially the syrup of the iodide of iron, is given 



382 CONSTITUTIONAL DISEASES. 

in doses of twenty-five drops thrice daily, and quinine and iro^ each in 
grain doses three times a day, with one-sixteenth of a grain of arsenic, or 
phosphites and hypophosphites of lime and magnesia, in tablespoon doses 
of the syrup, are frequently of great service. Also the iodide of am- 
monium in three-grain doses three times a day. 

2. In endeavoring to produce a reduction of the swollen glands by 
causing an absorption of the contents, the tincture of iodine painted on 
with a camel' s-hair brush, or small feather, so as to smart severely but 
not to raise a blister, and repeated daily for a week or so until the skin 
peels off is a valuable resource. A milder application of the same remedy 
is by the use of the ointment of iodine rubbed into the skin over the en- 
larged gland, night and morning, for weeks and even months if requisite. 

3. Cod-liver oil is an anti-strumous remedy of great power, and is 
more readily taken by the young than by adults; generally sea bathing 
and sea air are mostly the best of remedies. 

Ophthalmia. — Strumous ophthalmia occurs in children between the 
time of weaning and the end of the ninth or tenth year. Its chief symp- 
toms are redness of the white of the eye, with the formation of little 
blisters or pustles, often ending in minute ulcers on the cornea or clear 
portion. The eyes water very freely, and the intolerance of light is exces- 
sive, so much so as almost to be indicative of the disease. 

Treatment. — The management of these cases will tax the skill of both 
nurse and doctor to the fullest extent, although internal remedies are 
often also required, the nursing and outward applications are the most 
important. Great attention must be paid to cleanliness, and warm bath- 
ing of the eyes with anodyne fomentations are very serviceable. Appli- 
cations of the wine of opium or of a solution of nitrate of silver, of a 
strength of from iive to ten grains in an ounce of water, although they 
smart severely at first are often of very great benefit. 

Diet. — Good diet is indispensable in strumous affections. Hence the 
invalid should have all the advantages of an abundance of good mutton 
and beef, vegetables and ripe fruits in season, raw eggs, milk and cream, 
tepid or cool baths and sea air. 

PRESCRIPTION i. 

R. — Cod-liver oil and hypophosphites 5 ounces 

One or two tablespoonfuls three times a day. 



RICKETS. 383 

PRESCRIPTION 2. 

R. — Citrate of iron and quinine 10 grains 

Cod-liver oil I ounce 

Glycerine I " 

Take a tablespoonful three times a day. 

RICKETS. 

Causes. — The cause of rickets seems to be anything which induces 
enfeebled assimilation of food and impaired nutrition of body. Hence 
this affection is sometimes met with in such weakly children of even 
wealthy parents as suffer from defective action of the vital forces. Like 
scrofula, it is, however, especially a disease of the poorer classes. Insuffi- 
cient and especially improper food, the constant respiration of foul, im- 
pure air, residence in dark, damp, cold or filthy dwellings, these and sim- 
ilar circumstances readily serve, in all probability, to generate rickets. 

Symptoms. — This disease rarely appears before the seventh month, 
and most commonly does not declare itself until the child first begins his 
attempt to walk. When a child is about to be affected with rickets he 
becomes dull and languid, the appetite is variable and capricious, the 
bowels are irregular, the stools unhealthy and usually pale. Constitu- 
tional disturbance now arises, and a febrile state is soon established; the 
limbs become emaciated; the belly tumid; the face full and the head dis- 
proportionately large; the forehead projecting, and the sutures of the 
cranium remaining open or perhaps expanding slightly. The extremities 
of the long bones which are least concealed by muscle, as those of the 
wrists and ankles, and the sternal ends of the ribs, particularly these last, 
are swelled out into knobs. The legs begin to bend outward at the knee, 
giving rise to the deformity of bow-legs, or less frequently the knees are 
thrown forward and the feet outward, making the child what is called 
knock-kneed, and usually crippling it more or less for life. The bones 
of the arms and the collar bones may also become very much curved and 
twisted, showing that the popular delusion as to the cause of bow-legs has 
little foundation in fact. The deformity of the chest is often very great, 
the back being flattened, the breast bone pushed forward and the natural 
curve of the ribs lessened. In such cases the child is said to be pigeon- 
breasted. 

Diagnosis — This, of course, must be difficult in the early stage, as 
the symptoms closely resemble scrofula at that time, but after the curva- 
ture of the bones commences there can no longer be any doubt, as such 
softening of the bones during childhood only occurs in rickets. 



384 CONSTITUTIONAL DISEASES. 

Treatment. — The medical treatment of rickets must be subordinate 
to the hygienic, since far more depends upon good food, proper clothing 
and pure air than on drug medication. Milk diluted with limewater, Lie- 
big's food, and, if the infant is old enough, beef tea, extract of beef, raw 
meat, eggs, and so forth, should be given in abundance. The phosphates 
or hypophosphates of iron, lime, quinine and strychnia, as recommended 
when treating of scrofula, are very useful, and if the child is capable of 
digesting cod-liver oil it ought also to be administered. Should the diar- 
rhoea be troublesome a chalk and soda mixture, containing a grain of each 
as a dose for a baby one year old, or a mixture containing a grain of bis- 
muth in each dose for an infant of that age will probably be of essential 
service, and after the feverish symptoms are controlled the child, in suit- 
able weather, should almost live in the open air, especially if a seaside 
atmosphere can be obtained. 

Diet. — If the disease has occurred at a very early age it may be 
advisable to try the effect of changing the wet-nurse; and in general it 
will be proper to wean the child about the end of the ninth month, for 
protracted suckling is certainly one of the debilitating causes which dis- 
pose to rickets. While the child continues at the breast the diet of the 
nurse or mother ought to be carefully attended to, in order that the milk 
may prove nutritious and easy of digestion ; or its powers may be assisted 
by allowing the infant, in addition, small quantities of gelatin, beef tea, 
or yolk of egg, provided the absence of febrile excitement will permit. 
After the child has been weaned the diet must be suited to the degree of 
constitutional irritation which exists; but one leading principle should 
be to support the strength as much as possible without quickening the 
circulation or oppressing the stomach. 

CRETINISM. * 

Causes. — A condition of persons in. whom partial or complete idiocy 
is combined with great bodily deformity of the whole body, due to bad 
water, lack of sunlight, and life in deep valleys like those of the Alps. 

Symptoms. — There are three varieties, first, complete or incurable 
cretinism, which is characterized by idiocy, deaf-dumbness, deficiency of 
general sensibility and entire absence of reproductive power; second, 
semi-cretinism, which is a degree of the malady in which the mental 
faculties are limited to the impressions of the sense and the bodily wants. 
The general sensibility is obtuse, the head is badly formed and drooping, 



DIABETES OR DIABETES MELLITUS. 385 

the speech is rudimentary and the reproductive powers are feeble or 
absent ; third, incomplete or curable cretinism, in which the mental facul- 
ties, though limited, are capable of development. 

Treatment. — 1. The first thing to be accomplished is the removal of 
the young cretin, as soon as possible after the disease exhibits itself, to a 
pure, bracing atmosphere. 

2. The treatment requires an abundance of pure water for drinking, 
washing and bathing ; warm and cold baths and douches ; friction of the 
skin with brushes and stimulating liquids to rouse its action; warm 
clothing ; mineral tonics ; nourishing food ; iodine, cod-liver oil and phos- 
phates. The effort to develop the mind must follow the attempt to re- 
store the body to a healthy condition. 

DIABETES Oft DIABETES MELLITUS. 

Causes. — Twice as many men as women have this disease : It is most 
frequent among young and middle-aged adults; the mortality from it 
being greatest from fifteen to fifty-five. It is more common in cities and 
manufacturing districts than in the open country; occasionally it is 
hereditary. The exciting causes appear to be exposure to cold and wet; 
drinking cold water largely when heated; excessive use of saccharine 
food; intemperance; violent emotion; febrile diseases, and organic affec- 
lions and injuries of the brain and spinal cord. 

Symptoms. — In this remarkable disease there is an excessive discharge 
of urine containing grape-sugar, the saccharine principle of grapes and of 
honey called glucose, being produced in the body in great quantity and 
eliminated from the kidneys. The exhaustion, which results from the 
immense loss of fluid, sometimes amounting to several gallons daily, is 
often accompanied by other disturbances of the system due to the presence 
of sugar in the other secretions and in the blood and to the modifications 
of the nutrition thus effected ; opacity of the crystalline lens of the eye — 
constituting diabetic cataract — is occasionally one of the modifications of 
structure; shrinking of the substance of the brain is another, and a 
peculiar form of inflammation of the lungs is another. It is a disease 
which commonly, after a longer or shorter course, proves fatal. 

Diagnosis — The detection of sugar in the urine, not temporarily, but 
for a considerable time, is of itself sufficient to make out the case. 

Prognosis. — Eecovery is not impossible in diabetes, but a large ma- 
jority of cases end in death. Amelioration — keeping the disease in 
abeyance — is often an attainable end. 



386 CONSTITUTIONAL DISEASES. 

Treatment. — The most positive influence in diminishing the disease 
belongs to opium or codeina ; but this does not appear to interfere with the 
progress of the disease. The alkalies, pepsin, iron, quinine, salicylate of 
soda, alum, iodine, nitric acid, turpentine and the inhalation of oxygen 
have all been employed. 

Diet. — Since it is found that the amount of sugar discharged in the 
urine fluctuates very much in accordance with the starchy and saccharine 
materials which are eaten, it is the best for the diet of a diabetic patient 
to be freed, as far as possible, from substances which can be converted 
into glucose by the digestive organs. Hence the effort should be, in 
treating diabetes, to abstain from all starchy food as well as from every 
solid and liquid containing sugar. That meat and eggs may be taken, as 
a derangement of the liver is not found to be produced by them, and fish 
is a most important article with which to vary the monotony of the diet. 
Skimmed milk appears to answer a very good purpose in this disease. 

The following prescription is of value in diabetes mellitus: 

R. — Salicylate of soda 3 drachms 

Fowler's solution 1 drachm 

Glycerine * 1 ounce 

Water 1 V 2 ounces 

Mix and take a teaspoonful three times a day. 

PURPURA OR LAND SCURVY. 

Causes. — It chiefly occurs in individuals of delicate habit or enfeebled 
by their occupations or mode of life ; by confined, low or damp habitations, 
scanty food, hard labor, grief, anxiety, fatigue and watching. On the 
other hand purpura frequently occurs where no causes of a debilitating or 
depressing nature can be supposed to have existed. 

Varieties — The two varieties which are distinguished are the simple 
and the hemorrhagic, in the latter of which the malady is accompanied 
by bleeding from some of the mucous membranes of the body. 

Symptoms. — Various symptoms denoting general disorder of the 
system precede the appearance of the spots in purpura, generally for 
some weeks. In most instances languor, weariness on very slight exer- 
tion, faintness and gnawing pains in the stomach are complained of. The 
appetite is variable, generally poor, but sometimes there is an inordinate 
desire or craving for food. The tongue is yellowish and coated with a 
viscid fur, the countenance sallow or dingy, or the face may have a pale 
and bloated appearance with swelling beneath the eyelids. The purple 



PURPURA OR LAND SCURVY. 387 

^•pots usually appear upon the legs and afterward without any certain 
order on the thighs, arms and trunk of the body, and their formation is 
attended with great weakness and much depression of spirits. Deep- 
seated pains are felt about the region of the stomach as well as in the 
chest and loins. One of the most distressing and dangerous symptoms is 
when the patient becomes of a sallow complexion, waxy-colored and dingy, 
dropsical swellings of the feet and legs with deep and gangrenous sores 
appear, general dropsy often prevails and the sufferer dies exhausted. 

Diagnosis. — The diseases with which purpura is most likely to be 
confounded are typhus fever attended with scurvy. The origin and course 
of the complaint, the period at which the petechia? appear, the extent and 
variety of the accompanying hemorrhages will make its diagnosis clear. 

Treatment. — 1. In the treatment of this disease we are not to be 
guided by the name or external appearances, but by diligent attention to 
the symptoms and especially to the state of the functions and the habit and 
constitution of the patient. Where high excitement prevails with strength 
of pulse and vigor of constitution, and we have reason to suspect inflam- 
mation, purging, with a suitable antiphlogistic diet, are the appropriate 
remedies. 

2. Where a quite opposite state exists all active depletion must be 
abstained from and the strength supported by beef-tea and other meat 
nutriment ; at the same time tonics, such as quinine or Peruvian bark, the 
diluted mineral acids in five or ten-drop doses, iron and strychnine, must 
be administered. 

The following offers a good treatment: 

R. — Syrup of the superphosphate of iron., i% ounces 

Liquor of peroxide of hydrogen i% " 

Glycerine I Vi " 

Water i% " 

Take a tablespoon ful three times a day. 



Or, 



R. — Oil of turpentine 3 drachms 

Fluid extract of digitalis i drachm 

Mucilage gum-arabic iV> ounces 

Peppermint water I ounce 

Make an emulsion. Take a teaspoonful every three 
hours. 



388 CONSTITUTIONAL DISEASES. 

SCORBUTUS OR SCURVY. 

Character This is a disease allied to purpura, but attended with a 

spongy condition of the gums, and livid patches under the skin of consid- 
erable extent, which are harder than the surrounding structure. It has 
been stigmatized as the great plague of the ocean, and has been denomi- 
nated sea scurvy to distinguish it from land scurvy or purpura. 

Causes. — That the essential cause of scurvy is deprivation of fresh 
food, and, in almost all cases, of fresh vegetable food, is proved. Fresh 
meat will retard it in the absence of vegetables, but neither this or oranges 
and lemons will altogether prevent it through long periods. Additional 
promotive causes are severe cold, fatigue, exposure and mental anxiety or 
home-sickness. 

Symptoms. — 1. Languor, debility and lowness of spirits first occur; 
then swelling, sponginess and bleeding of the gums; the teeth loosen, and 
the breath is offensive. Palpitation of the heart and dyspnoea may be 
present. Spots (from subcutaneous extravasation of blood) appear on the 
limbs. Diarrhoea and dysentery often come on. Death may take place 
by a gradual exhaustion or by sudden syncope. 

2. A remarkable peculiarity of scurvy is the readiness with which all 
parts of the body suffer from pressure, and the slightest possible blow 
may produce an extensive bruise, a small eruption like flea-bites is often 
to be seen on the legs, and about the same time the muscles of the legs and 
thighs are apt to become hard and painful, and in a day or two the skin 
over the painful part grows yellow and then purple. These purple spots 
may be as large as the palm of the hand at first, and are liable to extend 
until they cover half of the limb. 

3. As the disease advances all the symptoms become aggravated. The 
loss of physical power increases, the purple spots have a tendency to 
ulcerate, and the resulting ulcers are especially distinguished by their 
putrid fungoid appearance, and their great tendency to bleed. 

Diagnosis. — Purpura hemorrhagica is undoubtedly not identical with 
scurvy, although "purpuric" extravasations are common to both. Pur- 
pura does not depend, as scurvy does chiefly, upon a fault of diet ; nor are 
the gums affected in purpura. 

Treatment. — 1. The great remedy for scurvy is lemon or lime juice ; 

in seemingly desperate cases the most quick and sensible relief has been 

obtained from lemon juice, when no other remedy seemed to avail. When 

the acid operates violently upon the stomach and bowels of those who are 



ANEMIA. 



389 



much weakened, the addition of wine and sugar is strongly recom- 
mended. 

2. A solution of nitrate of potash in vinegar has been most advan- 
tageously made use of in the proportion of one ounce of nitrate in one 
quart of vinegar, and a tablespoonful of this given two or three .times 
a day. 

3. Fresh vegetables alone will restore what is wanting. Potatoes, 
tomatoes, oranges and lemonade are the most generally available articles. 
If any medicine is useful as an adjuvant, it is the tincture of the chloride 
of iron in moderate doses. Sometimes citric acid does good. For the 
gums a wash of tannic acid or tincture of myrrh in diluted glycerine will 
be useful, or alum, brandy and water. Salt and whiskey rubbing of the 
skin will aid in dissipating the petechia?. 

Diet. — Medical men in charge of expeditions to a distance, for ordi- 
nary supplies should always insist on measures being taken to furnish 
enough fresh vegetables, or, next best, dessicated potatoes; after the latter 
onions, tomatoes, turnips, and so forth, and oranges and lemons rank. 
Wine is also decidedly though not inf alliby anti-scorbutic. 

The following is a good anti-scurvy remedy : 

R. — Common salt io scruples 

Chlorate of potash V-i ounce 

Rochelle salts 5 scruples 

Phosphate of soda 3 scruples 

Lemon juice 6 ounces 

Syrup of lemon 14 ounces 

Water 7 pints 

To be used as a drink several times a day. 

ANEMIA. 

Causes. — Poverty of blood. This is a special, morbid state, in which 
there is fullness of the surface of the body and deficiency of the red 
corpuscles of the blood. It is a common affection among women, and per- 
sons of both sexes who are ill-fed, or from any cause badly nourished, in 
crowded localities. It is occasioned by loss of blood, from disease or injury 
causing hemorrhage, from excessive suckling in a mother or wet-nurse, 
severe or protracted diarrhoea, or (more rarely) leucorrhea, typhoid or 
other forms of fever ; the malarial influence, sustained for a considerable 
time ; deficiency of food, light, warmth, or fresh air. 

Symptoms. — The face, the hands, and the general surface are pallid 
and slightly waxen or icteroid in their hue. There are vertigo, faintish- 



390 CONSTITUTIONAL DISEASES. 

ness, palpitation and an impaired action of the organs generally, especially 
of the stomach and bowels; digestion being deranged, with flatulency, 
constipation, and so forth. 

Diagnosis. — This is very much aided by the detection of various mur- 
murs, as the watery blood passes through the heart and larger veins. 
The jugular veins of the neck are often the seat of a well-marked venous 
hum in profound anemia. 

Treatment. — 1. In almost all cases it is essential to put the patient on 
nourishing diet, and especially where the anemia has been caused by im- 
perfect nourishment; yet care must be taken in the very impressible con- 
dition of the system which exists in these cases, that undue excitement be 
not induced. 

2. Our first effort should be to supply the materials for enriching the 
blood, and especially those which are necessary to construct the red corpus- 
cles, a deficiency of which appears to be the essential element in this 
malady. Iron, which enters into their constitution more abundantly 
than of any other tissues of the body, is hence obviously called for, and 
should be administered in whatever form can best be assimilated. Where 
it is well tolerated there is probably no better preparation than tincture 
of the chloride of iron, in twenty-drop doses three times daily, 

3. In cases where the tincture of the chloride of iron is not applic- 
able, or is objected to by the patient, the powdered iron, called also iron 
reduced by hydrogen, in doses of a grain thrice daily, can almost always 
be borne, and is frequently of the greatest service. All the compounds 
of iron require, however, to be used for a long time, usually several 
weeks and often for several months, in order to cure the anemic condition. 

4. The citrate of iron or the citrate of iron and quinine, in doses of 
from three to five grains, possesses one great advantage over many other 
preparations of this useful metal in the fact that while perfectly soluble 
they produce upon the organs of taste little of that styptic or ink-like im- 
pression which to many persons is so exceedingly disagreeable. The beef, 
wine and iron is also a most valuable remedial agent when properly pre- 
pared. 

Diet — The best food which the stomach can digest, and there is no 
doubt that the iron which exists in beef and mutton and gives much of its 
red color to the muscular fibres of the flesh, is in the most favorable state 
for assimilation into the human system, and often has a large share in the 
improvement which we are perhaps too ready to attribute to the chemical 
compounds prescribed. 



GENERAL DROPSY. 391 

R. — Corrosive sublimate 2 grains 

Liquor of chloride of arsenic 1 drachm 

Diluted hydrochloric acid V-i ounce 

Tincture chloride of iron Y2 ounce 

Syrup 3 ounces 

Water . . . . * 2 ounces 

Take a dessertspoonful in a wineglass of water after 
each meal. 

BERI-BERI. 

This is a very fatal but obscure disease occurring in Ceylon, the 
Malabar coast and outer ports of British India. 

Causes. — The causes are very obscure. It is a disease of debility, 
arising from a want of stimulating and nourishing diet, impure air and 
exposure to a moist and marshy atmosphere while the frame is debilitated 
by residence in an unhealthy station. 

Symptoms — It commences with the symptoms of anemia and pro- 
ceeds to the development of acute dropsy. 

Diagnosis. — The paralytic symptoms, together with the dyspnoea and 
dropsical effusions are sufficient to distinguish it from other diseases. In 
no disease is internal congestion so strongly marked, doubtlessly due to 
the congestion of blood in the brain and spinal marrow. 

Treatment. — 1. Mercury here appears to be the sheet-anchor, but must 
be administered to produce ptyalism. Saline and antimonial medicines 
will be called for and the strength supported by cordial liquors. Stimu- 
lating liniments should be applied to the extremities and a tonic plan of 
treatment pursued. 

2. In the more severe cases where the dyspnoea, vomiting, spasms 
and other symptoms are violent apply blisters to the breast, hot fomenta- 
tions and hot baths, and exhibit the strongest cordials and antispasmodics. 

R. — Muriate of pilocarpine 3 grains 

Water x k ounce 

Inject io to 20 minims with hypodermic syringe. 

GENERAL DROPSY. 

Definition. — A morbid collection of fluid in one or more of the serous 
cavities within the body or in the areolar tissue beneath the skin and in 
other situations. 

Causes. — A dropsical accumulation is to be distinguished from the 
effusion of liquid which takes place in certain inflammatory diseases, 



392 CONSTITUTIONAL DISEASES. 

pleurisy, peritonitis, pericarditis, and so forth. In other diseases the 
effusion is due to inflammation, whereas in dropsy transudation takes place 
intact, the part where it occurs being inflamed. 

Local Dropsy. — Dropsy may be local or general. It is local when the 
effusion of liquid is confined to a single serous *cavity or to the areolar 
tissue within a limited space. 

General Dropsy. — Dropsy is said to be general when effusion into the 
areolar tissue beneath the skin exists more or less over the whole body, 
accompanied with effusion into certain serous cavities, especially the 
pleural and peritoneal. 

Symptoms. — The symptoms of dropsy vary somewhat, according to 
the primary disturbance which has been the original cause of the effusion. 
If the blood is deteriorated by an undue proportion of water or is charged 
with excrementitious materials, such as urea, which ought to be eliminated 
by the kidneys in the urine, or contains a large excess of white corpuscles, 
its circulation through the capillary vessels is much impeded. The dropsy 
in these cases often begins in the form of oedema or swelling about the 
feet and ankles. The reproductive organs often become enormously 
swollen and ascites or dropsy of the abdomen soon sets in. After a time 
the increasing ascites, by pressing up the diaphragm, interferes with the 
respiration, causing distressing dyspnoea, which is more urgent in pro- 
portion as the blood is watery from anemia. The urine is often scanty 
and apt to contain an excess of urates, but it is only markedly albuminous 
when, as frequently happens, the kidneys become secondarily implicated. 
Among the latter symptoms are palpitation of the heart, deficient perspira- 
tion, mental distress, thirst, constipation, daily increasing weakness, and 
so forth. 

Symptoms of Cardiac Dropsy — Disease of the mitral or aortic valves 
in the heart is the most common cause of cardiac dropsy. The injured 
valve, sooner or later, interferes so much with the circulation that serious 
disturbances become manifest. At first, perhaps, there is only shortness 
of breath on going up a steep flight of stairs, or other active exertion, 
with some palpitation and debility, but after a few weeks or months the 
feet and ankles may begin to swell, the skin putting on a peculiar white 
and glistening appearance. As the effusion extends upward rest in the 
recumbent posture becomes impossible, and even in the sitting position 
only unrefreshing snatches of slumber can be obtained. The heart's 
action grows daily more and more embarrassed, the lungs more or less 



GENERAL DROPSY. 393 

congested and a frothy expectoration sometimes streaked with blood 
appears. 

Further Symptoms. — In the variety of general dropsy, which proceeds 
from disease of the liver, serous effusion into the cavity of the abdomen 
is the most prominent symptom. Whether the original hepatic disorder 
is congestion or hypertrophy of the liver, cancer, contraction or chronic 
hepatic inflammation, the dropsical symptoms usually commence with 
exudation of fluid into the abdominal cavity from the surface of its lining 
membrance, the peritoneum. Dropsy of the feet and legs, however, sub- 
sequently sets in. 

Acute General Dropsy. — Acute general dropsy from disease of the 
kidneys, or acute inflammatory dropsy may arise when the functions of the 
skin are suddenly suppressed, thus allowing certain morbid materials to 
accumulate in the blood and to set up inflammation in the secreting 
tubes of the kidneys. Typical examples of this form of dropsy are seen 
when, from exposure to cold, the action of the skin is checked during the 
stage of desquamation of scarlet fever, compelling the kidneys to remove 
the scarlatinal poison from the system when it seems to be particularly 
obnoxious to the renal tissues. In such cases the urine either gradually 
or all at once becomes scanty, dark brown in color, and on being tested 
by boiling is found to be loaded with albumen. 

Diagnosis. — The diagnosis of dropsy is usually made with ease, by the 
fact that the indentation produced on firm pressure with the finger upon 
the enlarged foot remains for a minute or so before it is filled up by 
return of the watery fluid into the connective tissue. This evidence of the 
existence of dropsy is most conclusively obtained when the test is applied 
over some bone which naturally lies only a little way beneath the skin, 
as for example, the breast-bone or the shin-bone. 

Treatment. — 1. The treatment of dropsy, either local or general, in- 
volves measures indicated by the diseases which stand in a causative rela- 
tion to the dropsy. Exclusive of these indications it is often an object of 
treatment to effect either removal or diminution of the dropsical accumu- 
lation. Remedies which produce watery evacuations from the bowels, and 
those which increase the secretion of urine are chiefly relied upon for this. 

2. The liquid in serous cavities may be removed by a puncture or an 
incision, an operation called paracentesis, or, commonly, tapping. In some 
cases of dropsy of the chest paracentesis is resorted to. Tapping of the 
abdomen is often employed, and is in many cases useful, not only by 
relieving suffering but promoting recovery. 



394 CONSTITUTIONAL DISEASES. 

3. In cases of general oedema or anasarca, if the effusion be very 
large, great relief is sometimes obtained by minute punctures of the lower 
limbs, through which the serum drains away in abundance. 

4. Where the acute general dropsy is dependent upon suppression of 
the action of the skin and kidneys, active purgation and the use of diuret- 
ics are to be employed. Jalap and cream of tartar (ten grains of the 
former with three drachms of the latter) every day or two will answer 
well for catharsis. A strong cathartic is croton-oil. The dose is a single 
drop, and this will operate in many instances most violently, producing 
within half an hour sickness, vomiting and profuse alvine evacuations. 

Diuretics. — The diuretics most satisfactory are the infusion of juniper 
berries (a pint daily), acetate of potash, citrate of potash, squills and 
sweet spirits of nitre. Colchicum is perhaps the most powerful of 
remedies, and we have succeeded with it in conjunction with mercurials 
in acting upon the kidneys in hepatic disease when no other remedy had 
any effect. Tonics, anodynes, and so forth, may, in visceral dropsy, be of 
more importance than diuretics. Of course it is desirable to lessen the ac- 
cumulation of fluid, but the effects of the remedies used must be carefully 
observed, and one symptom must not be allowed to overshadow all the 
rest. 

Diet. — In general dropsy attention to the diet is very important and 
efforts should be made to restrict the patient to the smallest amount of 
fluid with which he can sustain life comfortably. With respect to the 
nicer question of food, dry articles 'of food should be selected. It must 
be varied with the nature of the dropsy and the symptoms with which 
it is attended, and whoever understands the meaning of a phlogistic (in- 
flammatory) and antiphlogistic (opposed to inflammation) regimen will 
know how to apply either of these, or to vary from one to the other, as 
circumstances may require. 

For general dropsy: 

R. — Powdered jalap 20 grains 

Cream of tartar 3 drachms 

Powdered ginger 5 grains 

To be taken at one dose before breakfast, two or three 
times a week. 

Dropsy of kidneys : 

R. — Tincture digitalis I drachm 

Infusion of buchu 4 ounces 

Water . 4 ounces 

Take a teaspoonful every three hours. 



bkight's disease. " 39, 



Heart dropsy: 



R. — Strychina Sulph. f grains 

Bascham's Mixture 4 ounces 

Two teaspoonfuls 3 times a day. 

BRIGHT'S DISEASE. 

Albuminuria, dependent upon structural change in the kidneys, or 
to speak more correctly, disease of the kidney, characterized by albumen 
and dropsy. 

Causes. — It is a glandular disease of the cortical part of the kidney 
which gives occasion to the secretion of urine, which contains albumen 
and is of less specific gravity than natural, and which destroys by induc- 
ing other diseases. It is one-third more common in males than in females. 
It mostly occurs between the ages of forty-five and sixty-five. Acute 
Bright's disease is most often produced by cold and dampness, next by 
scarlet fever, pregnancy, or violent intemperance. The chronic form is 
greatly promoted by exposure to cold and wet, and is caused moreover by 
abuse of spirituous liquors. Other predisposing causes are gout, consti- 
tutional syphilis and affection of the bladder and urethra. 

Acute Bright's Disease. — After exposure to cold, or a drunken fit, or 
scarlet fever, the patient is seized with chilliness, headache, nausea, vomit- 
ing, pain in the back and limbs, checking of perspiration and oppression in 
breathing. Fever follows and the face, trunk and limbs become puffy 
with anasarca. Effusion may also occur in the pleura or peritoneum. 
The urine is scanty, heavy and dark in color from the presence of blood 
and very albuminous. The disposition to void it occurs more frequently 
than in health. The deposit from it, under the microscope, shows blood- 
corpuscles, loose renal epithelium, tube-casts and shapeless masses of fibrin. 
After one, two or three weeks, or even a longer period, the attack pro- 
ceeds to one of three terminations: recovery, death or lapse into the 
chronic state. Death results through uremia, secondary pneumonia, 
pleurisy, peritonitis, hydrocephalus or ascites. Probably two-thirds or 
more of the cases in the acute form recover. 

Treatment. — Cupping the loins, hot water or hot air or "blanket 
bath," active purging, as with cream of tartar and jalap, or citrate of 
magnesium, and diaphoretics, as citrate of potash or liquor ammonia 
acetatis. 

Diet. — Should be liquid and simply nutritious. 

Chronic Bright's Disease — This approaches so slowly as seldom to be 



396 CONSTITUTIONAL DISEASES. 

detected until after the lapse of months or years. Gradual loss of 
strength, pallor or puffiness of the face, shortness of breath and frequent 
disposition to urinate are early signs of it. But they are not always 
present; the denouement of the disease may be by a convulsion, oedema 
of the lungs, dimness of vision, or some violent local inflammation. 

Symptoms. — Albuminous urine, deposits of tube-casts and renal 
epithelium, dryness of skin, frequent micturition, especially at night ; gen- 
eral dropsy, or local effusions into the cavities, indigestion, anemia, uremic 
effects (headache, dizziness of sight, convulsions, coma, vomiting, diar- 
rhoea), enlargement of the heart and secondary inflammations, bronchitis 
is especially common. The progress of the case is usually interrupted by 
exacerbations and intervals; each fresh attack leaving the patient mani- 
festly worse than before. 

Diagnosis. — The presence of albumen in the urine, with dropsy, not 
of sudden origin or brief duration, is indicative of this affection. The 
microscope will show also free renal epithelium and tubular casts in the 
urine ; in advanced cases the casts are sprinkled with oil-dots. 

Treatment. — 1. Iron will do more good than any other medicine, un- 
less it be cod-liver oil in persons of strong stomach. They may be very 
well combined. The tincture of the chloride of iron is as good as any 
other chalybeate as a general rule. With some the citrate of iron in solu- 
tion, or a carbonate, or the iodide, will agree more readily. As an 
astringent the ammonio-f erric alum is claimed to possess the power of 
checking the waste of albumen through the kidneys. 

2. For the dropsy warm baths and hydrogogue cathartics are useful. 
Of the latter cream of tartar and jalap, two or three drachms of the 
bitartrate with ten or twenty grains of jalap two or three times a week, 
are the favorites. If serious dropsical accumulations threaten life, elate- 
rium (one-sixth or one-fourth grain every four hours, in pill, until it acts) 
may be given, or the pill of squills, powdered digitalis, etc. 

3. If the warm baths do not agree or fail to produce diaphoresis try 
the hot-air bath, at 130 degrees to 150 degrees Fahrenheit. This rarely 
fails to produce free perspiration. For weaker invalids the vapor bath" 
is available. Of diuretics, acetate of potassium, spirits of nitrous ether, 
and compound spirit of juniper will be least likely to disappoint. 

4. But all will not unf requently fail. We have as a last resource for 
the relief of great oedema the use of incisions with a lancet or needle in the 
swollen legs and feet. Care should be taken that erysipelas does not fol- 



UREMIC POISONING. 397 

low, by repeated warm sponging of the limbs and washing them with 
diluted glycerine. 

Diet — Nourishing diet, of which milk may generally be part, is of 
the utmost consequence. Regimen or hygienic management is of the 
utmost importance. Avoidance of exposure to cold, wet or great fatigue ; 
the reform of intemperance, if it has existed, or all other excesses, will 
be indespensable. Clothing should be sufficiently warm, with flannel next 
to the skin. Bathing frequently at such temperature as is borne without 
either chill or relaxation, and the bowels should be kept regularly open. 

The following are approved remedies : 

R. — Chloride of soda and gold 3 grains 

Corrosive sublimate 3 grains 

Extract of gentian sufficient to make 60 pills. 
Take one three times a day. 

R. — Iodide of soda 15 grains 

Phosphate of soda % drachm 

Common salt 3 drachms 

Water sufficient to make solution. 

Divide into three equal parts, and take one part every 
eight hours. 



VR2EKIC POISONING (UREMIA). 

Uraemic poisoning (uraemia) is also known as acute uraemia, uraemia 
convulsions, uraemic intoxication and uraemic coma, according to attending 
conditions. It may be described as a group of nervous phenomena which 
sometimes develop during the course of acute or chronic Bright's disease, 
being due to the retention in the blood of what is supposed to be urea. 
An attack of acute uraemia is always serious. The outcome depends upon 
the amount of poison retained, the length of time it has been in the 
system and the condition of the organs of elimination. If there be any 
suspicion of an uraemic condition the urine should be frequently examined. 

Causes. — Suppression of urine due to Bright's disease, cancerous 
kidney, the puerperal or lying-in state, operations on the uterus, bladder, 
rectum, etc., or any condition causing the failure of the kidneys to properly 
perform their functions. 

Symptoms. — Usually before the attack there is a decrease in urinary 
secretions, although in rare instances, during or immediately prior to 
the appearance of the uraemic phenomena, the normal flow of urine may 



398 CONSTITUTIONAL DISEASES. 

largely exceed the normal amount. Commonly the onset is with headache, 
dizziness of vision, vertigo, deafness, dilated and sluggish pupils, dark, 
unnatural color of face. There is generally a chill or chilliness followed 
hy fever, but there may be cool skin from the onset. The condition may 
develop slowly and gradually or it may come on suddenly by convulsive 
seizure followed by coma. In the latter case it is sometimes mistaken for 
apoplexy, but these differences are to be noted : (a) In uraemia the patient 
has usually been suffering from dropsy, while this is not common in 
apoplexy; (b) in uraemia coma is generally preceded by the symptoms 
above discribed, while in apoplexy coma is usually immediate; (c) the 
breathing in uraemic coma causes a sharp, hissing sound, while in apoplexy 
there is snoring; (d) greater or less paralysis always occurs with apoplexy 
while in uraemia there is no paralysis. 

Treatment. — During an attack elimination should be procured by a 
drop or two of croton oil in a little sweet oil, or a quarter grain of elaterin, 
or the following enema may be used : 

Epsom Salts 2 ounces 

Glycerine . 1 ounce 

Hot Water 4 ounces 

Free sweating should be encouraged by the use of hot packs, vapor or 
hot-air baths and the administration of Jaborandi. To relieve the con- 
vulsions give inhalations of chloroform, rectum injections of chloral and 
venesection. 



PART III OF BOOK IV 

Describes the nervous diseases and their causes, 
symptoms, diagnoses, treatments and effects. 



Aphasia 423 

Symptoms of 423 

Treatment of 426 

Apoplexy 422 

Congestive 422 

Hemorrhagic 423 

Symptoms of 422 

Treatment of 423 

Arachnitis 4 J 6 

Prevention of 416 

Atrophy of the Brain 426 

Treatment of 427 

Atrophy, Progressive Muscular ....431 

Brain, Atrophy of 426 

Congestion 420 

Dropsy of 421 

Fever 409 

Fever, Symptoms of 409 

Hypertrophy of 426 

Paralysis of 404 

Softening of 401 

Catalepsy 439 

Cerebral Congestion 420 

Cerebritis 413 

Convalescence in 420 

General 414 

Suppressed Menstruation in .. .420 

Symptoms of 413 

Treatment of 416 

Chorea 438 

Chronic Meningitis 412 

Congestion, Cerebral 420 

Congestive Apoplexy 422 

Convulsions, Infantile 435 

Cramp, Writer's 428 

Croup, Causes of 437 

Spasmodic 437 

Symptoms of 438 

Treatment of 438 

Delirium Tremens 4_I3 

Symptoms of 443 



Treatment of 443 

Dementia 446 

Diphtheritic Paralysis 430 

Symptoms of 430 

Treatment of 430 

Dropsy of the Brain 421 

Symptoms of 421 

Treatment of 421 

Epilepsy 436 

Symptoms of 436 

Treatment of 437 

Face, Paralysis of 404 

Facial Palsy 427 

Symptoms of 427 

Treatment of 428 

Falling Sickness 436 

Fi ts 435 

Symptoms of 435 

Treatment of 435 

General Cerebritis 414 

Symptoms of 414 

Heat Exhaustion 426 

Symptoms of 426 

Treatment of 426 

Hemicrania 441 

Hemiplegia 428 

Symptoms of 428 

Treatment of 428 

Hemorrhagic Apoplexy 423 

Hydrocephalus 421 

Hydrophobia 433 

Symptoms of 434 

Treatment of 434 

Hypertrophy of the Brain. ....... .426 

Treatment of 427 

Hypochondriasis 439 

Hysteria 439 

Symptoms of 439 

Treatment of 439 

Hysterical Paralysis 429 

Symptoms of 429 



399 



400 



INDEX TO PART III OF BOOK IV. 



Treatment of 4^9 

Idiocy .. . 447 

Imbecility 447 

Infantile Convulsions 435 

Paralysis 43 l 

Symptoms of 431 

Treatment of 431 

Inflammation of the Brain 413 

of the Spinal Marrow 421 

Insanity 444 

Symptoms of 445 

Treatment of 447 

Intercostal Neuralgia 441 

Lead Palsy 430 

Locomotor Ataxia 431 

Symptoms of 431 

Treatment of 431 

Lock-jaw 432 

Symptoms of 432 

Treatment of 43 3 

Loss of Memory 404 

of Speech 423 

Madness 444 

Mania 446 

Symptoms of 446 

Treatment of 446 

Melancholia 445 

Memory, Loss of 404 

Meningitis, Chronic 412 

Spinal 421 

Mercurial Palsy 430 

Migraine 441 

Symptoms of 441 

Muscular Atrophy 431 

Myelitis 421 

Nervous Diseases 401 

Neuralgia 440 

Intercostal 441 

Symptoms of 440 

Treatment of 442 

Neurasthenia 447 

Symptoms of 447 

Treatment of 448 

Palsy 427 



Facial 427 

Lead 430 

Mercurial 430 

Scrivener's 431 

Symptoms of 427 

Wasting 432 

Paralysis 427 

Agitans 430 

of the Brain 404 

Diphtheritic . .430 

Face 404 

Hysterical 429 

Infantile 431 

Reflex 429 

Syphilitic 430 

Paraplegia 428 

Symptoms of 429 

Treatment of 429 

Progressive Muscular Atrophy 431 

Rabies 433 

Reflex Paralysis 429 

Treatment of 429 

St. Vitus' Dance 438 

Symptoms of : 438 

Treatment of 438 

Sciatica 441 

Scrivener's Palsy 431 

Symptoms of 431 

Treatment of 432 

Softening of the Brain 401 

Symptoms of 403 

Treatment of 405 

Spasm of the Glottis 437 

Spasmodic Croup 437 

Spinal Meningitis 421 

Treatment of 422 

Sun Stroke 426 

Symptoms of 426 

Treatment of 426 

Syphilitic Paralysis 430 

Tetanus 432 

Wasting Palsy 432 

Wrist Drop 430 

Writer's Cramp 428 



ILLUSTRATIONS 



Brain, The 407 

Face, Nerves of 441 



Nerves, The 425 

Nerves of Side of Face 441 



CURATIVE MEDICINE 



PART III 

NERVOUS DISEASES 

Division of Nerves. — 1. Motor nerves or those in which irritation pro- 
duces muscular contraction. 

2. -Sensitive nerves, or nerves of common sensibility, in which irri- 
tation is followed by an agreeable or painful feeling, according to the 
nature or degree of the stimulation. 

3. Nerves of special sense in which irritation excites the peculiar 
sensations of light, sound, taste, etc. Many sensitive nerves arise from 
nervous centres in such close proximity to motor nerves that a stimulus 
applied to the former will react upon the latter and produce not only a 
direct sensation, but what is technically called a reflex action. It is a 
remarkable fact that whatever part of a sensitive nerve be irritated, 
whether it be the centre, the middle, or the extremity, the same sensation 
will be produced. 

Nature of Nervous Force — We can judge of the nature of the nervous 
force only by its effects. The muscular contraction caused by the irrita- 
tion of a nerve is due to the development of a peculiar vital force in the 
nerve structure, which is unlike any of the known physical forces. It 
bears certain analogies to electricity. 

1. The identity of their effects on muscular fibre. 

2. The rapidity of their action without producing any appreciable 
effect on the parts between the point of irritation and the point affected. 

3. The extreme sensibility of nerves to the electric current. 

4. The phenomena of electrical fishes. 

SOFTENING OF THE BEAIN (Ramollissement) . 

Peculiarity. — It is the consequence of chronic or acute inflammation, 
or it may occur from obliteration of the arteries. 

Softening of the mucous membrane of the digestive organs is of much 
more frequent occurrence than softening of the brain. 

(401) 
2G 



402 NERVOUS DISEASES. 

Causes. — Two causes appear to cooperate in producing softening of 
the brain. The first is of a mechanical, the second of a physiological 
nature, serosity, or pus, when in considerable quantity, appear to effect, 
mechanically, a diminution of the cohesion of the tissue in which they are 
contained. The pressure which they exercise arrests the circulation, and 
it would appear absorption also; for if this function were performed we 
should have an excavation or ulcer formed instead of a mass of soft, pulpy 
tissue. The circulation being thus arrested nutrition ceases to be accom- 
plished and the molecules of the tissues are disunited and detached. If 
while these changes are going on, or at some subsequent period, the func- 
tions of absorption be resumed, the softened tissue is partially or wholly 
absorbed and solutions of continuity of various extent are formed. The 
physiological cause, therefore, of softening is referable to a change in the 
vital properties of the affected tissue. 

Degree of Softening. — The degree of softening of the cerebral sub- 
stance may vary from a slight diminution of the natural consistence of the 
part to that of cream or even of thin milk. The first stage of softening of 
this substance is often so slight that it is hardly perceptible to the touch, 
and may, even when considerable, if not accompanied by some peculiarity 
of color, be altogether overlooked. 

Physical Characters. — The color of inflammatory softening of the 
cerebral substance presents considerable variety, dependent on the 
quantity of blood contained in the affected part. Redness and vascularity 
are, in general, greater in the first than in the second stage, but the degree 
and extent of either greatly depend on the quantity of blood in the 
cerebral vascular system. When the redness which accompanies softening 
arises from the presence of effused blood it may always be regarded as 
evidence that the softening is of recent occurrence. 

Other Evidences of Softening. — But there are other modifications of 
color which accompany softening of the cerebral substance. They indicate 
that the disease has existed for a considerable time, several weeks, or two 
or three months. The principal modifications of color consist of brown, 
yellow and orange, either separately or combined, and occupy either the 
softened substance, the part of the brain contiguous to it, or both at 
the same time. They are not observed unless the softening has been 
accompanied by effusion and originate in changes taking place in the 
effused blood. 

When Softening May Occur— Softening may occur in the brain and 
medullary substances at the same time. It may also occupy several por- 



SOFTENING OF THE BRAIN. 403 

tions of the brain at the same time, as the septum lucidum, fornix and 
walls of the lateral ventricles, the corpora striata and thalami, one or more 
lobes, a portion of one or both hemispheres, the brain and cerebellum, and 
is rarely met with in the latter organ without its being present in the 
former. Circumstances which give great variety and complexity to the 
functional derangement by which it is accompanied. 

Symptoms. — As the symptoms of the first period of inflammatory soft- 
ening of the brain must necessarily be those of inflammation of this organ, 
it would be superfluous to describe them here. It may, however, be 
observed that the severity of these symptoms does not always indicate a 
corresponding condition as to the extent of the softening which they pre- 
cede, nor do they present any one character which can be regarded as a 
sign that the inflammation on which they depend will terminate in soften- 
ing. When, however, they are taken in conjunction with those of the 
second period, they are frequently of great value as they afford us the 
means of establishing our diagnosis in cases where it would be otherwise 
impossible. 

Symptoms of Second Period. — The symptoms of the second period of 
inflammatory softening of the brain are of an entirely opposite character 
to those of the first period. Those of the first depending on the presence 
of irritation, or a morbid stimulus, are characterized by a state of excite- 
ment ; whereas those of the second being the consequence of the soften- 
ing or disorganization of the cerebral substance, are necessarily marked 
by a state of prostration, collapse or paralysis. They are announced by 
the gradual or sudden diminution of the intellectual powers, by the occur- 
rence of stupor or coma, by paralysis, difficulty or loss of speech and 
diminution of the sensibility of the skin, eye and ear. The relative fre- 
quency, degree and extent of these symptoms, as well as the order of their 
occurrence, present considerable variety. Thus, the derangement of the 
intellectual faculties, such as their diminution, suspension or abolition, is 
always present at the commencement of the second period, that is so soon 
as the softening of the cerebral substance has taken place. In some cases 
the derangement which they manifest is at first slight, increases gradually 
or rapidly and terminates in their entire abolition. In others these facul- 
ties are, from the commencement, gravely compromised and give no signs 
whatever of their existence. 

Peculiar Symptoms. — It is not rare to meet with cases in which their 
derangement is marked by remissions and exacerbations, or the occurrence 
of lucid intervals succeeded by profound stupor. The delirium whicli 



404 NERVOUS DISEASES. 

accompanies the first period of inflammatory softening either disappears 
or diminishes greatly in intensity when the second period is announced 
by the derangement of the intellectual faculties to which we have alluded. 
It diminishes with the diminution of these faculties and ceases when their 
suspension or abolition is indicated by the presence of coma and complete 
paralysis. 

Loss of Memory. — An imperfect state or the entire loss of memory 
and speech are necessary consequences of these latter conditions of the 
intellectual faculties. But the absence of any derangement of these facul- 
ties is not necessarily unaccompanied by derangement of memory and 
speech, particularly the latter, for a patient may recover the consciousness 
of his existence, perceive and comprehend what is passing around him, and 
yet be incapable of expressing himself in words on account of paralysis 
of the muscles by means of which the act of speech is accomplished. The 
diminution, suspension or abolition of the intellectual functions are always 
accompanied with paralysis of the muscles of voluntary motion, and the 
degree of the paralysis is, generally, in the direct ratio of the extent of the 
derangement manifested by these functions. 

Brain Paralysis. — The paralysis is rarely complete at the commence- 
ment. It is generally progressive with occasional alternations of increase 
and decrease before it becomes ultimately complete. The situation and 
extent of the paralysis present considerable variety and in many cases 
seem to correspond with the situation and extent of the softening, in the 
same manner as in apoplexy. The paralysis occupies one or both extremi- 
ties of the same side^when the softening is limited to one of the hemis- 
pheres of the brain, and paraplegia or universal paralysis is produced when 
both hemispheres, the pons varolii, etc., are the seat of this lesion. 
Paralysis occurs more frequently in the superior than in the inferior 
extremities; the seat of the lesion of the former being in the corpus 
striatum, and of the latter, the optic thalamus of the opposite side of the 
brain. 

Paralysis of Face Muscles — Paralysis of the muscles of the face, of 
ihe eye, of the tongue and of deglutition, depends likewise in the situation 
of the softening. Paralysis of the bladder and rectum is a frequent occur- 
rence of softening of the brain, and gives rise, in the first place, to an 
accumulation of the contents of these organs, and afterward to their in- 
voluntary escape, more particularly of the urine, from the distension of 
the bladder and the subsequent dilatation of its sphincter. It is under 
similar circumstances of the brain that the organs of hearing and of sight, 



SOFTENING OF THE BRAIN. 405 

which in the first inflammatory period of softening are highly susceptible, 
are rendered obtuse to a degree that a strong light or loud sounds im- 
pressed on the eye and ear pass unperceived. 

Permanent Muscular Contraction. — One of the most constant symptoms 
of inflammatory softening of the brain is a state of permanent contraction 
of the flexor muscles of the extremities. 

The last symptom which we shall notice is that of pain. This does 
not depend on the state of softening of the cerebral substance. It is the 
consequence of irritation or morbid excitement of the brain, the dis- 
organization of which has not yet taken place. It is generally most severe 
when it occurs as a precursory symptom, but it frequently accompanies 
the first period of the disease, and presents remission and exacerbations, 
variable in duration and degree. 

Treatment. — There are no successful cases recorded of softening from 
obliteration of the arteries, and in the few cases of the inflammatory forms 
of the disease, which have terminated favorably, it is more than probable 
that the softening was very limited in extent and affected the superficial 
or less important parts of the brain. As regards the state of softening, 
which, in point of fact, consists in a solution of continuity of the cerebral 
substance, it must be obvious that we possess no remedial agent capable of 
obviating such a change. The diseased state, therefore, of which we are 
treating, is incurable ; that is to say, the solution of continuity of which it 
consists will remain, even though the patient should recover. The essen- 
tial part of the treatment of softening of the brain relates, consequently, 
to the local morbid conditions which immediately precede this change, 
viz. : the diseased state of the arteries on the one hand and inflammation 
of the brain on the other. This state of the arteries, like the softening 
to which it gives rise, is, so far as we yet know, beyond the control of 
remedial agents. When, therefore, it is ascertained that the softening is 
the consequence of this state of the arteries, the only hope that can be 
indulged is partial relief, and the prolongation of life for a short period 
beyond that at which the disease would have proved fatal had it been 
allowed to run its natural course. 

Staying Treatment. — It is possible that the attack may be delayed by 
judicious treatment, employed when the first symptoms of cerebral de- 
rangement are perceived, such as pain in a particular part of the head, 
confusion of ideas, giddiness or unusual drowsiness and listlessness, to- 
gether with a prickling sensation or numbness in the muscles of the ex- 
tremities, face or tongue. 



406 



NERVOUS DISEASES. 



THE BRAIN. 



Figure No. i. 
1,1,1,1. Motor track delineated from 
the front columns of the 
spinal marrow to the hemi- 
spheric ganglion. 

2. Pyramidal body. 

3. Eminences in the medulla ob- 

longata. 

4. Variolus bridge. 

5. Legs of the brain. 

6. Streaked body. 

7. Hemispheric ganglion. 

8. Cerebellum. 

9. Olfactory nerve. 

10. Optic nerve. 

11. Fourth pair of nerves. 

12. Sensory root of the fifth pair. 

13. The seventh and eighth pairs 

of nerves. 

14. Front suture. 

15. Mammillary elevation. 

16. Corpora geniculatum. 
Figure No. 2. 

1, 1. Section of the callous body. 

2. Transparent partition. 

3. Front column of the vault. 

4. Section of front suture. 

5. Central substance of the 

chamber. 

6. Sylvius' aqueduct. 

7. Pineal gland. 

8. Medullar band which extends 

from the pineal gland to the 
front suture. 

9. Section of the legs of the 

brain. 

10. One of the white bodies, or 

mammillary bodies. 

11. Gray excrescence. 

12. Section of the intricacy of the 

optic nerves. 

13. Optic nerve beyond the intri- 

cacy. 

14. Olfactory nerve. 

15. Front surface of the hemi- 

sphere. 

16. Fissure between the back and 

middle lobes of the brain. 
Figure No. 3. 

1. Front extremity of the fissure 

of the brain. 

2. Back extremity. 

3. Front lobes of the brain. 

4. Middle lobe. 

5. The Sylvius fissure. 

6. Back lobe. 

7. Infundibulus point. 

8. Its body. 

9. White or mammillary bodies. 

10. Ash-colored matter. 

11. Legs of the brain. 

12. Variolus* bridge. 

13. Upper end of the medulla ob- 

longata. 



14. Back prolongation of the va- 

riolus bridge. 

15. Middle of the cerebellum. 

16. Front part. 

17. Back part. 

18. Upper part of the spinal mar- 

row. 

19. Middle fissure of medulla ob- 

longata. 

20. Pyramidal body. 

21. Rectiform body. 

22. Oval body. 

23. Olfactory nerve. 

24. Its bulb. 

25. Its external root. 

26. Its middle root. 

27. Its internal root. 

28. Optic nerve beyond the intri- 

cacy. 

29. The same before the intricacy. 

30. Motor of the eye or third pair. 

31. Pathetic nerves or fourth pair. 

32. Trigeminus or fourth pair. 

33. External motor or sixth pair. 

34. Facial nerve. 

35. Auditive nerve. 
36,37,3& Eighth pair. 
Figure No. 4. 

1. Vertical section of the head. 

2. Frontal cavity. 

3. Greater fake of the brain. 

4. Its origin from the rooster's 

comb. 

5. Its union along the sagital 

suture. 

6. Under or concave edge. 

7. Counteraction to the cere- 

bellum store. 

8. Cerebellum store. 

9. Union to temporal bone. 

10. Free edge of same. 

11. Tortuous elevations of the 

front right lobe of the 
brain. 

12. Front extremity of the callous 

body. 

13. Transparent partition. 

14. Section of the front suture. 

15. Front parts of the vault. 

16. The middle of same. 

17. Back end. 

18. Inner side of the bed. 

19. Section of streaked bodies. 

20. Side walls of the third ven- 

tricle. 

21. The dura mater, turned upside 

down. 

22. Section of the internal car- 

otid artery. 
Figure No. 5. 

1. Front lobe of the brain. 

2. Back lobe. 

3. Middle lobe. 





Fig. 1. — View of the course of the front 
columns of the spinal marrow terminating 
in the hemispheric ganglions of the brain. 



Fig. 2.— Middle vertical section of the 
callous body. The inner left side of the 
brain is also seen. 



8 SSSff. 




Fig. 3.— View of the base of the brain and cerebel- 
lum, together with the nerves. 

J89 




Fig. 4.— Section of the head showing the greater Pig. 5.— View of the appearance of the tortuous 

scythe, the horizontal apophysis of the diameter elevations of one side of the brain, seen In >m above, 
between the brain and the cerebellum and other 
parts found under the middle line of the head. 

THE BRAIN. 

For an explanation of the illustrations sec text on opposite page 407 



•±08 NERVOUS DISEASES. 

Further Treatment. — Bleeding from the temples, cupping in the nape 
of the neck, or small general bleedings, repeated from time to time as cir- 
cumstances may require, may, by diminishing the quantity of the blood, 
facilitate the circulation of this fluid through the brain. But, perhaps, 
the greater advantage would be derived by keeping the bowels freely open 
without inducing excitement or debility, chiefly by means of the neutral 
salts. The compound aloetic pill will be advantageously employed in 
those cases in which the disease occurs after the cessation of the cata- 
menia, or suppression of a hemorrhoidal discharge. A diminution of the 
circulating fluids, as well as their equalization, will be effected likewise 
by promoting all the secretions, particularly those of the urine and bile. 

Diet. — The food and drink of the patient should be particularly 
attended to. His diet should consist of those kinds of food which are 
most easily digested, and which afford the greatest quantity of nourish- 
ment in the smallest bulk. Ardent spirits, strong wines, fermented liquors, 
even strong coffee or tea and all stimulants should be avoided as more or 
less injurious. 

Treatment of Second Period. — The treatment of the second period, or 
that of softening from inflammation, is the same m principle as that of 
the former, in so far as it regards the state of excitement with which this 
morbid change is generally accompanied. But if the paralysis be fairly 
established and, notwithstanding the depletory and sedative measures 
which have been employed, continues to increase, neither our own ob- 
servation nor the recorded experience of others would recommend a steady 
perseverance in the means, the debilitating effects of which have not 
been sufficient to overcome the inflammatory excitement of the first period. 
Bleeding and active purgatives should now be laid aside; blisters or 
sinapism should be applied to the inferior extremities, the nape of the 
neck and superior part of the spine ; the head should be kept cool by the 
constant application of evaporating lotions ; the bowels evacuated once or 
twice a day by means of a mild aperient, or by injections, the secretion 
of urine and the cutaneous perspiration should also be promoted, by 
remedies of the least stimulating qualities. The retention of the urine is 
a complication which must be sedulously watched, that this fluid may be 
removed before it accumulates to a degree to prove injurious; stimuli or 
tonics should noiv be employed with a view to support the strength of 
the patient, but they ought never to be employed to such an extent as to 
produce excitement, as the powers of life are already greatly exhausted 
by the stimulus of the disease. 



BRAIX FEVER. 409 

BRAIN FEVER. 

(Cerebral Macula.) 

Difficult Diagnosis. — Under this term we propose to include the path- 
ology, symptoms and treatment of the inflammatory affections of the brain 
and of its membranes. We adopt this plan, not merely because of the 
intimate relation subsisting between these structures, but because when 
we trace the history of a number of acute affections of the encephalon and 
examine the lesions of structure presented after death, we shall frequently 
find that the substance of the organ, as well as the investing membranes, 
has been involved in the disease. Hence arises the difficulty of establish- 
ing the diagnosis between inflammation of the parenchyma of the brain 
and that of its membranes. 

Symptoms. — When either the arachnoid or pia mater, which closely 
invest the brain, are extensively inflamed, the functions of this organ 
become inevitably disturbed by sympathetic irritation, without its paren- 
chyma necessarily partaking of the inflammation, or if the inflammation 
extends to the parenchyma it is mostly confined to the superficial layer 
of cortical substance. Hence meningitis, besides headache and intense 
fever, we have an increase of the general sensibility, preternatural acute- 
ness of the external senses, violent delirium and convulsions, and, finally, 
collapse, coma and death. Extensive and acute inflammation of the 
hemispheres of the brain will be characterized by a nearly similar train 
of symptoms. 

Two Classes of Inflammation — We shall- proceed to consider inflam- 
mation of the encephalon under two divisions, viz.: 1. Inflammation of 
the membranes of the brain (meningitis) ; 2. Inflammation of the sub- 
stance of the brain (cerebritis). 

Inflammation of Brain Membrane. — An examination of the structure 
of the brain and of the peculiarities of the circulation in it and upon it 
would lead us to the inference that if the meninges be the seat of inflam- 
mation, the contiguous cerebral substance must participate in some degree 
in the irritative influence. In other organs the vessels, after entering 
them by trunks and branches of various sizes, branch out and ramify in 
their interior until they become capillary in their spongy and areolar 
tissue. But in the brain a different arrangement takes place, the vessels, 
Uxter entering at the base of the skull, communicate freely with one 



J-10 NERVOUS DISEASES. 

another and then branch out upon the surface of the brain, ramifying in 
an extended web of cellular tissue (pia mater) ; in this way they become 
reduced to so great a degree of tenuity before they enter the substance 
of the organ that it may be said to be surrounded by a vascular atmosphere 
from which its supplies are derived. Hence it is, that as the meninges 
and the contiguous cerebral substance are supplied from the same source, 
each will more or less become -affected by any inflammatory action set 
up in the other. 

Sympathetic Symptoms — Cerebral irritations are divisible into two 
great classes, symptomatic and idiopathic. Symptomatic irritation is for 
the most part connected with and dependent as a morbid condition of the 
chylopoetic viscera. We frequently observe that for weeks previous to 
the occurrence of pain or any disturbance in the head the digestive func- 
tions have been impaired, the bowels confined or irregular and the stools 
unnatural. In many of these cases, when the headache, retching, irreg- 
ular fever and even coma have set in, speedy and permanent relief has 
followed the use of purgatives, and the other means usually resorted to 
for correcting disordered functions. An irritative influence is in such 
cases propagated from the digestive organs to the brain by reason of the 
close sympathetic connection which subsists between them in health and 
in disease, and that irritation, if kept up for a while, will pass into positive 
inflammation, marked by its usual consequences. The irritation of worms 
and of teething may also induce similar results, more particularly in those 
constitutionally predisposed. We frequently observe these cerebral affec- 
tions to spring up during the course of other diseases, of which they may 
be considered as complications, viz. : continued fever, scarlatina, measles, 
whooping-cough, and they not infrequently follow accidents or injuries. 

Varying Symptoms — This affection presents a train of symptoms 
which varies in different ages and in different temperaments. Its most 
marked and ordinary character at its outset is an increased sensibility to 
all sorts of impressions, the ordinary external influences producing inor- 
dinate effects. Thus, a child is restless and sleepless, seldom even dozing, 
or if he does doze from time to time starting and waking up ; he attends to 
every sound, the eyes are suffused, the retina is so sensitive to light that 
he winks or turns away if his face is directed to a window or to a light ; 
the pupil is generally contracted but not invariably so. The head is often 
moved about or from side to side, so are the limbs ; the temper is peevish 
and nothing seems to soothe this irritable condition but motion up and 
down the room in the arms of the nurse or attendant. 



BRAIN FEVEE. 411 

Bowel Symptoms. — The state of the bowels varies much in different 
instances, they may be confined or relaxed, but the stools do not present 
any unnatural appearance. 

Increased Animation. — There is a minor degree of this state which is 
marked by increased animation and liveliness, which with ordinary ob- 
servers may pass for an increase of health and vigor, though an atten- 
tive observer will readily perceive that the countenance wants that dis- 
engaged air which exists in health, and on making a closer examination he 
will find that the eyes frequently close and wink and the countenance 
assumes an expression as of frowning; the hand, too, is frequently raised 
toward the head, and the fingers are fixedly closed. 

Indifference. — We occasionally observe a state the very opposite of 
this, a state characterized by want of animation, accompanied by plaint- 
ive moaning at times, and an indifference to surrounding objects. Though 
the patient does not sleep, yet his state is not that of waking, and if roused, 
betrays fretfulness and peevishness. These may be considered as so many 
indications of an incipient irritation, which in some constitutions may 
arise independently of any assignable agency, but which in many cases 
is referrable to an irritation propagated to the brain from the peripheral 
extremities of the nerves during dentition, or by worms in the alimentary 
canal, or by vitiated secretions, or a torpid liver. 

Fever Symptoms. — The symptoms above indicated are by some denomi- 
nated fever, some epithet being usually added for the purpose of indicat- 
ing its source, or its nature ; hence the terms gastric, irritative and hydro- 
cephalic fever. 

Morbid Excitement — The most expressive term which we can employ 
is that of "sensitive erethism," or morbid excitement. It is distinct from 
inflammation of the brain, of which it is frequently the precursor, and 
according to individual peculiarities, or other modifying circumstances, it 
may end in cerebritis, meningitis or that modification of the latter called 
hydrocephalus, and this termination is. but too often unexpected by the 
practitioner, whose attention has perhaps been directed to secondary indi- 
cations and minor effects, while the erethismal state of the brain has crept 
on unheeded. The condition here indicated cannot be supposed to exist 
unaccompanied by an increased flow of blood through the cerebral vessels, 
or in other words, an increase in their degree of tension ; and as the tension 
may vary from a slight degree of fullness to the greatest of which the 
vessels are susceptible, such a state of local determination of blood will 
soon end in inflammation if not subdued by proper means. 



412 NERVOUS DISEASES. 

Further Symptoms. — The actual inflammatory attack is generally 
ushered in by headache more or less violent (the pain being referred to 
the temples, the vortex or forehead, sometimes to the occiput and base of 
the skull), by intolerance of light, heavy and suffused eye, with quick 
pulse, are also attendants ; so, in many instances, is vomiting. In those 
who have suffered much from mental disquiet spasmodic twitchings are 
sometimes perceived, not unlike those which arise from slight electric 
sparks. In children and very young persons it frequently commences with 
a sudden and long-continued convulsion without any previous warning. 
After a while the convulsive movements cease, a remission takes place, 
and the patient appears free from complaint for one or more days, when 
a second attack occurs which may terminate in coma or death. 

Changes in Membrane. — After having been the subject of inflamma- 
tion the membranes present various changes dependent either on the dura- 
tion and intensity of the attack or on the frequency of its recurrence ; but 
all of them are referrable to the following heads, viz. : simple redness of 
the arachnoid ; thickening and opacity with increased firmness ; serous ef- 
fusion beneath or upon it or into the ventricles; puriform or sero- 
purulent exudations ; false membranes ; increased vascularity and thicken- 
ing of the pia mater. We also find lesions consisting of granulations 
scattered in the meninges over the surface of the brain and in the sylvan 
fissure, which have been shown by the microscope to be of a tubercular 
nature. 

CHRONIC MENINGITIS. 

The Delirium. — Meningitis is in many instances so slow in its progress 
as to assume the chronic form. We have then delirium and progressive 
paralysis as constant attendants. The delirium is at first partial, it is a 
monomania with weakness of intellect, but, after a time it passes on to 
maniacal excitement and finally subsides into confirmed idiocy. The 
paralysis in those cases does not exhibit a total privation of sensation and 
motion in any particular part of the body; it is at first slight, but grad- 
ually increases and extends to the whole muscular system, rendering the 
gait feeble and vacillating and ultimately destroying the power of motion. 
It is remarkable that the diminution of sensation is not proportioned to 
that of motion. Spasmodic movements with contraction and rigidity of 
the limbs sooner or later set in, and, finally, epileptic attacks, which ter- 
minate in fatal apoplexy. 

The Paralysis. — The paralysis which occurs presents this remarkable 



INFLAMMATION OF BRAIN SUBSTANCE. 413 

feature, that it seems to shift about from one hour to the other, one day, 
for instance, the right leg is found to be drawn up with greater energy 
than the left, when the sole of the right foot is tickled, but on repeating 
the examination a few days afterward it is the left leg which now feels and 
moves better than the right. It would seem from this as if the paralysis 
has shifted from one side to the other, but such is not the case, the limb 
which was first palsied is still so, but the illusion arises from the circum- 
stance that the palsy has not increased in degree in the first limb, while 
the second limb has become involved to a great degree. Motor power-Iras 
not returned in the former, but has been more gravely impaired in the 
latter. • 

After-Death Facts. — The lesions which are found after death subse- 
quently account for these facts. When the right limbs alone were para- 
lyzed the brain is found to be disorganized on the left side ; but when the 
paralysis apparently shifted from one side to the other both hemispheres 
are found diseased, but more deeply and more extensively on the opposite 
side to that of the limbs which w T ere most palsied. This apparent mobility 
of paralytic symptoms more frequently occurs in meningitis than in- any 
other complaint. _ . 

Causes. — Meningitis is a frequent consequence of injuries of the head, 
of fractures, concussion or even w r ounds of the scalp. It not infrequently 
happens that a w r ound of the head heals rapidly and that the patient 
returns to his usual occupation thinking himself quite well, but after ten 
or fourteen days he begins to feel pain in the situation of the wound which 
gradually increases in intensity, and in a very short time all the symptoms 
of cerebral inflammation become manifest. A child may suffer serious 
injury from a fall, and as all mention of the accident is suppressed by his 
immediate attendant, it escapes the notice of others and no ill effects fol- 
low perhaps for a week or two ; the child then, however, loses appetite, 
becomes restless and irritable, febrile excitement, delirium and convul- 
sions succeed and too often are the precursors of a fatal termination. 

INFLAMMATION OF BRAIN SUBSTANCE (Cerebritis). 

Symptoms. — The most usual premonitory symptoms are a general 
"uneasiness and restlessness with a tendency to congestion in the head ; a 
sense of weight and fullness ; occasional attacks of pain in the head, or of 
temporary apoplexy or epilepsy; flushing of the face and increased heat 
of the head ; drowsiness and vertigo ; preternatural acuteness of the ex- 



414 NEEVOUS DISEASES. 

ternal senses; intolerance of light and optical illusions; contraction of 
the pupils, strabismus or imperfection of sight ; tinnitus aurium or various 
other noises in the ear; confusion of thought; failure of the memory; 
mental excitement or depression, or some striking alteration in the habitual 
character and pursuits of the individual. 

Additional Symptoms. — In some cases there is little appearance of 
indisposition throughout the day, but the symptoms are aggravated at 
night; the sleep is uneasy or disturbed by alarming dreams, and in chil- 
dren there is often grinding of the teeth. Pains in the limbs and fre- 
quent cramps, general lassitude and muscular debility are often felt, al- 
ternating with fits of shivering and f everishness ; the digestive functions 
are disordered; there is a general loss of appetite; often obstinate vomit- 
ing; the bowels are either irritable or torpid, the secretions being always 
unhealthy. 

Symptoms Following Inflammation — The above symptoms precede 
either general or partial inflammation of the brain. Those which follow 
indicate more especially the invasion of partial and chronic inflammation, 
a long-continued, fixed and deep-seated pain in one part of the head ; pain, 
numbness, weakness, a sensation of creeping and tingling in one extremity 
or in one-half of the body, or confined to one portion of the extremity; 
there may be numbness and loss of power in one finger only or in one set 
of muscles. Sometimes the speech is affected so as to produce a degree of 
hesitation, stuttering or indistinctness of pronunciation, drowsiness, 
languor, depression of spirits are observed, also more particularly in the 
chronic form of cerebritis. Some of these premonitory symptoms may 
have been present for weeks, for months, or even for a year, or for a 
longer period. 

General Cerebritis — General cerebritis is always acute. Its symptoms 
are divisible into two periods, viz. : 1. The period of irritation or excite- 
ment. 2. The period of collapse. 

Symptoms. — The symptoms which characterize the period of excite- 
ment are intense pain extending over the greater part of the head; great 
excitement of the cerebral functions; violent delirium; preternatural 
acuteness, of both the external and internal senses; intolerance of light; 
brightness, redness, wildness or protrusion of the eyes ; contraction of the 
pupils ; tinnitus aurium ; flushing of the face ; throbbing of the temporal 
arteries ; paroxysms of general convulsion ; rigidity of some of the mus- 
cles on one or both sides of the body in the interval of the paroxysms'. 
There are also severe shooting pains in the extremities, greatly increased 



INFLAMMATION OF BRAIN. 415 

by extending them; twitching -of the muscles of the face; rolling of the 
eyes; quick, suspicious and irregular breathing; rapid, full and hard 
pulse; subsultus tendinum; red and dry tongue, either tremulous when 
protruded or in violent motion, pushing out the cheek or forcibly thrust 
out of the mouth; great thirst; occasionally severe vomiting, especially 
in children; scanty and high-colored urine. The paroxysms of convul- 
sion are always attended with an exacerbation of the symptoms. The 
respiration is hurried, and the pulse rises suddenly, forty or fifty beats 
in a minute. When the convulsions subside the pulse and respiration be- 
come comparatively slow and feeble. 

Further Symptoms. — The symptoms just enumerated may last from 
twelve to forty-eight hours or more, when they are succeeded by others of 
an opposite character, which constitute the second period or that of col- 
lapse. The headache is now no longer complained of ; delirium gradually 
passes into stupor or coma; the preternatural acuteness of the senses is 
succeeded by obtuseness and insensibility; the convulsions subside into 
general muscular relaxation and more or less complete paralysis succeeds. 
The pupils become dilated and motionless; the eyes sunk, pale and dim; 
there is sometimes strabismus or deafness ; the pulse is rapid, small, un- 
equal or intermittent; there are frequent rigors, the skin afterward feel- 
ing cold and covered with a clammy sweat; the face is pale, sunk and 
cadaverous ; the respiration is slow or irregular and stertorous. When the 
patient lies senseless on his back and swallows with difficulty, the fatal 
issue is not far distant. There may be several alternate paroxysms of 
excitement and collapse until the patient finally sinks into a state of coma 
which soon ends in death. 

Diagnosis. — When the inflammation occupies at the onset a large 
portion of the brain, it is generally complicated with meningitis and 
characterized by disturbance in all the vital functions. 

Course of the Disease. — When, however, a smaller portion of the brain 
is engaged in inflammation the course of the disease is seldom so rapid; 
its invasion is more gradual and preceded by symptoms of irritation in 
some of the organs of voluntary motion, sensation or intelligence. Con- 
vulsive rigidity and retraction of the muscles are sometimes observed in 
connection with meningitis ; but it may be generally distinguished from 
spasmodic paralysis by several well-marked signs. There is no actual 
paralysis, and when the convulsive retraction intermits the patient fully 
recovers the power of voluntary motion in the same manner as after the 
paroxysms of spasmodic rigidity in tetanus. This convulsive rigidity is 



416 NERVOUS DISEASES. 

scarcely ever limited to one region or to one side of the body as m partial 
cerebritis, but affects a variety of parts at the same time on both sides. 

Treatment. — The inflammatory nature of the more acute forms of 
cerebritis and arachnitis is so obvious that their treatment has always been 
conducted in correct principles. Until very lately, however, the inflam- 
matory character of partial and chronic cerebritis was either entirely over- 
looked or imperfectly understood, that though active treatment was some- 
times adopted at the beginning of the disease it was soon laid aside, and 
remedies of an opposite description substituted. These affections were in 
fact generally set down as nervous, mistaken for rheumatism, neuralgia, 
nervous dyspepsia and debility or nervous palsy, and treated by tonics, 
electricity and stimulants ; the fatal termination of the disease being thus 
accelerated. 

Preventive Treatment. — Cerebritis and arachnitis are so formidable 
that their prevention is of no less, if not greater importance, than their 
treatment. It is extremely important to have recourse to active measures 
on the very first appearance of any of the premonitory symptoms, how- 
ever trifling ; as we may thus succeed in effectually removing that state of 
congestion and irritation of the brain, which is the precursor of inflam- 
mation. The means of accomplishing this are the careful and timely re- 
moval of all the exciting causes ; of every source of irritation, both bodily 
and mental ; regulation of the diet ; avoiding all excesses ; relaxation from 
study; change of air; general and local blood letting, counter-irritation, 
with occasional purgatives. 

Vigilance Required. — Great vigilance is particularly required in the 
cerebral affections of infants and children who frequently suffer without 
complaining. A predisposition to affection of the brain may often be 
suspected by some slight cast or rolling of the eyes ; by dilatation of the 
pupils, or occasional startings or attacks of spasmodic croupy breathing 
during sleep ; there may be every other appearance of perfect health with 
these symptoms, which are often only evanescent. 

Relieving Congestion. — When it is necessary to relieve the brain from 
habitual congestion by occasional topical bleeding, the method of taking 
blood from parts as remote from the disease as possible seems to us pref- 
erable to that of abstracting blood from the head itself. When the ves- 
sels of a part are partially emptied of their blood, if they have been much 
weakened by long-continued over-distension or previous disease, so as to 
have lost their elasticity, there will be an immediate flow of fresh blood 
to the part; this will take place on mere hydrostatic principles. 



INFLAMMATION OF BRAIX. 417 

Uses of Bleeding. — Xo fact is better established than that the loss of 
an exceedingly small quantity of blood from certain parts of the body is 
sufficient to relieve distressing symptoms of congestion and oppression in 
others most remote from them; as, for instance, a very slight discharge 
of blood (one or two ounces) from the hemorrhoidal veins being suffi- 
cient instantly to remove vertigo, flushing, earache or oppressed breath- 
ing; the same is the case in a still more striking manner with the cata- 
menia, although some account must be taken of the influence of uterine 
irritation over the system. We prefer, therefore, in cases of habitual con- 
gestion in the brain, taking blood occasionally from the feet or legs, by 
opening a vein or applying leeches and letting them bleed in a foot-bath ; 
or the application of leeches to the arms whenever practicable. We have 
found this the surest method of affording permanent relief, and by re- 
peating it at certain intervals the tendency to cerebral congestion may be 
completely overcome. We have pursued this plan in lunatics with the 
very best results. 

Cooling the Head. — The insertion of an issue is often advisable as a 
preventive in people of a plethoric habit. The head should be kept cool 
by the frequent use of cold ablutions, the hair cut short, the head and 
shoulders raised at night ; tight bandages round the neck must be avoided ; 
the daily use of the cold shower bath is often very beneficial, but a reac- 
tion takes place in the head unless it be used with the feet immersed in hot 
water. The feet, legs and lower parts of the body ought to be carefully 
kept warm and dry. 

Further Treatment. — In the treatment of cerebritis, when fully de- 
veloped, attention must be paid to its two periods of excitement and col- 
lapse. The remedies chiefly to be relied upon are blood letting, general 
and topical purgatives, cold applications to the head and counter-irritation. 

Treatment of More Acute Cases. — In the more acute cases the patient 
must be freely bled from a large orifice. If the symptoms continue un- 
abated the bleeding must, however, be repeated several times, at intervals 
of a few hours, and this practice must be carried during the first period of 
the disease to the utmost limit of the patient's strength. It often happens 
that very little impression is made on the disease by the first bleeding and 
no amendment takes place until after the second. The symptoms often 
abate after bleeding, but a fresh exacerbation may take place in the course 
of a few hours. Topical bleeding, by cupping or leeches, is. Tinder such 
circumstances, highly beneficial. 

Head Treatment. — The head must be shaved, and pounded ice mixed 
27 



418 XEBVOUS DISEASES. 

with cold water and vinegar may be applied to the scalp. A very effectual 
method of applying cold is by making the patient hold his head over a 
basin and pouring a stream of cold water on it from a certain height ; this 
often removes the heat and flushing and calms the excitement; it should 
be repeated as often as the heat and flushing return. The application of 
cold to the body is always followed by a reaction, and the temporary relief 
refrigerants afford will be succeeded by an increase of the inflammatory 
symptoms and their use become decidedly injurious unless their depress- 
ing action be kept up by a steady and repeated application. 

Other Remedies. — The remedies next to bleeding and cold, ^and often 
not less efficacious, are active purgatives, which must be administered at 
short intervals until copious evacuations be procured. In some cases *no 
marked amendment has taken place until the bowels have been freely 
moved; they are sometimes exceedingly torpid, for reasons which have 
already been assigned, and large doses of cathartics may be required. Com- 
binations of calomel, jalap, scammony, followed by any of the purga- 
tive mineral waters, are the purgatives on which the most reliance can be 
placed. Croton oil is sometimes a valuable remedy, from the facility of its 
administration and certainty of its effects. Mercury may be given freely 
as a purgative. 

Use of an Emetic. — We have sometimes found tartar emetic of great 
service when there was no irritability of stomach to prevent its being 
tolerated ; the power of tartar emetic in controlling the action of the heart 
and subsiding the inflammatory diathesis is now fully established ; a solu- 
tion in the proportion of one grain to the ounce and a tablespoonful given 
every hour or two, suspending it should vomiting occur, has often been 
attended with great benefit. The remedy is in general well tolerated, 
owing to the torpor of the stomach; violent vomiting should, however, be 
prevented, as it would obviously be extremely injurious. 

Treatment of Second Stages. — In the second stage of acute cerebritis, 
that of collapse and coma, general blood letting is to be used most spar- 
ingly; decided advantage, however, has resulted from a moderate bleed- 
ing even at a late period. In this stage topical bleeding is more generally 
indicated. There are periods of exacerbation in the symptoms which 
should be watched and overcome by these means, which may be persevered 
in as long as there is any hardness and resistance in the pulse. We have 
seen a patient instantly recover from a state of profound coma by the 
abstraction of a very small quantity of blood with the cupping glass. In 
this stage we may have recourse to counter-irritation with advantage; 



INFLAMMATION OF BRAIN. 419 

blisters may be applied between the shoulders, to the occiput or to the neck 
or legs. There is an objection to their being applied to the whole head, 
that it prevents the subsequent application of cold. We have, however. 
in desperate cases, seen a decided amendment follow the application of a 
large cap blister. Particular attention should be paid to the abdominal 
region, and especially that of the bladder, which ought to be examined 
morning and evening in order to detect retention of urine, and we must 
take care not to be led into error by an incontinence of urine from the 
over-distension of the bladder; this must be obviated by drawing of! the 
urine with the catheter twice a day. 

Treatment of Chronic Forms. — In the more chronic forms of cerebritis, 
unattended with fever or much general excitement, the same activity of 
treatment is of course not admissible. We must still, however, pursue the 
antiphlogistic plan, modifying it according to the urgency of the symptoms. 
During the period of irritation, with cephalgia, vertigo, or rigid spasm 
of the extremities, moderate bleeding, general and topical, purgatives and 
counter-irritation are the only remedies from which any advantage is to be 
expected; they must be repeated at longer or shorter intervals, according 
as the strength of the patient and the continuance of the symptoms may 
seem to indicate. A great deal is to be accomplished in all chronic inflam- 
mations by persevering in a moderate course of antiphlogistic treatment. 
We must watch carefully any signs of amendment, remembering that 
there is a great tendency to collapse, and that the natural course of the 
complaint is characterized by irregular remissions and exacerbations. 

When to Cease Active Treatment. — When the period of irritation is 
over, and is followed by a remission of all signs of excitement, by a com- 
plete paralysis of the muscles, and by other evident signs belonging to the 
period of softening and suppuration, the strength of the patient must no 
longer be reduced by active treatment. In all inflammatory diseases, when 
the stage of excitement and disorganization is over, a process of repara- 
tion commences, which requires for its completion a certain degree of 
power in the constitution. If at this period we persevere in lowering the 
general strength, we deprive the constitution of its natural resources and 
interfere with its healing operations. 

When the Excitement Turns. — It becomes, therefore, an object of con- 
siderable importance to watch the moment when the tide of excitement 
is on the turn, and when the powers of the constitution are verging to a 
state of collapse, in order that we may abstain from an injurious inter- 
ference, husband the patient's strength and even support it if required. 



420 XERVOUS DISEASES. 

This precaution is particularly necessary in old people and young chil- 
dren. 

Convalescence. — After convalescence has been established the patient 
will still require to be closely watched for some time before his recovery 
can be considered fully confirmed ; he must be kept perfectly quiet, free 
from every species of excitement and the regimen duly regulated. When 
the brain has once suffered from inflammation it is slow in recovering its 
tone, and the most trifling cause, such as a slight mental exertion or emo- 
tion, a full meal, and so forth, has been in many cases sufficient to 
occasion a relapse. 

Suppressed Menstruation. — When cerebritis has occurred after sup- 
pressed evacuations or the metastasis of other diseases, we should endeavor 
to procure their return. If menstruation is suppressed, leeches should be 
applied to the pubis or inguinal regions, and the frequent use of hot 
pediluvia recommended. If cutaneous eruptions or rheumatic gouty pains 
in the joints previously existed, blisters or rubefacients are to be applied 
to the parts' originally affected. 

Summary of Symptoms of Brain Congestion — The following summary 
gives a connected view of the various morbid conditions of the brain, 
which are the effects of congestion and inflammation, together with their 
symptoms : 

Cerebral Congestion. — Cerebral congestion, over-distension of vessels; 
vertigo, tinnitus aurium, confusion of sight, cephalgia, if the pressure 
in the vessels be carried to a sufficient extent to intercept the circulation ; 
simple apoplexy, seldom fatal, recovery rapid. 

Permanent Cerebral Congestion — If the cerebral congestion be per- 
manent, or returns frequently ; drowsiness, oppressed intellect ; the vessels 
become weakened and on a sudden increase of congestion are ruptured; 
extravasation of blood, sanguineous apoplexy ; destruction of cerebral sub- 
stance and compression; loss of consciousness, permanent or temporary; 
sudden and complete paralysis without spasmodic affection of the muscles. 

General Congestion. — General congestion, followed by inflammation 
of a considerable portion of the brain ; deep injection ; partial sanguineous 
infiltration; dotted and ecchymosed striated appearance of the cerebral 
substance; general cerebritis (combined usually with arachnitis). Period 
of high excitement of all the cerebral functions, with general convulsions, 
followed by a period of collapse and coma. 

Partial Congestion — Partial congestion and inflammation of the 
brain; 1st period, the same deep injection and sanguineous infiltration, 



SPINAL MENINGITIS. 421 

more circumscribed ; partial cerebritis. Partial symptoms of irritation in 
the organs of motion and sense; weakness, pain, numbness, spasmodic 
paralysis, confined to one side or a few regions of the body. 2d period, 
infiltration of pns in the cerebral substance ; softening ; abscess ; complete 
paralysis ; relaxation and flaccidity of the muscles ; loss of feeling ; aboli- 
tion of some of the external senses or intellectual faculties ; death, either 
gradual or sudden, by the extension of the inflammation or by pressure. 

Cerebral Inflammation. — After sanguineous apoplexy and sudden and 
complete paralysis, inflammation of the cerebral substance surrounding 
the coagulum; consecutive cerebritis, the paralyzed limbs affected with 
pains, convulsive motion, spasmodic rigidity. 

Slow Congestion — Slow and gradual congestion with very slight irri- 
tation; long, continued state of low inflammation, ending sometimes in 
softening, sometimes in induration, or else in an infiltration of serous 
fluids and white softening. Various forms of chronic cerebritis, sense 
and motion very gradually weakened and impaired without pains or 
spasmodic rigidity in the muscles. 

DROPSY OF BRAIN. 

(Hydrocephalus.) 

Causes. — Water in the head; dropsy of the brain. This is almost 
always an affection of early life. Sometimes it is congenital. It is mostly 
a passive dropsical effusion; certain cases show signs of a chronic or 
subacute inflammatory condition of the arachnoid membrane of the brain. 

Symptoms. — Languor, strabismus, convulsions, loss of appetite and 
increase in the size of the head. This last may be enormous. 

Treatment. — Moderate purging every few days, or once a week, sus- 
taining the strength by nourishing food, and, if it be borne, cod-liver oil ; 
diuretics; shaving the head and rubbing it nightly with mercurial oint- 
ment ; occasionally blistering the back of the neck, in a child. Pneumatic 
aspiration may perhaps prove useful in hydrocephalus. To remove the 
fluid gradually and safely mild stimulating baths have a very beneficial 
influence. 

INFLAMMATION OF THE SPINAL MARROW, MYELITIS, SPINAL 

MENINGITIS. 

Symptoms. — The symptoms of this uncommon affection are: constant 
and severe pain in the back increased by motion; spasmodic contractions 



422 NERVOUS DISEASES. 

or rigidity of the muscles followed "by paralysis, fever, constipation of the 
bowels and retention of urine. In myelitis proper, as distinguished from 
spinal arachnitis, there is no pain or muscular rigidity "but only paralysis 
of motion and sensation. 

Treatment. — Cupping or leeching along the spine, followed by a 
blister and active purgation with saline cathartics, constitute the essential 
parts of the treatment of simple inflammation of the spinal cord or of its 
membranes. 

APOPLEXY. 

Causes. — These have been divided into external or obvious, and in- 
ternal or such as can only be discovered after death. The external causes 
or those acting mechanically by evoking pressure on the brain; such are 
fracture of the skull with depression of a portion of bone, or blood extrava- 
sated immediately beneath the fractured bone without depression. The 
reality of this cause is shown by the effect of direct pressure made upon 
the surface of the brain by the point of the finger in cases where a portion 
of the skull has been removed by the trepan, or on the fontanelle or 
opening between the cranial bones in the head of infants. Causes tend- 
ing to increase the arterial action of the brain, either by direct application 
to the head itself, or indirectly through the medium of other organs. 
Causes which operate by impeding the return of blood from the brain, 
as stooping; the application of a tight ligature round the neck so as to 
compress the internal jugular veins ; tumors of any kind so situated in the 
neck or chest as to interrupt the return of blood from the brain to the 
heart; diseases of the heart or lungs impeding the transmission of the 
blood through the pulmonary vessels ; or a voluntary suspension of breath- 
ing after a full inspiration ; or in blowing wind instruments, or in making 
great muscular efforts of any kind. The internal causes are those that 
are only discoverable after death, viz. : extravasation of blood in the 
substance of the brain or in the ventricles, or serous accumulations in 
any of the cavities or between its membranes. 

Symptoms — We have two forms of genuine apoplectic seizure : con- 
gestive and hemorrhagic. In the first the premonitory symptoms are, 
carotids, distension of the temporal arteries and jugular veins ; constipa- 
tion, languor, dullness, drowsiness, dimness of sight, vertigo, headache. 
The attack is marked by sudden stupor ; with slow and sometimes snoring 
respiration, full and slow pulse, dusky or turgid appearance of the face. 
The total loss of perception may be brief, its partial absence or deficiency 



LOSS OF SPEECH. 423 

continuing for some time. Slight convulsive movements are not uncom- 
mon. Paralysis of the muscles occurs only for a short time after the 
attack, if recovered from. 

Hemorrhagic Apoplexy. — In hemorrhagic apoplexy generally no clear 
premonition is given, the attack being very sudden; a stroke, literally 
unconsciousness is complete for some seconds, minutes or hours. After 
this, general or local paralysis, most often hemiplegia (paralysis of one 
side of the body) is left; the mental powers also, in many cases, being 
impaired at least temporarily, during the coma; the breathing is com- 
monly stertorous and the pulse slow and somewhat full, the head hot and 
the face more or less dark or flushed. But the fullness of the blood-vessels 
and heat of the head are much less, as a rule, than in congestive apoplexy. 

The younger the patient and the more vigorous his antecedent health 
the more probable is the existence of the congestive form; and, also, the 
better the prospect of recovery from hemorrhage within the cranium, 
if only the effects of pressure be exerted at the time. 

Treatment — 1. If, in a person under fifty, not before of broken con- 
stitution, we find the head hot, face turgid and flushed, the arteries and 
veins of the neck and temples full, the pulse also strong, and the heart's 
impulse so (or the heart's action vigorous though the pulse at the wrist 
be oppressed) blood may be taken, carefully, from the arm or by cups or 
leeches applied to the back of the neck. 

2. Older and more doubtful cases may be treated tentatively with 
cups alone, aided by mustard plasters to the legs, back and epigastrum in 
turn; with laxative injections into the rectum during the attack and 
saline purgatives afterward. The head should be kept raised and cooled 
with wet cloths until its temperature becomes normal. If the hair be 
thick, it should be cut very short or shaved off entirely and an ice-cap 
placed thereon over the whole surface. When, however, there is reason, 
as usually is the case in really old or broken-down patients, to believe the 
structural degeneration, arterial or that of ramollissement, is the source 
of the attack, loss of blood will be out of place. Iodide of potassium for 
some time will aid absorption. 

LOSS OF SPEECH. 

(Aphasia.) 

Symptoms. — Loss of speech may occur as one of the symptoms of 
disease of the brain, either functional and transient, or organic and irre- 



424 



NERVOUS DISEASES. 



THE NERVES 



Figure No. i. 

i. Plexus or bunch of nerves in 
the carotid region. 

2. Sixth external motor nerve. 

3. First branch of the 5th ophthal- 

mic nerve. 

4. A branch on the nose partition, 

which goes to the incisive 
foramen. 

5. Concurrent branch of the Vid- 

ian nerve, dividing itself into 
carotid and petrosas branches. 

6. Back branches of the palate. 

7. Lingual nerve joined by the 

tympanum cord. 

8. Hard part of the 7th pair or 

facial nerve. 

9. Upper cervical ganglions. 

10. Middle cervical ganglions. 

11. Lower cervical ganglions. 

12. Roots of the great splenic nerve. 

13. Lesser splenic nerve. 

14. Renal plexus. 

15. Solar plexus. 

16. Mesenteric plexus. 

17. Lumbar ganglions. 

18. Sacrum ganglions. 

19. Vesical plexus. 

20. Rectum plexus. 

21. Lumbar plexus. 

22. The rectum. 

23. The bladder. 

24. The pubis. 

25. Crest of the ileum. 

26. The kidney. 

27. The aorta. 

28. The diaphragm. 

29. The heart. 

30. The larynx. 

31. The submaxillar gland. 



32. The incisive teeth. 

33. The nasal partition. 

34. Globe of the eye. 

35, 36. Cavity of the cranium. 



Figure 
1. 

2. 
3- 

4- 
5- 
6. 

7- 
8. 

ci- 
io. 



12. 
13. 
14. 



No. 2. 

Section of the bone of the fore- 
head. 

Section of the occipital bone. 

Muscles in the back of the neck. 

Integuments on the skin. 

Frontal cavity. 

Middle spongy bone. 

Lower spongy bone. 

Middle passage of the nose. 

Lower passage of the nose. 

Thickness of the -roof of th: 
mouth and depth of the nose. 

Opening of the eustachian tube. 
The catheter is at the nose 
and is going through the tube. 

Cartilage of the nasal division. 

Genio-gloso muscle. 

Veil of the palate. 



Figure No. 4. 

1.1. The cubital nerve. 

2.2. The ramus profundis dorsalis 

(deep-seated nerve of back of 
arm). 

3. Extreme of the cutaneous nerve 

of the arm. 

4. Branch of the radial nerve. 
5,5. Back view of the digital nerves, 

or of the fingers. 
6. Back branch of the cubital 
nerve. 




Fig. 1.— The great sympathetic nerve 



Fig. 3.— View of the nervous system in man, showing the nerv- 
ous centres (the brain and the spinal near row) whence start the 
other nerves which provide the whole body. 




Fig. 4.— View of the nerves on the back part of the forearm and hand. 

THE NERVES. 

For an explanation of the illustrations see text On opposite page. 



4:26 NERVOUS DISEASES. 

movable. Such a loss of language is termed aphasia, not articulation, as 
in aphonia, but expression is, in this affection, wanting. The power to 
unite words from memory, to convey meaning, is lost ; but, in some cases, 
at least, they may be copied correctly. 

Causes. — Hemiplegia of the right side has in a number of examples 
coincided with aphasia, and, several times, also, autopsy has shown soften- 
ing or other lesion of the left anterior portion of the cerebrum. Valvular 
lesion of the heart sometimes accompanies this disease. 

Treatment — Cases of aphasia are very rare. There is no special 
measure of treatment except that of general principles, and treat untoward 
ones as they arise. 

SUN STROKE. 

Symptoms. — This is a disease occurring in persons exposed to exces- 
sive heat and characterized by vertigo, sometimes with violent pain in the 
head, gradual increase of listlessness and torpidity and a desire to lie down. 
The feverish symptoms may culminate in more or less sudden and com- 
plete insensibility. 

Treatment. — The most obvious demand in regard to treatment is to 
abstract the excessive heat from the body as rapidly as possible, and this 
can be most speedily accomplished by cold sponging, rubbing the head, 
neck and chest with ice or by the cold pack. Light should be excluded from 
the patient as far as possible, and if the pulse is feeble stimulants should 
be given by the mouth or by injection. If prompt improvement does not 
occur the hair should be cut short and a blister applied to the nape of 
the neck. 

Heat Exhaustion. — In heat exhaustion the patient is generally found 
with a cool skin, a feeble pulse and pallid face, without disturbance of the 
intellect. In such a condition stimulants, dry heat of hot-water bags or 
bottles, mustard plasters to the stomach and perfect rest and quiet are 
indicated. 

HYPERTROPHY AND ATROPHY OF THE BRAIN. 

Meaning. — Hypertrophy means an actual enlargement or overgrowth 
of the brain structure generally, while atrophy signifies a general wasting 
of the substance of the brain. 

Causes. — The brain is sometimes the seat of morbid growths, includ- 
ing cancers, fibroid and bony tumors, tubercular deposit in large masses, 



PARALYSIS OK PALSY. 427 

and casts containing parasites. All these affections are, fortunately, very 
seldom met with. 

Treatment — The treatment in such cases is, of course, to cut out the 
tumor and the affected portion of the nerve with as little delay as possi- 
ble, whenever it can be accomplished. 

PARALYSIS OR PALSY. 

Causes. — Palsy is one of the most common and most distressing mis- 
fortunes which mankind is obliged to suffer. Yet its various forms are 
rather symptoms of deep-seated disease than disease themselves. Thus 
palsy of a limb is very frequently a symptom of structural disease of 
the brain or spinal cord, but it occasionally occurs from a diseased nerve 
trunk itself. It may affect a whole limb or only part of one, and is 
sometimes limited to a group of muscles in a particular region. 

Symptoms. — The following conditions give rise to paralysis of motion : 

1. Disease or injury to a nerve in some part of its course, destroy- 
ing its power of transmitting the force, which is expressed by a contrac- 
tion of the muscle to which the nerve is distributed. 

2. A disease of some portion of those central parts of the nervous 
system, whence the nerve takes its origin, or with which it may be con- 
nected directly or indirectly. 

Varieties of Palsy. — There are many varieties of palsy, among the 
most important of which are the following : 

According to its nature it may be motor (acinesia), and sensory 
paralysis (anesthesia). 

Facial Palsy. — This is an affection of the portio dura of the seventh 
pair of cephalic nerves, the motor nerve of the face. It occurs at any age, 
usually from rheumatoid inflammation of the sheath of the nerve at its 
escape through the cranium, through the stylo-mastoid foramen. 

Symptoms. — One side of the face is without change of expression, 
and the eye on that side is not closed (in severe cases) from the paralysis 
effecting the orbicularis palpebra muscle. The tongue is not affected in 
the movements. The facial motor nerve is not often involved in the 
much more serious cases of cerebral palsy. 

Diagnosis — Absence of disturbance or of incompleteness of control 
over the tongue, while the power over the eyelid is partly or wholly lost 
with the absence of severe cerebral symptoms, will, especially in a young 
person, make the diagnosis easy as well as important. 



428 KEEVOtrs diseases. 

Treatment. — The treatment of this form of local palsy may he by 
repeated small blisters behind the ear, followed, when convalescence has 
begun, by some warm covering (cotton wadding, flannel or silk) to protect 
the part from cold. 

Writer's Cramp. — Pressure upon a nerve may cause its paralysis, gen- 
erally temporary. A man has been known to have his hand rendered 
powerless for three weeks by sleeping all night with his arm bent under 
his head. Friction, the endermic application of strychnia and galvanism 
may be used in such a case. Writer's cramp or scrivener's palsy, is the 
result of exhaustion of certain muscles from over-use. Its cure is rest. 

Hemiplegia. — This means half palsy and is a paralysis in which one 
lateral half or side of the body is stricken with powerlessness so accurately 
that it is customary to define the condition by the terms right and left. 

Causes. — Brain lesion is most often the cause of this affection ; either 
an apoplectic clot, a tumor or softening. 

Symptoms. — In severe cases the arm and leg may be equally motion- 
less, but if there is any difference between them the leg is generally the 
limb less affected, the last to be attacked, and the first to recover some of 
its powers. Suddenly, almost always, but not always with loss of con- 
sciousness, the patient loses the power of motion and more or less sensa- 
tion on one side. In complete cases the parts involved are the arm and 
leg, the muscles of mastication and half the tongue. 

Treatment. — 1. Essentially the same principles are applicable to this 
as have been mentioned in connection with apoplexy. The younger the 
patient the more vigorous his or her previous health, and the fuller the 
circulation the more appropriate may be the general or local abstraction 
of blood to diminish pressure upon the brain. Where softening is appre- 
hended bleeding should be exceptional and cautious. Eest, regulation of 
the bowels, and counter-irritation of dry cups to the upper part of the 
spine, and afterward a blister, with friction, as with brandy and red 
pepper, or whiskey and hot water, or salt and spirits, to the affected limbs. 

2. In the hysterical form, if it lasts long, electricity may be applied 
locally with safety and advantage. In any curable case passive exercise 
of the weak limbs will be very useful. 

Paraplegia. — Paraplegia is that form of palsy in which one-half of 
the body below the chest and including the lower limbs is stricken with 
the disease. 

Causes. —Spinal disease or injury is its source, with or without cere- 



PARALYSIS OK PALSY. 429 

bral implication or complication. It may come suddenly or gradually; 
generally its beginning, at least, is sudden. 

Symptoms. — When the spine is affected, as well as in the reflex form, 
numbness in the feet and pain in the back are apt to be early signs. The 
power of motion is lessened or lost in the lower limbs. The muscles may 
be either relaxed or contracted. The lesion of the spinal marrow, if pro- 
gressive, is productive of loss of power over the bladder and bowels. 
Bed-sores with deep ulceration and sloughing may occur in protracted 
cases. 

Treatment — When myelitis is believed to exist, at an early stage, 
local depletion to a moderate extent may be advised. In many cases coun- 
ter-irritation by repeated sinapisms, or stimulating liniments will be 
proper. While inflammation or active irritation of the spinal cord is 
made apparent by the symptoms (pain, cramps, muscular twitching or 
rigidity), strychnia is not suitable. After these have subsided it may be 
given, not more at first than the thirtieth of a grain twice daily. If it 
produce jerking movements of the hands or feet, or nervous restlessness, 
or any marked uneasiness it should be suspended. Electricity may be 
used with similar caution in a secondary stage of paraplegia. 

Hysterical Paralysis. — In females this is among the many forms of 
functional disorder which that strange but not yet clearly defined dis- 
order, hysteria, may produce. 

Diagnosis. — The affected limb, in walking, is dragged after the other, 
as if a dead weight ; while in cerebral hemiplegia the palsied leg and foot 
are brought round in a curve, the body being bent toward the sound side 
at the time. 

Treatment. — Tonics, good nourishment and change of air are most 
required in all hysterical cases. For the paralysis itself electricity is use- 
ful. Mild shocks for a few minutes twice a day may be given with 
advantage. 

Reflex Paralysis — Causes. — Worms, dysentery, diarrhoea, uterine irri- 
tation, teething and external injuries are all thought to induce reflex 
paralysis in certain instances. Diphtheritic and scarlatinal palsies have 
been placed in the same category. The simplest and clearest cases are 
those of wounds. 

Treatment. — In true reflex paralysis^ the removal of the irritant cause 
produces instant relief. When the nature of the case does not admit of 
such prompt relief, if the diagnosis be clear, the same indication remains, 
to address our remedial measures to the seat or source of peripheral 



430 ZSTERVOUS DISEASES. 

irritation. Palliate, if we cannot cure the trouble there, and we will ob- 
tain palliation, if not relief, of the reflex disability. Electricity has 
proved signally useful in the subsequent treatment. 

Diphtheritic Paralysis. — After the termination of an attack of diph- 
theria, commonly within three weeks, the muscles used in swallowing and 
speaking, less often those of the upper and lower limbs and the sense of 
sight may be partially paralyzed. Loss of sensibility usually accompanies 
the loss of motor power. This condition of things may last for weeks or 
even months, but is generally recovered from. 

Causes. — The immediate cause of the paralysis of the peripheral 
lesion of the nervous terminations is the toxemic influence upon those 
centres of the morbid poison of diphtheria. 

Treatment — Passive exercise, stimulating friction and electricity, 
change of air and sea-bathing are suitable measures for this affection. 

Syphilitic Paralysis. — The most unequivocal instances of this nature 
are accounted for by periostitis within the cranium, involving the dura 
mater, or by nodular exostosis pressing upon the brain. The most remark- 
able fact connected with such cases is the prompt curative effect upon it 
of iodide of potassium. 

Lead Palsy. — Considerable time of exposure to the influence of lead 
is generally necessary to cause this. So commonly does it first affect the 
extensor muscles of the forearm that the cognomen of "wrist drop" is 
often applied to it. When it lasts for some weeks the muscles waste 
away. 

Symptoms. — A blue line is observed to form along the edge of the 
gums. Pain precedes the palsy and attends recovery of power. Mostly, 
though after a long time, lead palsy is recovered from. 

Treatment. — Iodide of potassium appears to act as an eliminant of 
the lead accumulated in the system. Ergot is also useful. Faradic elec- 
tricity has been found decidedly beneficial used in moderate strength for 
a few minutes two or three times a day. 

Mercurial Palsy. — This is occasionally met with in those who work 
in metal. Mostly tremor is a predominant symptom. Early withdrawal 
from the influence of the cause and the continued use of the iodide of 
potassium are the principal measures of treatment. 

Paralysis Agitans, called also shaking palsy, is described as a more 
or less constant involuntary and uncontrollable shaking of the hands, arms, 
head or, progressively, of the whole body. Slight or moderate degrees of 
such tremor are common enough from general nervous debility. Extreme 



PARALYSIS OR PALSY. 431 

cases evince the wreck of the cerebro-spinal system and are, therefore, 
incurable. In other cases the treatment is upon general principles. 

Progressive Muscular Atrophy — This is still another uncommon and 
incurable form of paralysis due to a gradual decay and wasting of the 
muscles, but commencing sometimes with an apparent enlargement or 
hypertrophy of these organs. 

Locomotor Ataxia. — This results from a disease called sclerosis, or 
hardening of certain motor-centres in the brain and spinal cord, or 
syphilis. 

Symptoms. — Rheumatoid pains precede loss of power, occasional stra- 
bismus (cross-eye) and incontinence of urine may occur. Then there is 
an awkward, unsteady gait; the sensibility of the feet becomes blunted, 
and walking is insecure. If the patient shuts his eyes he falls down, and 
even with them open he reels as if drunk. The duration of this progres- 
sive disease varies from six months to ten or twenty years. 

Treatment. — Hygienic management, general tonics, electricity and 
very careful use of strychnia. 

Infantile Paralysis. — This is a variety developed in very young chil- 
dren and occasionally present from time of birth. As a rule this palsy 
arises from disease of the spinal cord and its membranes. 

Symptoms — It comes on with acute symptoms of fever and con- 
vulsions, ending in paralysis of one or more limbs. In some cases the 
child gradually recovers from the effects of the malady, but in many the 
impairment is permanent and the limb, ceasing to develop in proportion 
to the rest of the body, appears in the adult as if shrunken and withered, 
constituting a lamentable and hopeless deformity. 

Treatment. — Much can be done towards preventing complete loss of 
power by persevering and systematic movements, application of galvanism 
and exercise as suggested in the article on hemiplegia. 

Scrivener's Palsy. — Called also writer's cramp. It is the result of long 
continued and unnatural excitement of the nerves controlling the fingers 
and hand in writing. 

Symptoms. — The earliest indication is a painful sense of fatigue and 
weakness which comes on shortly after commencing to write. Sooner or 
later this begins to be accompanied by involuntary spasms of the muscles 
employed in holding the pen and the handwriting grows unsteady, scrawlv 
and almost illegible. At first the spasms and irregular movements can 
be more or less controlled by voluntary effort, but they gradually become 
worse and worse, until at last the use of the pen is an impossibility. 



432 NERVOUS DISEASES. 

Treatment. — Eest from writing, tonics and electricity accomplish a 
cure in some instances, but the prospect of recovery is small, and it is, 
therefore, very important to avoid the disease by moderation in writing, or 
by the use of the ingenious typewriter. 

Wasting Palsy. — A few of the muscles of one limb, or the voluntary 
muscles of the whole body may lose their power and then waste away 
to almost nothing. Insidious in its approach the affection may last from 
six months to several years. It may end in recovery. The shoulder and 
ball of the thumb are frequent points of commencement for the palsy 
and atrophy. 

LOCK-JAW. 

(Tetanus.) 

Description. — When a patient is the subject of an uncontrollable 
spasmodic contraction of the muscles of the lower jaw, he is said to have 
"trismus" or lock-jaw; and when the same condition attacks other or all 
the voluntary muscles of the body he is said to have "tetanus." 

Causes. — 1. Tetanus includes trismus and generally begins with it, 
though trismus may be a local affection. It is found in children as a 
result of dentition, and in adults as a consequence of diseases involving 
the teeth, gums or jaws. It is a spasmodic affection produced by reflected 
irritation set up by a local disease, is rarely associated with any con- 
stitutional disturbance and is, for the most part, cured on removal of 
the cause. 

2. Tetanus is likewise generally associated with some local source of 
irritation, some wound or injury, it is then called "traumatic;" when an 
external or visible cause can be made out, it is denominated "idio- 
pathic;" when rapid in its course it is called acute; when slow, chronic. 
The acute form is usually the result of an accident and generally fatal. 
The chronic is for the most part idiopathic and more curable. 

Symptoms. — There are no general or local premonitory symptoms by 
which the onset of this affection can be recognized, and the earliest indi- 
cations of its approach are generally a difficulty in opening the mouth, 
with stiffness in the muscles of the lower jaw; yet these symptoms may 
be so slight as to pass unheeded, or to be misinterpreted, when, however, 
some rigidity of the muscles of the neck, throat or abdomen can be made 
out and the first indications of the "tetanic grin" recognized. 

3. As the disease progresses the muscular system of the body gen- 



HYDROPHOBIA, OR RABIES. 433 

eially will be more or less affected, and, in different cases, different 
groups of muscles will be involved. Those of the back are most frequently 
attacked and their contraction may be so powerful as to cause an arching 
backward of the frame. The muscles of respiration are, as a rule, af- 
fected only in acute cases, and the chief danger to life consists in the 
severity of the spasms which attack them. When severe the first spasm 
may be fatal and may occur at an early or at a remote period of the 
affection. When the jaw is unlocked by a spasm of the depressor muscles, 
the tongue is sometimes suddenly shot out from between the teeth and 
often wounded. 

4. As the disease advances the jaws become completely fixed and 
deglution is then impossible. The spasms of the muscles of the frame 
become more intense and frequent and the powers of the patient rapidly 
decline. The pulse which was rapid becomes more feeble, while the 
expression of the countenance betokens agony of the body and despair 
of the mind. The slightest manipulation or movement of the patient 
sets up a fresh spasm, and any emotion may do the same. The skin 
becomes bathed with a cold sweat, and, if death is not caused by suffoca- 
tion, exhaustion soons puts an end to suffering. 

Treatment. — Among the specific remedies which have been greatly 
trusted the Calabar bean stands foremost and may be given in full doses, 
such as half a grain of the extract in two or three hours. Camphor is 
also recommended in doses of from Rve to ten grains. The bromide of 
ammonium or potassium has been administered with advantage. It was 
hoped that a valuable drug for this disease had been found in chloroform, 
but experience has not justified the expectation. The hydrate of chloral 
has now taken its place and been of some service. Indian hemp in doses 
of a grain every hour, aconite and belladonna in quantities of one-fourth 
of a grain have also been recommended. Ice applied in bags along the 
spine has apparently been of great value. The administration of remedies 
by subcutaneous injection, in these cases, promises to be a valuable ad- 
junct to practice enabling us rapidly to introduce into the system drugs 
Avhich act antagonistically to tetanic spasm. Tetanus antitoxine should 
be administered early. 

HYDROPHOBIA, OR RABIES. 

Meaning the "dread of water," which is more correctly termed 
"rabies" is a disease contracted from a rabid animal, generally from its 
bite through the saliva or mucus. 
28 



434 NERVOUS DISEASES. 

Stages of the Disease. — In the dog there are three well-marked stages 
of the complaint. The first is the melancholic, characterized by melan- 
choly, depression, snllenness and fidgetiness; the second, the furions, by 
excitement or rabid fury, and the last, the paralytic, by general muscular 
debility and actual paralysis. 

Symptoms. — 1. In man the disease may show itself at any period from 
six weeks to a year after the inoculation. A month or more after the bite 
of a mad dog, or other rabid animal, the wonnd having healed, irritation is 
felt in it, nervous restlessness also exists which increases (in most cases) 
to violent, angry delirium. Then difficulty of swallowing occurs from a 
spasm of the muscles of inspiration (gasping) taking place at the moment 
of deglutition, making the patient choke. 

2. The same spasmodic gasping is brought on by any sudden im- 
pression, as of sound, a flash of light or even a current of air passing 
over the face. Insomnia exists ; the patient grows prostrate and must 
die for want of food and drink, even if the affection of the cerebro-spinal 
axis were not itself fatal. 

3. There is intense thirst, but the characteristic dread of water, not 
as a fluid, however, but as connected with the difficulty of drinking. The 
sight of water is frequently sufficient to bring on shuddering, yet it is 
when the patient carries water to his lips that he is seized with the typical 
terrors. 

4. A rabid man is always rational and tries to drink, but the attempt 
excites terror and the expression of his inability. His eyes become fixed, 
features contracted and his countenance expressive of the deepest anxiety, 
his limbs shake, and the whole body shivers. The paroxysm lasts a few 
seconds, then subsides, but only to be renewed on the slightest breath of 
air touching the body. During the calm sudden terror of an unknown 
kind haunts the mind and imaginary calling of friends often exists. 

Symptoms of Last Stage. — In the third and last stage the longing for 
drink becomes intense, with an increasing inability to take it; the voice 
becomes hoarse and the mouth full of frothy fluid. The patient tries to 
get rid of this by spitting, and then becomes frightened at its results. 
Convulsive seizures increase in frequency and intensity, the spasm of the 
respiratory muscles threatening life ; at last a fatal spasm takes place and 
death by asphyxia ensues. 

Treatment. — There is not satisfactory evidence that a case of genuine 
rabies canina or hydrophobia has ever been cured. If we cannot cure, 
what can or should we do ? We may certainly promote easy death by 



INFANTILE CONVULSIONS. 435 

allaying the wretched sufferings of the patient by nitrous oxide, ether, 
or chloroform. Hypodermic injection of atropia or morphia might, per- 
haps, more effectually quiet the suffering and even afford more possibility 
of cure than inhalation of anesthetics. In all cases of bites from dogs or 
animals, however, in which the faintest suspicion of rabies exists, free 
cauterization with lunar caustic should be performed. Mental stimu- 
lants, in the way of inspiring hope and removing fear, must be duly ad- 
ministered and such general treatment as may be needed. No drug has 
yet been discovered that has the least influence on the disease, either in 
preventing or curing it. 

What is known as the "Pasteur cure for hydrophobia" is in great 
favor among some medical men. It is rather a preventive agent or treat- 
ment and no doubt possesses great value. 

FITS OR INFANTILE CONVULSIONS. 

Causes. — The exciting causes are numerous, constipation of the 
bowels, indigestion, worms, irritation of the gums in teething and excite- 
ment of the brain, as by fright, are about the most frequent. Many 
acute and chronic diseases of infancy (scarlet fever, meningitis, whoop- 
ing-cough, and so forth) have convulsions among their occasional symp- 
toms or complications. 

Symptoms. — Premonition of a fit is often observed in the child's fret- 
fulness, or restlessness, or gritting of the teeth in sleep. When a fit comes 
on the muscles of the face twitch, the body becomes rigid at first, then in 
a state of twitching motion, the head and neck are drawn backward, the 
limbs violently flexed and extended ; sometimes these movements are con- 
fined to certain muscles, or are limited to one side. 

Treatment. — 1. The treatment of a child during the convulsion is, of 
course, to be directed first toward relaxing the spasm, and immediately 
after that is accomplished to removing the cause of the trouble, which, in 
two cases out of three, will prove to be irritation of the gums or bowels. 
To shorten the paroxysm the child should at once be placed in a warm 
bath and a cloth wrung out of cold water applied to its head. 

2. If the gums are swollen, or have been tender and irritated at the 
time of teething, lance them freely, dividing the tense gum down to the 
coming tooth. If the bowels have not been moved give at once an enema 
of castor oil, soap and glycerine, or some other laxative material, with 
warm water. If there is reason to suppose that the intestinal worms, 



436 ETERVOTJS DISEASES. 

which most children harbor, are causing disturbance, active vermifuges 
such as a grain of santonine before dinner and supper for a child two 
years old, followed by two grains of calomel at bed-time, ought to be 
employed. 

3. Cupping the back of the neck, in some cases where time is allowed 
by a protracted fit, may be resorted to, especially dry cups. Full doses of 
bromide of potassium, asafetida and valerian are often very useful in 
diminishing the excitability of the nervous system, which is especially 
great during the age of childhood. 

PRESCRIPTION NO. i. 

R. — Bromide of ammonia 40 grains 

Bromide of potash % drachm 

Syrup 1 ounce 

Water 1 ounce 

Half a teaspoonful for a child 2 years old, every three 
or four hours. 

PRESCRIPTION NO. 2. 

R. — Bromide Soda 3 drachms 

Bromide potash 3 drachms 

Liq. potass, ars 1% drachms 

Peppermint water 3 ounces 

Infus. gentian co 5 ounces 

Tablespoonful three times a day for an older child. 

FALLING SICKNESS OK EPILEPSY. 

Periodical convulsions with unconsciousness during the attack. 

Causes — Hereditary transmission of this disease is common. Intem- 
perance, venereal excess and self-abuse, blows on the head and fright are 
among the most frequent exciting causes. 

Symptoms. — Premonition occurs in a minority of cases before an at- 
tack; headache, dizziness, terror, spectral illusions, a creeping or blowing 
sensation, like that of a current of air or stream of water, beginning in a 
hand or foot and extending toward the trunk. Then, often with a scream, 
the patient falls down and is violently convulsed. Foaming at the mouth, 
grinding of the teeth and biting of the tongue are common ; the face is 
flushed, the eyeballs roll, the pupils are unaffected by light, sometimes 
vomiting, or involuntary urination or defecation takes place; the respira- 
tion may be very laborious. The fit lasts on an average from five to ten 



SPASMODIC CROUP. 



437 



minutes. The interval between the attacks may be from several months 
down to a few days. In old cases there may be two or three paroxysms 
daily. They vary much, even in the same individual. The condition 
after the attack is also various, generally drowsiness or deep sleep follows 
it, or headache, debility or delirium, sometimes maniacal frenzy. 

Treatment. — 1. During the paroxysm, when habitual, little can be 
done. Place the patient so that he cannot strike his head or limbs against 
anything hard, loosen the clothing about the neck to form free respiration 
and circulation and insure fresh air about the patient, protect the tongue 
from being bitten, if possible, by placing a cork or piece of India rubber 
between the teeth. Care must be taken that such an object does not pass 
into the throat and choke the patient, which can be prevented by tying 
a strong string to it. 

2. To break up the recurrence of the fits is the problem for which a 
vast number of remedies have been tried in vain. Bromide of potash, 
valerianate of zinc, belladonna, arsenic and digitalis have all been em- 
ployed. Strangely enough this disease is very apt to improve temporarily 
under any new treatment, no matter how absurd, which takes a strong 
hold on the patient's imagination. 

3. Self -management is very important to the epileptic. Temperance 
with nutritious diet is necessary ; regularity of the evacuation of the bowels 
is imperative ; abundant exercise in the open air, short of exhaustion, does 
good; systematic gymnastics have even cured some cases. 

PRESCRIPTION. 

R. — Bromide of potash 3 drachms 

Bromide of soda 3 drachms 

Bromide of ammonia 3 drachms 

Iodide of potash I % drachms 

Iodide of ammonia i% drachms 

Tincture of columbse I % ounces 

Water 6% ounces 

Take two teaspoonfuls before each meal and three tea- 
spoonfuls at bed-time. 

SPASMODIC CROUP OR SPASM OF THE GLOTTIS. 

Causes. — This is the most important of several varieties of simple 
spasm in different parts of the body, among which ordinary croup is a 
familiar example. It consists in a spasm of the muscles of the glottis or 



438 NERVOUS DISEASES. 

opening into the windpipe, by which a crowing or croupy cough is pro- 
duced, with hard or stridulous breathing. 

Symptoms. — This disease especially occurs in young children, where 
it is due to some reflex irritation, such as that of teething, reflected from 
the nerve centres which control the muscles of the glottis. It may gener- 
ally be distinguished from the alarming malady, true croup, by its coming 
on suddenly without fever, marked heat of skin or quickened pulse. 

Treatment. — To relax the spasm sprinkling of a little cold water in 
the face, or tickling the fauces with the finger or with a feather, so as to 
produce vomiting, frequently answers the purpose. Should it fail the 
child should be immediately placed in a warm bath. After an attack 
the gums should be carefully examined and freely lanced if found swol- 
len, every attention being paid to the general health. Much needless 
alarm would be spared to anxious parents and nurses if it were generally 
understood that there is no likelihood of this disease leading on to the 
fatal malady, true croup, which may always be excluded from considera- 
tion if the child is free from fever, coughs loudly and has no huskiness of 
the voice. Give syrup of ipecac frequently until vomiting takes place. 

CHOREA OR ST. VITUS' DANCE. 

Causes. — From six to sixteen, in both sexes, especially often, how- 
ever, in girls, chorea occurs. Nervous debility is almost always present 
before the attack. Fright is a frequent cause, overfatigue or mental ex- 
citement, blows or falls may produce it. Rheumatic fever is sometimes 
followed by it. 

Symptoms — Incessant and irregular movements of the voluntary 
muscles over which the will has but partial control. Walking in severe 
cases is difficult or unsafe ; the hands cannot be regulated enough to write 
or work; speech may be affected; the muscles of the face often twitch 
grotesquely. The pupil is, in some cases, unnaturally dilated ; palpitation 
of the heart may occur, and also constipation and indigestion. The urine 
is of great density; the countenance assumes a blank and foolish expres- 
sion, and the mind itself may in time grow seriously enfeebled. 

Treatment. — Good diet, salt bathing and systematic gymnastic exer- 
cises will suffice for mild cases. Where marked anemia exists iron 
(citrate, phosphate oa- hypophosphate, tincture of chloride, syrup of 
iodide) is important. Obstinate cases may be treated with Fowler's 
solution of arsenic, in small doses, gradually increased. Cod-liver oil 



HYSTERIA. 439 

should be given if great debility exists. In chronic cases the tonics before 
mentioned with the addition of the hypophosphites should be resorted to, 
and change of climate is very likely to be of service. 

HYSTERIA. 

From its occurrence nearly always in females and from a supposition 
of its originating in some affection of the womb, this name has been given 
to a variable disorder, of which the main characteristic is morbid ex- 
citability of the whole nervous system. 

Symptoms — 1. A "fit of hysterics" is a paroxysm whose nature may 
vary from mere uncontrollable laughter or crying to a severe epiliptiform 
convulsion. This last, however, differs from epilepsy in that being less 
complete loss of consciousness and in its curability. 

2. Simulation of other diseases, indeed the assumption of severe 
functional disorders of different organs, is a common trait of hysteria. 
There may be hysterical amaurosis ; hysterical insanity is not uncommon ; 
nor is hysterical paralysis or coma rare. Retention of urine, cough, 
aphonia, and so forth, are often thus produced. 

Catalepsy. — Catalepsy or trance is a condition allied to hysteria in 
some respects, in which the whole frame lies prostrate and helpless, or 
that a limb, lifted up, falls back as if it were relaxed and dead while 
yet the consciousness of the person affected may be retained without the 
sensitiveness to physical pain. This curious state of existence is not well 
understood, and in our present ignorance of its nature the chief importance 
lies in its being distinguished from death early enough to prevent that 
most horrible of all human misfortunes, being buried alive. 

Hypochondriasis. — This is a very obstinate affection, often hereditary, 
and occurring more frequently in men than in women. During the attack 
there is apparently great depression of mind without mental disease. The 
patient imagines he is afflicted with maladies of the most varied kinds; 
is tormented with ideas of impending miseries and dangers; thinks he 
suffers from swellings or contortions of the body, which may be purely 
creations of fancy. This disorder in the male corresponds very nearly 
to hysteria in the female and like it can only be cured by attention to the 
general health. Tonics, exercise and cheerful occupation are the best 
remedies. 

Treatment of Hysteria. — Much skill and care will often be required 
in the management of hysteria, as each one has peculiarities of its own. 



440 NERVOUS DISEASES. 

Generaly a tonic regimen is demanded. Iron and cod-liver oil are most 
often the appropriate remedies. Bromide of potassium is sometimes quite 
useful. For a paroxysm of "hysterics" asafetida is universally safe and 
reliable in pills of three grains each. Sinapisms and pediluvia are also 
proper. Menstruation is often irregular in hysterical women ; it should be 
regulated as far as possible. Exercise in the open air, as a rule, is very 
important for such persons. Mental and emotional excitement should be 
avoided ; but tranquil, even engrossing, occupations will be beneficial. For 
hysterical paralysis electricity is promptly useful. Cold bathing, espe- 
cially the shower-baths or sea-bathing, when followed by reaction, will do 
good. 

NEURALGIA. 

Meaning. — Pain, without inflammation or other disorder, except that 
of the nerve or nerve-control involved; literally nerve pain. This may 
affect any of the sensitive nerves. It is also sometimes referred to parts 
which have, in health, no sensibility; as the heart, stomach, and so forth. 
Different names are given according to its site. Thus, tic douleureux is 
facial neuralgia ; hemicrania, that affecting one side of the head ; sciatica, 
that of the hip ; gastrodynia, neuralgic pain in the stomach ; pleurodynia, 
in the side. Angina pectoris is, chiefly, a neuralgic affection of the heart. 

Symptoms. — The pain is generally acute, shooting or darting, with 
tenderness of the part upon pressure. There is, however, no heat or 
swelling, or throbbing of the blood-vessels in pure neuralgia. Complicated 
cases occur in which inflammation and neuralgia exist together, and in- 
flammation of the fibrous neurilemma may be the immediate cause of the 
neuralgic pain. 

Causes. — Neuralgia is always dependent upon debility arising from 
one cause or another, as, for instance, anemia, mental anxiety, gout, rheu- 
matism, syphilis and dyspepsia. In fact, a great German authority upon 
nervous diseases declares, with as much truth as poetry, that "neuralgia 
is the prayer of the nerves for iron in the blood." 

Next to the sciatic nerve no other is so often the seat of neuralgic 
pain as the trifacial, and this is, perhaps, partly owing to the fact that 
the superficial branches are spread out over a large surface upon the side 
of the face and more exposed to cold and changes of the weather than any 
other part of the body where the epidermis is equally delicate. Terminal 
branches of the trifacial come out through the bones of the head at 
points over the eye, beneath the eye and at the side of the chin — as shown 
24 



NEURALGIA. 



441 



in the marginal illustration. These, then, are the tender points, where all 
the branches of this nerve are involved in the neuralgia, and it is from 
these points that the darting bony pains seem to radiate. 

Hemicrania or Migraine. — This is a combination of neuralgic symp- 
toms with ordinary headache occurring in paroxysms, and usually limited 
to one side of the head or brow. It is apt to commence in childhood and 
ro on to advanced age, occurring in both sexes, but more often in women 

than in men. In women the 
attacks are especially apt to 
appear just before the men- 
strual period or during its 
course. 

Causes — The headache 
is probably due to excitement 
of the sensitive filaments of 
the trifacial nerve — distri- 
buted to the dura mater — 
and also to the sympathetic 
fibres accompanying the 
blood-vessels, which connect 
the nervous supply of the 
brain with that of the 
stomach so intimately. 

Symptoms. — As gener- 
ally manifested it increases 
rapidly soon after waking in 
the morning, with chilliness, 
loss of appetite, sliminess of 
the mouth, sickness of the 
stomach, vomiting of a little greenish fluid, and at last the headache be- 
comes so intense as to be almost unbearable. 

Sciatica. — This is often associated with both rheumatism and gout, 
but is also frequently brought on by catching cold. Occasionally it is due 
to accumulations in the bowels, or to diseases of the bones through which 
the nerve makes its exit. The painful points are usually found back of the 
trochanter or most projecting point of the thigh bone, at certain spots in 
the thigh about the knee and ankle joints. 

Intercostal Neuralgia. — This, like intercostal rheumatism, resembles 
the pain of pleurisy and of pneumonia, and has often given rise to un- 




Distribution of Nerves on the Side of the Face. 



442 NERVOUS DISEASES. 

founded anxiety as to the existence of these more dangerous diseases. It 
may be at once distinguished by careful examination of the lungs. 

Neuralgias of the arms, neck, shoulder, and so forth, are unhappily 
common and sometimes very intractable. 

Pathology. — At least three sources of pain are possible. 1st. Local 
disease affecting a nerve. 2d. A morbid state of a sensorial nerve centre. 
3d. A morbid condition of the blood. Neuralgia always fixed or return- 
ing in the same spot, is likely, although not certain, to depend upon a 
fault in the nerve itself, as neuroma (tumor of a nerve). Radiating pain 
must at least involve part of a nerve centre. Flying pains, never long 
seated in one part of the body, are due to a defect or morbid poison (as 
that of gout or malaria) in the blood. 

Treatment of Neuralgia. — 1. This must, of course, depend upon the 
cause or nature of the case. Tic douleureux often depends upon decay 
of the teeth; if so, they must be attended to. Other purely local neu- 
ralgias require local treatment. Laudanum or paregoric, applied by satu- 
rating a cloth and laying it upon the part covered by oiled silk to prevent 
evaporation, is an efficient local anodyne. So is chloroform, similarly ap- 
plied; it is very pungent, burning like mustard. Sinapisms will some- 
times relieve promptly. 

2. Mere warmth, as of flannel steeped in hot water, will do in some 
instances. Rubbing for a few moments with saturated tincture of aconite 
root until the. skin tingles, or the application of ointment of veratria, 
twenty grains to the ounce of vaseline, may be used in severe cases. In 
the most obstinate ones a blister may be applied, dressed, after removal 
of the cuticle, with two grains of the acetate of morphia, diluted with ten 
grains of gum arabic. Carbolic acid is a powerful local anesthetic, though 
(unless diluted with oil or glycerine) very irritating to the skin; or, most 
prompt usually of all, solution of morphia may be hypodermically injected. 

3. Of anodynes internally used, belladonna has, for neuralgia, the 
greatest reputation. It will not quell suffering so directly as opium or 
morphia, but it will more entirely do away with the neuralgic state. For 
this, however, iron, especially in combination with quinine or strychnia, 
is the most effective medicine. Cases of neuralgia which will not be 
benefited by iron are decidedly exceptional. 

4. In some instances application of the galvanic current will remove 
the pain of neuralgia as if by magic, and when relief can thus be secured 
it is far preferable, as the distressing sickness, headache and constipation, 
which so often result from opium and other narcotics, may thus be avoided. 



DELIRIUM TREMENS. 443 

Auxiliary Treatment. — The hygienic treatment is almost equally im- 
portant with the medicinal, and a thorough examination of the habits of 
life pursued by the patient will almost always lead to the discovery of 
some violation of sanitary law, which must be corrected, before a hoped- 
for cure can be realized. 



PRESCRIPTION i. 

R. — Menthol .20 grains 

Muriate of cocaine 10 grains 

Chloral 5 grains 

Vaseline 3 drachnfe 

Apply the ointment to face where pain is seated. 

PRESCRIPTION 2. 

R.— Citrate of caffeine 10 grains 

Phenacetine V2 drachm 

Make ten capsules. Take one every 2 or 3 hours. 

PRESCRIPTION 3. 

Tablets acetanilide and sodium bromide. One as needed 
every three or four hours. 



DELIRIUM TREMENS. 

Causes may arise under two different conditions or circumstances. 
Where stimulants are suddenly withdrawn from one accustomed to them ; 
and, while their use in excess is continued. 

Symptoms. — Sleeplessness, debility, tremors, horror, hallucinations, 
often with loss of digestive power. The insomnia is a cardinal symptom ; 
if the patient sleeps a whole night he recovers. Debility varies in degree 
in different cases ; in a first attack it is not always great, tremor is nearly 
always present. The illusions of the patient are wonderfully real, and 
usually dreadful. He is pursued by demons or beset by moral enemies; 
he cannot bear to be alone, especially in the dark. Sometimes, however, 
the visions are indifferent, or even amusing. 

Treatment — If the patient be not much prostrated, give only ale or 
porter, a bottle or two in the day, with hop tea ad libitum and a grain of 
opium every three or four hours. Very weak patients, accustomed to 
spirits, might have a tablespoonful of whiskey or brandy every two, three 
or four hours, according to their condition. Hydrate of chloral sometimes 



444 NERVOUS DISEASES. 

answers as well as, or better than, opium. Bromide of potash with tinc- 
ture of hyoscyanus repeated every three to four hours. 

Diet. — Beef tea and mutton broth, and so forth, seasoned with red 
pepper, are preferred as diet. In an obstinate case sleep may follow the 
raising of a blister upon the back of the neck. Substituting valerian for 
opium, or combining the fluid extract or tincture of valerian with morphia 
solution answers well in some cases. Injection of laudanum into the 
rectum is occasionally resorted to. Success in treatment has been ob- 
tained from the use of chloroform in doses of one or two drachms. The 
corrugated stomach of a spirit drinker will probably bear the pungency 
of chloroform better than anetheis. The large majority of first attacks 
of mania-a-potu are curable. Third and fourth attacks are often fatal, or 
are followed by permanent insanity. 

PRESCRIPTION i. 

R. — Indian hemp 10 grains 

Divide into 12 pills. Take one every two or three hours 
until drowsy. 

PRESCRIPTION 2. 

R. — Hyoscyamus 1 grain 

Alcohol 1 drachm 

Water 1 drachm 

Inject 5 to 10 minims with hypodermic sj^ringe. 

INSANITY OR MADNESS. 

Causes. — 1. This consists chiefly in a particular organization of the 
brain and nervous system, rendering those individuals so constituted 
liable to become insane when exposed to the influence of certain agencies, 
which in other persons either give rise to a different train of morbid 
phenomena, or are, perhaps, devoid of any injurious effects. 

2. Among the agents which give rise to madness there is none more 
influential than intemperance, or the frequent use of ardent spirits. That 
the predisposition to madness, when it has once arisen, is frequently trans- 
mitted, is a fact too well established to admit of doubt. 

3. The exciting causes of insanity may be divided into moral or 
psychical and physical. The principal psychical are grief, fright, anxiety, 
care, or an excited state of any passion ; the emotions aroused by disap- 
pointment, excessive or prolonged employment of the intellectual facul- 
ties, and so forth. Anything which will produce a hyperemia of a por- 



INSANITY OK MADNESS. 44:5 

tion or the whole of the brain by which the nutrition and consequently 
the normal function is interfered with. 

4. The principal physical causes are drunkenness and the use of 
narcotic or poisonous drugs, want of food, want of sleep and over-exertion ; 
other nervous diseases such as epilepsy, chorea and hysteria; severe in- 
juries to the head, particularly from blows, causing fracture of the skull 
or concussion of the brain, sunstroke and tumors in the brain. Acute 
febrile diseases as typhoid, typhus and malarial fevers, and it may occur 
during the course of pneumonia in the form of acute mania. The poison 
of Asiatic cholera may so interfere with the nutrition of the brain as to 
produce not only transient delirium but mania, which may continue sev- 
eral days or weeks. Acute rheumatism is sometimes a cause, chronic con- 
stitutional diseases are frequent causes, and among the most formidable 
of these is constitutional syphilis. Diseases of the genital organs some- 
times exert an important influence in producing insanity. 

Symptoms. — 1. The earliest symptoms of coining insanity are de- 
pressed manner, unusual excitement, anger and rashness. 

2. An important symptom in all forms of insanity is impairment of 
the faculty of attention. The inconsistency of the beliefs of the insane is 
one of the earliest noticeable symptoms, and they are classed as "delu- 
sions" and "hallucinations." A delusion is a false belief in regard to some 
fact which generally concerns the patient, and which is so strongly rooted 
that all attempts to reason him out of it are futile. A hallucination is a 
false perception of one of the senses ; the patient may fancy that he sees 
a spirit or a person who does not exist. 

Melancholia. — This may be acute or chronic, and is marked by ex- 
treme depression of both mind and body. The first stages of melancholia 
are generally preceded by a condition called hypochondriasis, which may 
be considered as the mildest form of insanity. There is a feeling of 
bodily illness at this time more than at any other, or in any other form 
of insanity. 

Treatment — 1. The treatment of a case of chronic or subacute melan- 
cholia will vary with its history and symptoms. An asylum is not indis- 
pensable if the patient's means are sufficient to provide him with proper 
care. He may be benefited by travel and change of scene ; but when his 
condition will not admit of this a proper place, either a private house or an 
asylum, should be selected, and an attempt made by therapeutical and 
hygienic measures to restore the cerebral defect by sleep and nourishment 
of the body. 



446 NERVOUS DISEASES. 

2. There are three conditions which require constant attention : want 
of sleep, rejection of food and constipation. To remedy the first chloral 
is most beneficial. The practical aim is to produce sleep, regularity of the 
evacuations by laxative medicines and to sustain the strength with nourish- 
ing food and wine. 

Mania. — There are two varieties, the acute and chronic. In the acute 
form the excitement is extreme, and follows closely upon the delusion or 
derangement of ideas. In the chronic form the delusion or derangement 
is confirmed but less obtrusive, while the excitement is subdued or comes 
on at long intervals. Mania has generally a sort of stage of incubation, 
during which sleeplessness is one of the most important and earliest 
symptoms. In another class of patients the primary symptoms are those 
of gloom and despondency, out of which the maniacal excitement appears 
to develop. In both varieties there is generally a marked departure from 
the individual's usual state of physical health. The different forms of 
mania in which the disposition to commit murder, suicide or arson, or to 
steal, is quite uncontrollable, are well known. When a single tendency of 
this kind is very prominent the case is usually denominated one of 
monomania. 

Treatment. — The treatment consists on regulating the bodily func- 
tions, giving food freely, combined with plenty of drink, also wine, and in 
the judicious use of chloral. Rest is of the highest importance, and baths 
of warm water are of great benefit, the head to be kept cool during the 
operation. Purgatives at the outset of the attack may be of use, as aiding 
to arrest it. 

PRESCRIPTION. 

R. — Fluid extract of conium i V2 drachms 

Fluid extract of hyoscyamus \Vi drachms 

Hydrate of chloral 2% drachms 

Syrup of orange peel 1 V2 ounces 

Take a teaspoonful every two or three hours, as occa- 
sion requires. 

Dementia — Dementia is literally a want of mind, and the word indi- 
cates a condition in which there is feebleness of intellectual grasp, or 
attention, imbecility of word and act and general deficiency of mental 
power. It is one of the common terminations of both mania and melan- 
cholia, and if long continued, its outward signs are a vacant and puzzled 
look, a lack-lustre eye, a weak smile and a meaningless laugh. This kind 
of insanity is almost a natural termination of extreme old age and is then 



NEUEASTIIENTA. 447 

called senile dementia. Not infrequently the subjects of it become 
paralytic. 

Imbecility — Imbecility is a condition in which the mind is from 
birth unfitted for the active and thoughtful duties of life, and in which 
the person affected is said to be half-witted, or wanting in general in- 
telectual capacity. This condition of deficient mental development may 
be associated with moderately good physical health in early life, but there 
seems to be usually some taint in the system, so that the family of im- 
beciles is, as a rule, short-lived, the members dying early of consumption, 
diabetes, or of some degeneration of the brain and spinal cord. 

Idiocy. — Idiocy is a still lower grade of mental Aveakness, in which 
the intellectual faculties are below the standard necessary for reasonable 
life. In the true idiot the head is of a reduced size and the appetites and 
propensities are very little, or not at all, controlled by reason. Many 
idiots are deaf and dumb, but most of them retain their sight. The sad 
condition of these poor creatures may be often ameliorated by systematic 
training, but complete cure after puberty is hopeless. 

Treatment of Insanity. — The treatment of insanity is generally best 
carried out in asylums for the purpose. To quiet a patient temporarily, 
or on his way to a suitable institution, bromide of potassium in quantities 
of thirty grains, or chloral in fifteen-grain doses every two or three hours, 
morphia by hypodermic injection, or otherwise, and even chloroform by 
inhalation may be necessary. 

NEURASTHENIA. 

Neurasthenia, sometimes referred to as spinal irritation, nervous 
exhaustion, etc., is a functional condition of the nervous system, causing 
a lessened desire to perform or attend to the various duties of life. 

Causes. — Heredity is sometimes a factor ; it may be an outcome of 
various chronic diseases ; nervous temperament ; overwork ; sexual excesses ; 
alcoholism ; excessive use of tobacco, etc. 

Symptoms — Neurasthenia may affect any organ of the body. One 
of the earliest manifestations is a weakness of the mental faculties in 
not being able to concentrate the thoughts, endeavoring to do so bringing 
on headache, fear, feelings of weakness and depression, palpitation of the 
heart, coldness of the hands and feet and chilliness, often followed by 
flashes of heat. In males genito-urinary disorders frequently occur with 
dread of impotence. In females painful menstruation, ovarian irritation 



448 NEEVOUS DISEASES. 

and irritable uterus are frequently present. Care should be taken in 
diagnosing to distinguish between neurasthenia, or true nervous exhaus- 
tion, and nervous debility accompanying some organic disease. 

TbeatmejSt. — Sight must not be lost of the fact that the patient is a 
sick individual and should have rest, quiet -and good food. Pleasant com- 
panionship and relief from responsibility are essential and where possible 
travel is especially recommended, care being taken, however, that the 
patient does not become fatigued. Among the internal remedies of value 
are arsenic, strychnia, the valerianates, Pil. Carm-Allen and the hypo- 
phosphites. 

Neuritis. — Simple neuritis, an inflammation of the nerve trunk, char- 
acterized by pain ^(of ten severe), impaired sensation and atrophy. Among 
the principal causes may be included wounds, injuries and compression 
of the nerves, exposure to cold or wet, rheumatism, syphilis. The 
affected nerve is red and swollen; the fibres have undergone some granu- 
lar change. The inflammation may extend upward or downward. In 
long standing cases the diseased nerves are found to be made up largely 
of connective tissue replacing the degenerated structure. The most de- 
cided symptom is pain, with tenderness along the course of the nerve 
trunk, of a burning, tingling, tearing and often intense character, in- 
creased by pressure or motion. Sometimes contractions and muscular 
cramps occur, followed by impaired motion. The prognosis is favorable 
with proper treatment. 

Treatment. — The affected part should be placed at rest. If the dis- 
ease is severe, blister along the course of the nerve. Internally full doses 
of iodide of potassium. Sodium salicylate and phenacetine are often 
useful. Locally, sedative lotions. Leadwater and laudanum, oil of tea- 
berry. Various liniments often relieve the intense pain. Syphilitic cases, 
iodide of potassium does the most good. If due to rheumatism, the 
salicylates and alkalies are indicated. If anemia is present, iron and 
hypophosphites is indicated. 



PART IV OF BOOK IV 

Treats of the structure and diseases of the eye, ear 
and nose. 



Abscess in the Ear 480 

Treatment of 480 

Acne Rosacea 488 

Treatment of .488 

Adenoids 489 

Amaurosis 463 

Treatment of 463 

Anatomy of the Ear 473 

of the Nose 483 

Aqueous Humor, The 454 

Asthenopia 465 

Treatment of 465 

Astigmatism 469 

Treatment of 469 

Auditory Canal 473 

Auricle, Eczema of 478 

Hematoma of 479 

Boils 480 

Bones of the Nose 484 

Bony Tumor of the Ear 481 

Cartilages of the Nose 484 

Cataract 463 

Treatment of 464 

Fetid 487 

Nasal 485 

Catarrhal Conjunctivitis 456 

Treatment of 456 

Cerumen, Impacted 481 

Choroiditis 463 

Treatment of 463 

Conjunctivitis 455 

Catarrhal 456 

Diphtheritic 458 

Phlyctenular 456 

Cornea, The 452 

Inflammation of 459 

Crystalline Lens •••453 

Day-Blindness 470 

Treatment of 470 

Diphtheritic Conjunctivitis 458 

Treatment of 458 



Drum, Ear 476 

Ear, Abcess in 480 

Anatomy of 473 

Bony Tumor of 481 

. Diseases of 473 

Drum, The 476 

Perforation of 482 

Thickening of 483 

Foreign Objects in 477, 481 

Insects in 477 

Tumors of 478 

Earache 482 

Treatment of 482 

Ear- Wax 476 

Eczema of the Auricle . . , . . 478 

Treatment of 479 

Epistaxis ' 485 

Eustachian Tube, Inflammation of.. 483 

Exostosis 481 

Treatment of 481 

Eye, The 451 

Socket, The 451 

Structure of 451 

Fetid Catarrh 487 

Treatment of 487 

Foreign Bodies in the Ear.... 477, 481 

Treatment of 481 

Furunculosis 480 

Glaucoma 465 

Treatment of 465 

Granulated Eyelids 472 

Grape-like Tumors 488 

Gutta Serona 463 

Hematoma of the Auricle.... 479 

Treatment of 479 

Hordeolum 471 

Impacted Cerumen 481 

Inflammation of the Cornea 459 

of the Eustachian Tube 483 

of the Lachrymal Gland 470 

Insects in the Ear 477 



29 



449 



450 



IKDEX TO PABT IV OF BOOK IV. 



Iris, The 452 

Iritis 462 

Treatment of 462 

Keratitis 459 

Treatment of 459 

Labyrinth, The 476 

Lachrymal Gland, Inflammation of.470 

Lens, Crystalline 453 

Mastoiditis 479 

Causes of 479 

Treatment of 479 

Membrane, Schneiderian 484 

Myopia 466 

Treatment of 466 

Nasal Catarrh 485 

Causes of 486 

Polyps 488 

Causes of 488 

Treatment of 488 

Nerve, Olfactory 484 

Night-Blindness 470 

Causes of 470 

Treatment of 470 

Nose, Anatomy of 483 

Bleed 485 

Causes of 485 

Treatment of 485 

Bones 484 

Cartilages 484 

Warts on 489 

Objects in the Ear 477 

Olfactory Nerve, The 484 

Ophthalmia 455 

Neonatorum 457 

Treatment of 457 

Purulent 457 

Pustular 456 

Strumous 456 

Ossicles 476 

Ozena 487 

Perforation of the Ear Drum 482 

Causes of 482 

Treatment of 482 

Phlyctenular Conjunctivitis 456 



Polyps, Nasal 488 

Pupil, The 452 

Purulent Ophthalmia 457 

of Infants 457 

Treatment of 457 

Pustular Ophthalmia 456 

Treatment of 456 

Retina, The 45 1 

Structure of 453 

Retinitis 462 

Causes of 462 

Treatment of 463 

Schneiderian Membrane 484 

Sclerotic Coat, The 452 

Sclerotitis 462 

Treatment of 462 

Semi-circular Canals, The 477 

Short-Sight 466 

Sight, Weak 465 

Socket of the Eye 451 

Squinting 471 

Causes of 471 

Treatment of 472 

Stirrup, The 477 

Strabismus : 471 

Strumous Ophthalmia 456 

Stye 471 

Treatment of 471 

Trachoma 472 

Treatment of 472 

Trichiasis 471 

Tumors of the Ear 478 

Bony 481 

Grape-like 488 

Tympanum, The 476 

Vitreous Humor, The 454 

Wax 481 

in the Ear 476 

Plugs 476 

Treatment of 481 

Warts on the Nose 489 

Weak Sight 4S5 

Wild Hairs 471 

Treatment of 471 



ILLUSTRATIONS 



Crystalline Lens 4m 

Curvature of Lens 4C6 

Eye, The 461 



Eye, Section of 452 

Operation for Cataract 464 



CURATIVE MEDICINE 



PART IV 
DISEASES OF THE EYE, EAR AND NOSE 

Importance of Subject. — The diseases of the eye are so important, and 
serious injury or loss of the organs of vision is such a terrible misfortune, 
that they demand a careful consideration. For the better comprehension 
of this group it will be needful, however, to give some preliminary ex- 
planation in regard to the eye, and also the ear and nose, with their 
appendages. 

Wonders of the Eye — The eye is probably the most wonderfully in- 
genious and complex organ of the human body, and being proportionately 
delicate, requires to be guarded with the greatest care. Few catastrophes 
are more grievous than that of total blindness, and most people would 
rather lose all the other senses than be deprived of sight. 

Structure of the Eye. — The intricate structure of the eye may perhaps 
be best comprehended if we remember that its general plan is that of a 
photographer's camera, the convex glass in the front of which corresponds 
with the crystalline lens of the eye, a picture of external objects being 
formed upon the artist's ground-glass plate in the one case, and upon the 
retina at the back part of the eyeball in the other. 

The Retina. — Now, the retina is simply the expanded optic nerve, 
which has the peculiar power of perceiving lights or colors, and the chief 
difference between the eye and the camera is, that in the former temporary 
impressions only are perceived by the brain, through the optic nerve and 
retina, and in the latter instrument these temporary impressions are in- 
tended to be rendered permanent on the sensitive plate or paper, as a 
photographic picture. 

The Eye Socket. — The eye is carefully protected from accidental in- 
jury by being embedded in a deep cavity or socket in the solid bones of 
the face and head, which guard it jealously from attack on either side and 
at the back. This socket is much larger than the eye itself, and the bony 
cavity is filled up behind and at the sides of the eyeball with an admirable 
cushion and packing of soft fat. 

451 



452 



DISEASES OF THE EYE, EAR AND NOSE. 



The Corner — The eye itself, as can be readily seen in that of a pig or 
sheep from a butcher's shop, is a white ball almost exactly round, except 
where the clear circle projects a little in front. This clear part, called the 
cornea (1), is as transparent as glass, and set in the space made for it in 
the white part of the eyeball, very much as a watch crystal is set in its 
frame. The white portion of the ball, called the sclerotic coat (2), is a 
tough membrane, very strong and dense, which gives shape to the organ 
of vision, and protects the extremely delicate structures within. The 
cornea and sclerotic coat each average about one-twentieth of an inch 
in thickness. 

The Iris. — Inside of the cornea is a circular curtain, with a round hole 
in the middle, called the iris (7), so named because it varies so much in 
color, being frequently blue in blonde individuals, and brown or black in 
brunettes. 

The Pupil — The round 
hole in the centre of the iris is 
called the pupil, and is the 
black spot seen on looking into 
a person's eye. This spot va- 
ries in size according to the 
amount of light, being larger 
in the shade and smaller in 
bright sunshine. In human 
beings it always remains 
round, unless the iris is dis- 
eased, but in the cat, for ex- 
ample, it changes its shape, 
becoming a narrow slit in a 
strong light. 

Use of the Iris. — This 
closing up of that curious cur- 
tain, the iris, is a beautiful 
provision for shutting off an 
excessive amount of light, 
which would otherwise pass through the pupil in too great quantity, and 
irritate the sensitive parts of the organ of vision within. 

The Sclerotic Coat— The sclerotic coat is lined on its inside with a 
thin layer of black membrane, called the choroid coat (3), which seems 
to have almost exactly the same object as the black lining of the photog- 




Section of the Human Eye. 



STRUCTURE OF THE EYE. 45 3 

rapher's camera, namely, to absorb any extra rays of light, and so prevent 
the picture from being indistinct. 

Structure of Retina. — Inside of the choroid coat, and immediately in 
contact with it, lies the retina, a third hollow ball, made up of an expan- 
sion of the optic nerve, which enters the eye- at the back (8), through 
openings in the sclerotic and choroid coats. The retina is made up of 
several layers, the outermost of which is formed by the terminations of 
the nerve-fibres in what are called the rods ancL cones of vision. These 
rods and cones are so wonderfully sensitive that through them we can 
perceive the differences of color and outline in the images of objects 
formed within the eye. They therefore correspond to the sensitive plate 
in the camera of a photographer. 

Other Portions of the Eye. — The remaining portions of the eye are 
chiefly useful in forming this image of which we take cognizance, and act 
upon the light exactly as the lenses of an opera-glass or of a camera do, 
except that they are provided with a more convenient way of changing the 
focus as may be required. The first of these which the light reaches, after 
it penetrates the cornea, is the crystalline lens (12). 

Crystalline Lens. — This lens can be readily seen by squeezing it out 
of the eye of a pig or sheep after death, is very much like a large dew- 
drop or rounded diamond, in size, shape and general appearance, and is 
solid enough to bear gentle handling. It has the form of a small, thick 
magnifying glass or lens, and if held over the letters of a printed book, is 
at once seen to have the same power of making objects seen through it 
look larger. 

Position of Crystalline Lens. — The crystalline lens is placed in the 
eyeball a little behind the iris, and is large enough to extend out beyond 
the edge of the pupil, unless that opening in the curtain is wider than 
usual. If it were not so perfectly transparent we could see the crystalline 
lens every time we looked a person straight in the eyes, as is shown in 
cases of cataract, a disease where the lens becomes first milky and then 
opaque, so that its position can easily be recognized, and the edge of the 
iris seen to move over it, as the pupil expands and contracts under the 
influence of varying degrees of light. 

Arrangement of Focus. — Every one who has looked much through a 
telescope or opera glass, knows that a different arrangement of focus is 
needed to show a near and distant object clearly, and that this altered 
focus is obtained by adjusting the relating positions of the component 
lenses. In the living eye, nature contrives to obtain this necessary effect 



454 



DISEASES OF THE EYE, EAR AND NOSE. 




Flexible Crystalline Lens. 



of two or more lenses with a single one, by making that one (the crystal- 
line) soft enough to change its shape a little, as shown in the diagram, 
and then providing a muscle called the ciliary muscle (M), through the 
action of which the lens may become more convex, that is, rounded (as at 

B), and so enable us to see 
near objects more dis- 
tinctly. It is the mechan- 
ical effort required to keep 
this little muscle con- 
stantly on the stretch that 
causes the eyes to feel so 
tired after long applica- 
tion over reading small 
print or doing fine work 
of any kind. Hence, avoidance of too prolonged a strain of this nature 
is an important part of the hygienic care of the sight, on account of such 
a tendency as exists to exhaust the power of this muscle. 

The Aqueous Humor — The space between the crystalline lens and the 
cornea is filled by the aqueous humor (11), a watery fluid bathing the 
front and back of the iris, which, floating thus in a clear, transparent 
fluid, has an opportunity to move with entire freedom, and so most per- 
fectly perform its duty as a ^curtain to shut off any excess of light when- 
ever there is danger of a superabundance injuring the sensitive retina 
within. The aqueous humor, being shut in by the convex cornea, must, 
of course, take the shape of that clear membrane, and, forming with it a 
convex lens, still further aids the crystalline body in bringing the rays 
of light to a focus upon the retina, and so forming a sharp image upon that 
sensitive membrane. 

Action of Aqueous Humor. — The action of the aqueous humor in this 
instance is precisely similar to that of water poured into a glass globe 
standing in the sunshine. "Whilst the globe is empty, it has but little ef- 
fect in concentrating the sun's rays into a focus, but when filled with 
water, its power as a lens is considerable, and it may even operate so ener- 
getically as a burning-glass as to set fire to inflammable substances placed 
at a proper distance. Want of suitable curvature, and also in many cases 
the fact of its being curved unequally in different directions, by making 
the lens or magnifying glass too strong or too weak, has much to do with 
causing imperfect sight. 

Vitreous Humor. — The chief bulk of the eye is made up of the vitreous 



OPHTHALMIA. 455 

humor, which receives its name from its vitreous or glassy appearance. 
This fluid is contained in the cavity of the retina, and has running through 
it numerous fine, interlacing fibres, as transparent as itself, which prob- 
ably help to prevent the delicate retina from being injured by its shaking 
about during violent movements of the head and body. 

Duty of Vitreous Humor. — The vitreous humor has little or no share in 
aiding to form the image upon the retina, but does perform an important 
duty in keeping the globe distended, so that in a sound eye the retina is 
held at the exact distance, where it can receive images of objects cast 
upon it in their sharpest and best defined condition. 

How to Understand the Eye. — An excellent way to understand fully 
how the eye acts as an optical instrument, is to actually make a camera of 
the eye of an ox or other large animal, by cutting away the sclerotic coat 
at the black part, and then shading this in a small box, for instance, so 
that the images formed by cornea and crystalline lens can be seen inverted 
upon the translucent retina at the hinder portion of the eye. 

Eye Diseases. — The diseases of the eye, according to the nomenclature 
here followed, are seventy-five in number, so that it is impossible properly 
to describe the treatment of any but the more important. Among the 
first of these are to be ranked the diseases of the conjunctiva. 

CONJUNCTIVITIS OR OPHTHALMIA. 

Character. — This is an inflammation of the delicate membrane over 
the front of the eye, covering the whole of the cornea, and the part of the 
sclerotic coat or white of the eye, which is naturally visible. 

Symptoms. — The usual symptoms of inflammation can nowhere be 
observed more distinctly than in the eye ; the four great characters of this 
morbid process, as described by Celsus, about the beginning of the first 
century, being very apparent. Here, as elsewhere, redness, heat, pain 
and swelling are the indications of inflammation, just as they were in the 
days of the old Roman physician, more than eighteen hundred years ago. 
The redness of the eye in ihis affection varies with the intensity assumed, 
but in severe cases it may completely obscure the white of the eye, so that 
the whole surface, except the cornea, appears quite red. The pain and 
burning heat of the eyes are sometimes almost unendurable. 

The Swelling. — The swelling of the conjunctiva is often so consider- 
able as to rise up all around the edge of the cornea, and this projection of 
the inflamed membrane may be so great as to prevent the eyelids from 



4-oQ DISEASES OF THE EYE, EAR AND NOSE. 

being closed. Intolerance of light and profuse now of tears, the latter 
resulting from irritation sympathetically extended to the lachrymal gland, 
which supplies those persuasive drops of salt-water, are common symptoms 
in some forms. 

Catarrhal Conjunctivitis — Catharral conjunctivitis or catarrhal oph- 
thalmia, as it is also named, is the form of this affection usually produced 
by cold. Redness and pain, as if a particle of dust had got into the eye, 
with a free discharge of water, are the first symptoms. Intolerance of 
light is not very great, unless the cornea becomes involved. Vision may 
be slightly obscured, but is seldom seriously affected. 

Treatment. — 1. The treatment consists of active purgation with calo- 
mel (one-tenth to one-fifth of a grain every hour until one to two grains 
are taken), followed by epsom or rochelle salts. Soothing lotions to the 
eye, as, for example, that of sassafras pith with a very little extract of 
belladonna to begin with, and, after a day or two, applications of weak 
solutions of lunar caustic (silver nitrate) should be used. 

R. — Silver nitrate 15 grains' 

Distilled water 1 ounce 

Mix. Directions. — Apply to the inner eyelids with a 
little cotton wrapped on a toothpick or a matchstick. 

The application should be made once a day for several days, and 
although the caustic solution smarts severely at first, it leaves, after fifteen 
or twenty minutes, an astonishing feeling of relief to the affected organ, 
and in favorable cases rapidly reduces the inflammatory action. 

2. To prevent the eyelids from adhering during sleep, and so aggra- 
vating the trouble when pulled apart in the morning, an ointment should 
be used, preferably that recommended by Professor Pegensticker, which 
is a favorite of most physicians. The formula is: 

R. — Yellow oxide of mercury 1 grain 

Vaseline or cosmoline 1 ounce 

Mix thoroughly and apply lightly to inner eyelids night 
and morning. 

3. In many cases "ordinary salt water or a 2 per cent, solution 
of boric acid will suffice to effect a cure. Simple conjunctivitis of a 
chronic nature is often associated with catarrh of the nasal mucous mem- 
brane, and may be cured by correcting the catarrh of the membrane." 

Pustular Ophthalmia. — This, called also phlyctenular conjunctivitis 



OPHTHALMIA. 457 

and strumous ophthalmia, is the form m which the scrofulous predisposi- 
tion to disease is very apt to manifest itself in young children. It is 
almost always accompanied with an eczema of the head or face. 

Treatment. — Iu this affection general treatment for the constitutional 
disease is the most important. The patient should be placed in the best 
hygienic surroundings. The eyes should be kept clean with an antiseptic 
solution, as a 2 per cent, boric acid wash, and the yellow oxide of mercury 
ointment, mentioned above, rubbed into the eyes once or twice daily. 

Purulent Ophthalmia. — This is a more violent and contagious form of 
conjunctivitis, in which the sight is sometimes seriously endangered. The 
discharge of thick, yellow pus or matter is abundant, and the inflammation 
sometimes progresses with great rapidity. 

Treatment. — Active purgation, leeching followed by blisters behind 
the ears, and application of the stronger solutions of nitrate of silver, are 
often necessary to preserve the sight. In the contagious variety great care 
must be taken to avoid conveying the disease from the sick to the well by 
the use of soiled towels, handkerchiefs, and so forth. 

Spread of the Infection. — In bad cases it is probable that the infection 
may occur by being wafted along in the atmosphere through a large room, 
or even through a whole house, as is seen sometimes in boarding schools 
and children's infirmaries. 

Purulent Ophthalmia of Infants {ophthalmia neonatorum). — This is 
another contagious form of the disease, affecting new-born children and, 
if not properly attended to, destroying their sight. It is the result of an 
infection with the gonococcus which RTiesser discovered in 1879 to be the 
cause of gonorrhea. The inflammation develops in less than three days 
after birth. 

Symptoms. — First there is redness and irritability of the conjunctiva. 

2. In about twenty-four hours an excessive secretion of tears and a 
whitish discharge appears. 

3. This is followed later by a swelling of the lids and of the conjunc- 
tiva and a change in the character of the discharge from a whitish to a 
yellow, purulent type. 

4. The child suffers very little at first, but later, when the discharge 
becomes more plentiful and thinner, the patient loses his appetite, is rest- 
less and suffers a great deal of pain 

Treatment. — The treatment is divided into two classes. 1. Prophy- 
lactive or preventive; and 2, Curative. 

1. That prophylaxis is possible was demonstrated by Crede, a noted 



458 DISEASES OF THE EYE, EAR AND NOSE. 

obstetrician of Bonn, who reduced the percentage of these cases in the 
wards of his hospital from 13 per cent, to less than 2 per cent. 

Application of the Treatment. — This he accomplished by dropping one 
or two drops of a 2 per cent, solution of nitrate of silver in the eyes of 
new-born infants. This procedure is commanded by law in some com- 
munities. American authorities only recommend it where the birth canal 
is presumed or known to be affected. 

Analysis of Prophylactic Treatment — The Cyclopedia of Medicine and 
Surgery (Gould and Pyle) says: The prophylactic treatment consists: 

1. In removing the disease from the mother before labor if possible. 

2. Through disinfection of the vagina before labor with solution of 
creolin, carbolic acid, boric acid, salicylic acid, mercuric chloride or other 
antiseptic. 

3. Thorough disinfection of the child's eyes as soon as born. 
These precautions should be carried out in all suspicious cases. 

2. Curative Treatment. — After the disease has made its appearance, 
the most strenuous efforts and the most unceasing vigilance and care are 
demanded to prevent a partial or total loss of sight. Many of the blind we 
see about us, for whom we feel so much sympathy, can blame their un- 
fortunate condition upon the lack of treatment in the first few days of 
their lives. 

If possible a physician should be summoned at once and his orders 
followed implicitly, and it may be necessary for him to see the child 
several times a day to make the necessary applications. 

Kules for Treatment. — If a physician can not be had, thorough atten- 
tion to the following rules will probably result in a cure: 

1. Cold applications which tend to lessen the amount of local inflam- 
mation. 

2. Freqment and thorough flushings of the eyes with mild antiseptics, 
as boric acid in distilled water all day and night every hour or two. 

3. The application of lunar caustic (silver nitrate) ten grains in the 
fluid ounce of distilled water, two or three times a day. 

4. If any ulcers appear on the cornea, weak yellow oxide of mercury 
ointment should be rubbed, thoroughly but gently, into the lids twice a 
day. 

5. Nourishment, cleanliness and warmth must be maintained. 
Diphtheritic Conjunctivitis — This is a condition of the eye caused by 

an infection with diphtheria. Fortunately it is extremely rare in America. 
Symptoms. — Pain is present, the lids are swollen and hard. The dis- 



DISEASES OE THE CORNEA. 459 

charge is scanty and may be watery or a thin pus. The constitutional 
symptoms of diphtheria may be present. 

Treatment. — Instillations of very weak solutions of atrophine will re- 
lieve the pain. Antitoxin should be administered very early. Otherwise 
the treatment is the same as in purulent conjunctivitis. 

Trachoma. — Granular conjunctivitis, or granular* lids, is also a con- 
tagious disease of the eyes. 

Symptoms. — The inner sides of the lids become rough, inflamed, and 
covered with little projections which irritate the cornea at every move- 
ment of the ball or lids. It seriously affects vision, and is often very 
obstinate, but can frequently be vastly benefited. 

Treatment. — 1. Perseverance in constitutional treatment. 

2. Local applications of nitrate of silver solution, or sulphate of 
copper to the granulations. 

3. Unless improvement follows soon, local treatment should be dis- 
continued and a specialist consulted. There is rarely complete recovery. 

DISEASES OF THE CORNEA. 

Causes. — Keratitis or inflammation of the cornea may occur from a 
punctured wound of the eye, or it may be the result of the scrofulous dia- 
thesis, or even more commonly of inherited syphilis. It occasionally 
results in -ulceration of the cornea, which sometimes perforates this struc- 
ture and, allowing the humors of the eye to run out, irrevocably destroys 
the sight. 

Treatment. — Local treatment of the accompanying conjunctivitis and 
the use of atropia to keep the pupil dilated, so that it, the iris, may not 
become involved in the inflammation, are important, but the chief reliance 
must be placed upon constitutional remedies for those general diseases, of 
which this affection of the eye is little more than a symptom. The white 
spot or scar left by an ulcer of the cornea is generally permanent, and not 
only disfigures the organ of vision, but more or less completely obscures 
the sight for life. 

Preventive Treatment. — Since a scar of this kind is so injurious and 
when once fully formed can scarcely ever be removed, the ounce of preven- 
tion is of tenfold importance, and every care should be taken, by securing 
the most skillful treatment for ophthalmia as promptly as possible, to re- 
duce to its smallest dimensions the danger of such a catastrophe to sight. 



460 



DISEASES OF THE EYE, EAR AND NOSE. 



THE EYE 



Figure No. i. — Iris, ciliary muscle 
and coroidea membrane, 
i. The pupil. 
2. Ciliary muscle. 

4. Arteries of the coroidea mem- 
brane. 
5>5>5>5- Sclerotic tunic, cut circularly 
and removed. 
7. The optic nerve. 



Figure No. 2. — Vertical section c.f 
the pupil. 



Figure No. 3. — Artificial eye. 



Figure No. 4. — External muscles of 
pupil. 

1. Part of the sphenoidal bone to 
which some muscles are at- 
tached. 
2.2. External straight muscle. 

3. Optic nerve. 

4. Internal straight muscle. 

5. Upper straight muscle. 

6. Lower straight muscle. 

7. Upper oblique muscle. 

8. Insertion of the upper oblique 

muscle of the pupil. 

9. Lower oblique muscle. 

10. Sclerotic tunic. 

11. Cornea. 

12. Cartilaginous pulley of the upper 

oblique muscle. 

Figure No. 5. — View of the second 
pair of optic nerves. 



1. Globe of the eye. The left, per- 

fect. The right one has the 
sclerotic and coroidea tunics 
removed, showing the retina. 

2. Quiasm of the optic nerve. 

3. The whitish bodies. 

4. The infundible. 

5. Varolius bridge. 

6. The medulla oblongata. 

7. Third pair : motor nerves of the 

eye. 

8. Fourth pair : pathetic. 

9. Fifth pair: trigeminous. 

10. Sixth pair: external motors. 

11. Seventh pair: auditive and facial 

nerves. 

12. Eighth pair : pneumogastric, ac- 

cessory, spinal and glosso- 
pharyngeal. 

13. Ninth pair : hypoglossus. 

Figure No. 6. — Lachrymal apparatus 
(the skin of the eyelid has been re- 
moved). 

1. Cartilage of the eyelid. 

2. Insertion of the eyelashes. 

3,S- Lachrymal ends or openings of 
lachrymal canals in the eye- 
lids. 

4. Conduit to the nose. 

6. Cul-de-sac at the orbital extrem- 

ity of the canal. 

7. Lower corner of the eye. 
9. Lachrymal gland. 

10,10. Canals carrying tears to the eye. 



Figure No. 7. — Formation of an 
image on the retina. 





Fig 1 —The iris, the ciliary muscle and 
coroidea membrane. 



Fig. 2.— Vertical section of the pupil. 




Fig- 3.— An artificial eye. 




Fig. 4.— External muscles of the pupil. 




Fig. 5.— View of the second pair of optic 
nerves. 




Fig. 6.— Lachrymal apparatus (eyelid skin 
has been removed ). 




Fig. 7.— Formation of an image in the retina. 



THE EYE. 

For an explanation of the illustrations see text on opposite page 



461 



462 DISEASES OF THE EYE, EAR AND.NOSE. 

DISEASES OF THE SCLEROTIC COAT. 

Symptoms. — Inflammation of the sclerotic coat, or sclerotitis, is gen- 
erally characterized by the intense, deep-seated pain it causes, and by the 
pink hue of the white of the eye produced. The chief varieties are the 
rheumatic and the syphilitic. 

Treatment. — The treatment is to be more especially directed towards 
counteracting by general remedies the poisons of these two virulent con- 
stitutional affections. 

IRITIS. 

Character. — This is an inflammation of the iris, which may be simple 
or gouty, syphilitic or scrofulous. 

Symptoms. — Its symptoms are intense pain in most cases, although in 
others little uneasiness is felt ; change in color of the iris, contraction of the 
pupil, and impairment of vision. Inflammation of the iris has always pos- 
sessed a great interest for physicians, because it is the only cavity lined by 
a serous membrane into which we have the privilege of looking and seeing 
what is going on when the membrane which forms its boundary is in- 
flamed. Hence, the observation of a case of iritis is not only the most 
interesting, but also the most instructive, lesson in the sciences of path- 
ology and therapeutics which nature ever vouchsafes to us, as we carefully 
watch the progress of the disease and the effects of medical treatment from 
day to day. 

Treatment. — Since one of the greatest dangers of iritis is that the 
pupil will be drawn together by the whitish lymph infused in the inflam- 
matory process, and, by being thus closed, shut off the sight, it is very 
important to keep this opening of the pupil as large as possible by the use 
of belladonna, or its active principle, atropia, throughout the attack of 
iritis. Besides this, general bleeding, or free leeching behind the ears, 
or on the nape of the neck, followed by repeated blistering, should be em- 
ployed, and active purgatives with mercury to slight salivation contribute 
toward the cure. Opium by hypodermic injection to relieve the intense 
pain, and cool anodyne applications to the affected organ, are valuable 
palliatives. 

RETINITIS. 

Character. — This is an inflammation of the retina and seldom occurs 
alone. It may be due to Bright's disease, may result from a specific taint, 
or may be of the hemorrhagic variety. The last named condition is nearly 



cataract. 463 

always in the aged and is an occasional accident happening in cases where 
the kidneys are hard and shrunken. 

Treatment. — The treatment is of course directed to the disease which 
causes this inflammation. 

CHOROIDITIS. 

Causes. — This is also usually in conjunction with systemic diseases, as 
tuberculosis, syphilis, rheumatism and gout. The suppurative variety may 
be due to a blow or may be carried from some distant suppurative process. 

Treatment — The treatment is directed to the cause and is mostly 
general. 

AMAUROSIS OR GUTTA SERONA. 

Character. — This is a disease of the retina, dependent upon various 
changes of the retinal surface and ending in an inability of the nervous 
expansion to receive and transmit visual impressions from the outside 
world to the brain. 

Causes. — 1. It may be produced by exposure of the eye for a longer 
or shorter period to a white, dazzling object like snow, and snow-blindness 
is the most familiar example of this affection. 

2. It also occurs occasionally from accidents, such as lightning-stroke 
and blows on the head. 

3. It may be due to degenerative changes in the retina following 
exhausting illness, or connected with sympathetic irritation. 

4. Excessive use of tobacco sometimes produces it. 

Treatment. — Where the cause of amaurosis can be discovered and 
removed, some hope of cure may be indulged, but ordinarily the melan- 
choly fate of becoming permanently blind — as the poet Milton was ren- 
dered by this malady — awaits the patient. Of course, the earlier treat- 
ment is undertaken the better is the chance of arresting the malady before 
utter destruction of the sight is accomplished. 



CATARACT. 

Character. — This is an inappropriate but long-established term indi- 
cating an opacity of the crystalline lens of the eye. In cataract, the lens 
becomes white and opaque, first at some point on its surface, or in the 
capsular membrane which envelops the albumenoid substance of which 



464 DISEASES OF THE EYE,, EAR AND NOSE. 

the lens is composed. The opacity extends, until at length the whole of 
the lens may be involved, and blindness rendered complete. 

Development of Cataract. — The development of cataract is -usually 
slow in its progress, except in the case of diabetic cataract, or cataract 
from a punctured wound, which may form in a few days. The process 
of becoming totally opaque is called by surgeons the ripening of the 
cataract, and it is customary to wait for the cataractous change or ripen- 
ing to be complete before any operation is attempted for its cure. 

Causes. — Most frequently there is some change in the vascular system 
supplying the lens, and to this lack of nutrition is due. Senility, diabetes 
mellitus, convulsions, injury, exposure and privation are the causes. 

Treatment. — No medical treatment, as yet discovered, is of any avail 

in the treatment of cataract, but 
the disease may be entirely 
remedied by the operation of ex- 
traction, which is illustrated in the 
accompanying figure. As there 
shown, a peculiar, wedge-shaped 
knife, called a cataract-knife, is 
used to cut an opening in the edge 
operation for cataract. f ^ e cornea, through which the 

opaque lens is carefully drawn out, and then the eye closed up and per- 
mitted to heal. 

Restoration of Vision — When successful, as this operation proves in 
the hands of skillful oculists nearly nine times out of ten, useful vision 
is restored, and by the aid of very thick spectacles, to substitute the lost 
crystalline lens, the patient is often enabled to read, write or sew, as well 
as before being attacked with this disease. This operation of extracting 
the cataract is generally the most successful with the common form, which 
occurs in old people, where the crystalline lens is not only opaque, but 
hardened into a sort of horny substance. 

Treatment of Other Forms. — In some of the other varieties of cataract, 
such as that produced by wounds or other injuries, especially in young 
people, the treatment by breaking up the lens with a very delicate knife, 
about the size of a large needle, is resorted to with success. The old- 
fashioned operation for cataract by couching, or reclination of the opaque 
crystalline lens, is now generally abandoned, as being much less satisfac- 
tory in every way than the process of extraction. 

Cataract Often Hereditary. — The tendency to the formation of cataract 




WEAK SIGHT. 465 

is often hereditary, but something can be done by hygienic care of the 
eyes to avert, or at least to postpone, its active development. Since it has 
been found that operatives who use their eyes opposite to a very strong 
light — such as glass-blowers — are particularly liable to cataract, it is 
advisable to avoid such exposure as much as possible. 

Effect of Electric Lights — Very probably electric lights may tend to 
promote the formation of cataract, unless guarded with special care. It 
is a curious fact, however, and one which at once disproves the fanciful 
theory that cataract is a disease of over-civilization and excessive study, 
that cataracts are frequently met with in animals, especially the horse, 
where the disease may often be seen in great perfection. 

GLAUCOMA. 

Symptoms — This is a disease in which the most prominent symptom 
is an increase in the tension of the eyeball. By primary glaucoma we 
mean an increase in tension originating in the eye itself independent of 
any outside influence. Secondary glaucoma is the same condition due to 
an injury, some previous inflammatory process, or resulting from valvular 
heart disease, and so forth. 

If the glaucoma is simple in character, the first symptom is partial 
loss of vision. In cases of inflammatory character pain may be the first 
feature to attract attention and may be much more severe at times. 

Predisposing factors are heredity, excesses of various kinds, gouty 
or rheumatic tendencies. 

Treatment. — Medical treatment is of value in some primary cases. 
Warm applications may ease the pain, or instillation of one-quarter to one 
per cent, solution of eserine. Operative measures of various kinds may 
be necessary from iridectomy to complete removal of the globe. 

WEAK SIGHT OR ASTHENOPIA. 

Weak or enfeebled sight, though a term in familiar use, is not easily 
defined as specially connected with any constant change in the eyeball. 

Causes. — It may be due to an irritable condition of the retina, or to 
an impoverished state of the blood. More frequently, perhaps, it arises 
from a want of power to keep up the accommodation of the eye for dis- 
tances, to nervous anxiety about the sight, or to the commencement of one 
of the serious organic diseases about the eyes and its appendages. 

Treatment. — Except in the latter case, much can be done by treat- 
30 



46T5 DISEASES OF THE EYE, EAR AND NOSE. 

inent, using general and local tonics, and by care of the eyes in the mode 
to be pointed out in the next article. 

SHORT-SIGHT OR MYOPIA. 

Character. — This is a very common condition of vision in which, from 
the greater convexity or improper position of the lenses of the eyeball, 
the focus of parallel rays of light does not fall upon the retina, but at some 
point in the vitreous humor. This error of development, as it often is, 
will be better comprehended by the aid of the annexed figure, in which 
is shown a diagram of the eyeball and the course of the rays of light, to 
form a clear and distinct image of the arrow, on the retina at ~b, b. If, 
however, the eyeball is elongated, so that the retina occupies the position 
of the line marked 3, as is often found to be the case in near-sighted per- 
sons, it is obvious that the rays of light will have passed their true focus, 




The Error in Curvature of Lens. 



and consequently when they reach the retina in this wrong position can 
only give a blurred and indistinct image of the object. 

Remedy — The remedy for myopia is the use of a concave glass, ac- 
curately adapted to the particular eye for which it is employed, and 
just strong enough to render the rays of light so divergent when they 
strike the cornea that they will be brought to an exact focus upon the 
misplaced retina, in its unnatural position, making in this way one error 
precisely counterbalance the other. 

Application of the Remedy. — This remedy should by all means be 
applied even in early youth, in order to prevent the effort of accommoda- 
tion, the straining of the eye to see as much as other children do at school 
and elsewhere, from not only increasing the myopia, but laying the 
foundation of more serious disease and ultimately, perhaps, destroying 
the sight. 

Increase of Short-Sightedness. — The alarming increase of myopia, and 



SHOUT SIGHT. 467 

especially its prevalence among young people of both sexes in city schools, 
must have caused many observant biologists to speculate as to the exact 
mechanism by which the unfavorable influences of our present civilization 
were at work so as to bring about this rapid deterioration of the visual 
organs in the last few generations of mankind. 

Myopia Hereditary. — There is no doubt also that myopia is hereditary, 
and that according to the great law of "the extinction of the unfit," the 
children of myopic parents are predisposed to the development of this 
disease. Hence they will almost certainly suffer from it if they are 
exposed to conditions which would be apt to engender near-sightedness 
in healthy eyes, from any taint of hereditary tendency. 

Preventive Measures. — Among the general conclusions arrived at by 
scientists for aiding in this object, so important to the rising generation, 
the following are worthy of especial notice : 

1. In the first place, study-rooms should be well lighted during the 
day, and especially toward evening, because a feeble or badly-arranged 
light compels us to diminish the distance between the eye and the book 
whilst reading or writing. 

2. Light should be allowed to enter from the left side. Illumination 
from the front is more or less dazzling, and obliges the pupils to bend 
forward too much, or to sit sidewise in constrained and fatiguing positions. 
Again, light coming from behind is entirely insufficient, because in great 
measure cut off by the head and upper part of the body of each scholar. 

3. The windows of a school-room should be large and high, and be 
arranged along the left side of the apartment, so as to shed the light upon 
desks placed in rows, at right angles to the wall in which the windows 
are cut. 

4. The light from above, furnished by a skylight, is not so good as 
that derived from lateral illumination. The light of lamps is recom- 
mended as being preferable to gas, and the gaslight shining through 
ground-glass globes is condemned as being particularly objectionable. 

5. The inclination of the desk at which the pupil sits to read or write 
is a matter of no small importance. Desks which are horizontal, or only 
slightly inclined, favor the development of myopia, by compelling the 
scholar to bend the head over a good deal Avhilst reading or writing. Such 
a position brings on, as a result of mere weight of the blood, passive con- 
gestion of the head and eyes, and this in turn results in an intra-ocular 
tension, insensible, perhaps, when it first appears, but very marked in its 
effects when long and constantly continued. 



468 DISEASES OF THE EYE, EAR AND NOSE. 

Children's School Desks — Besides, a child who acquires the habit of 
leaning forward in this manner is very apt to bend nearer and nearer his 
book, as the muscles of his back become fatigued, and thus, by straining 
his power of accommodation at short focus, promote the rapid development 
of myopia. The desks of school children should therefore be sharply in- 
clined at an angle of 40 degrees or 45 degrees when used for reading, and 
their seats should not be too high, and should be furnished with comfort- 
able backs. 

6. Great care should be taken to secure school-books well printed in 
large, clear type ; since those printed in small, indistinct letters, upon bad 
paper, with poor ink, as is the case with too many of the classics and the 
dictionaries in common use, necessitate a close approximation of the eyes 
to the page, and consequently exaggerated efforts at accommodation, favor- 
ing myopia. Furthermore, all punishments of school children which con- 
sist in depriving them of recreation or exercise out of doors, or in adding 
to their amount of study, and consequent employment of the visual ap- 
paratus, should be relinquished. 

Faults of School Furniture. — The general principles which must be 
kept in view in the construction of seats and desks for school* children, 
according to the investigation of Cohn and others, may be expressed as 
follows: 

The faults of school furniture which give rise to injurious postures, 
and so conduce both to myopia and asthenopia, as well as to scoliosis or 
lateral curvature of the spine, are: 

1. Want of, or unsuitable, backs. 

2. Too great a distance between the seat and the desk. 

3. Disproportion, generally too great a difference between the height 
of the seat and that of the desk. 

4. Wrong form and slope of the desk. 

Ideal School Desks. — Dr. Liebreich gives a very clear exposition of 
the way in which these defects cause the diseases already mentioned, and 
concludes with the subjoined recommendations, which he considers, how- 
ever, less advantageous than what he calls the American plan of having 
the seat and desk made to every child's 1 measure, or the Swiss system, 
where seven or more different sizes of seats and desks are manufactured 
to suit the different classes : 

1. One and the same size and model desk should be used for chil- 
dren and grown-up persons of both sexes. 



ASTIGMATISM. 469 

2. The adaptation to the height of each child should he effected by 
varying the height of the seat and the footboard. 

3. The edge of the table is always to be in a perpendicular line above 
that of the seat. 

4. ISTo seat is to be without a back, and the top of this is always to be 
one inch lower than the edge of the table for boys, and one inch higher 
than the edge of the table for girls. 

5. In all classes where the boys change places the height of the 
seat is to be regulated in proportion to the average height of the pupils. 

6. In all girls' schools, in all those boys' schools where the children 
do not change places, in boarding schools, and in private schoolrooms, 
the seat of each child should be accurately regulated in proportion to its 
height. 

Back Support, Etc — The support for the back should incline only a 
few degrees from the perpendicular, and be so arranged as to press upon 
the spinal column just above the hips of the pupil. The breadth of the 
seat should be considerable, in order to support most of the thighs, and its 
height just such as to allow the feet to rest easily upon the footboard. 
The desk should be so arranged, by means of a hinged flap or otherwise, 
as to hold the book at an angle of 40 degrees or 45 degrees whilst reading, 
and the paper at an angle of 20 degrees whilst writing is being performed 
by the scholars. 

ASTIGMATISM. 

Definition — This term is applied to a defect of sight due to a differ- 
ence in the curves of the cornea and crystalline lens in different directions ; 
that is to say, the cornea, for example, may be so curved in the direction 
of a horizontal line through it as to have a focus of one inch, and be so 
much less curved on a perpendicular line that its focus in that direction 
is an inch and a quarter. The result of this different refraction, in 
different meridians of the globe of the eye, is necessarily an indistinctness 
of vision, because all the rays of light entering the eye from a bright point 
are not brought precisely to a point again upon the retina as they should be. 

Treatment. — This defect, which is found to be exceedingly common, 
especially in myopic eyes, can be very accurately corrected by the use 
of properly adjusted cylindrical glasses, which are so arranged as to distort 
the rays of light before they enter the eye just enough in a contrary 
direction to cause them to be brought to an exact focus by the imperfect 
cornea and crystalline lens of the astigmatic eye. 



470 DISEASES OE THE EYE, EAR AXD ZSTOSE. 

Use of Spectacles. — Spectacles giving this compensation onght to be 
procured and faithfully worn, not only because their use will tend to pre- 
serve the eyes, which would otherwise be apt to grow strained in the effort 
to make up for this defect by accommodating the lens, but also on account 
of the headache which is often the result of such constant effort to adapt 
the eye to clearer vision. 

Day-Blindness. — Day-blindness is a term used to describe a disease in 
which the person affected can only see when the light is subdued,, as in 
the twilight. ^ 

Night-Blindness. — Night-blindness, on the contrary, indicates a con- 
dition in which there is indistinctness of vision, except in a bright light. 

Causes. — The causes of these two conditions are not very well under- 
stood, but night-blindness is known to chiefly affect those who have used 
their eyes too long and too steadily in a brilliant illumination or who have 
been exposed to intense or sparkling light. 

Treatment. — Rest is the chief means of cure, but prevention of these 
diseases by the proper protection of the organs of vision by colored glasses, 
or by the mechanical appliances mentioned when speaking of light, is in- 
finitely preferable. 

DISEASES OF THE TEAR APPARATUS. 

Character. — The lachrymal gland, which supplies the tears, and is 
situated at the upper and outer angle of the eye, is subject to inflamma- 
tion and the usual structural changes which result from that process. The 
most common disease, however, connected with the lachrymal apparatus 
is obstruction of the lachrymal duct or tube, which runs from the inner 
corners of the eyelids down into the cavity of the nose, and conveys the 
tears into the nasal cavity, which, under ordinary circumstances, they 
merely serve to keep comfortably moist. 

Causes — This obstruction may result from inflammation of the lining 
membrane of the duct, caused, perhaps, by cold or brought about by acute 
or chronic inflammations of the nasal chambers. If neglected, abscess 
may result requiring surgical interference. 

Treatment — In its incipiency attention to the nasal passages and 
correction of the deformities and catarrhal condition there may suffice 
to effect a cure of the constriction of the duct. While acutely inflamed, 
anodyne lotions, as lead water and laudanum, cold or hot applications 
should be faithfully tried. When dilatation of the duct is demanded it 
should be continued until a cure is effected. 



DISEASES OF THE EYELIDS. 471 

DISEASES OF THE EYELID. 

STYE OR HORDEOLUM. 

A stye is a little boil at the edge of the lid. 

Causes. — When styes recur, refractive errors should be at once sus- 
pected and corrected. Ill health favors a stye as it does boils in other 
localities. Uncleanliness is sometimes the cause. 

Symptoms — These are so well known that it is not necessary to go 
into them. Suffice it to say that when a yellow spot is discernible on the 
stye, it is ripe and should be opened. 

Treatment. — To hasten the pointing of a stye, apply hot compresses 
for fifteen minutes every two hours. Tonics are indicated in the debili- 
tated ; glasses — properly fitted — should be worn, and a boric acid eyewash 
used until long after the stye has disappeared. 

WILD HAIRS OR TRICHIASIS. 

Dangers. — This is the name for that growing in of the eyelashes, com- 
monly known as wild hairs in the eye. Even one of these hairs, by rub- 
bing upon the sensitive cornea whenever the patient winks, may cause 
much irritation and even injury to the sight. 

Treatment. — Temporary relief is afforded by pulling out the offend- 
ing hairs with small tweezers, but often a surgical operation is necessary 
to accomplish a permanent cure. 

SQUINTING OR STRABISMUS. 

Character. — This disease is the commonest of the derangements of 
the eyeballs within their orbits. In it the eye is involuntarily drawn from 
its straight position to one or the other side, so that the natural and agree- 
able parallelism of its axis with that of its fellow is not maintained. 
When the eyes are turned in toward the nose, as is more commonly the 
case, the strabismus is called convergent, and when the squint is outward, 
it is spoken of as divergent strabismus. 

Causes. — This defect is due either to shortening of one of the six 
little muscles by which the eyes are moved in their sockets, or to the 
spasmodic contraction of one of these muscles, or to paralysis of one of 
them and relative over-action of its natural opponent. Strabismus is in 



472 DISEASES OF THE EYE, EAR AND NOSE. 

some cases an acquired affection, and may even result from the bad habit 
among children of imitating deformities of this kind. More frequently 
it appears to be the product of hereditary tendency. It may affect both 
eyes in the same person, and even in the same direction, and is then 
called double strabismus, or it may be confined to one eye. the other 
remaining perfectly healthy. 

Treatment. — Something can be done in the treatment of this malady 
when it first commences in children who are not too young to wear spec- 
tacles by having these arranged with half pieces of black glass, so that 
the patient is compelled to look straight forward. But the simple opera- 
tion of cutting through a part or the whole of the contracted muscle is in 
suitable cases the best remedy, and often, not always, proves perfectly 
successful in removing the deformity. 

TRACHOMA (Granulated Eyelids). 

Trachoma is a highly contagious disease which attacks the eyes. It 
is a granular conjunctivitis, characterized by small, sago-like elevations on 
the conjunctiva, followed by the lids adhering to the eyeball, ulcers form 
and the eyelids contract and are deformed, at the same time destroying 
the sight. 

Persons of all ages suffer from this disease and school children are 
exposed to it in the mountainous districts of Kentucky and other States in 
the United States. 

The disease is spread by the ignorant persons of pauper countries, 
where their habits are dirty. They usually know nothing of sanitation 
or hygiene. They live in large numbers in small huts or cabins, which 
are scarcely large enough for two people; all using the same towel and 
sleeping in the same bed with the one who suffers from the disease. 

Prevention — A child or adult suffering from trachoma must be iso- 
lated from the rest of the family, school children, etc. As these cases 
occur among the very poor they should receive treatment in a public in- 
stitution. The State and Federal authorities can prevent its spread by 
appropriating money to fight the disease, by sending into the mountainous 
districts, physicians and nurses to treat and educate the people ; erect suit- 
able buildings to place the sufferers in until cured. 

Every person with granulated eyelids or sore eyes should summon a 
physician, or report the trouble to the local board of health, as immediate 
attention to the trouble will prevent blindness and protect others. No case 



DISEASES OF THE EAR. 



473 



should be treated by home remedies. Delay means blindness to you and 
others in the community. 

Do not use a towel that any one else uses if you have granulated lids. 
Do not go near any public place where people congregate. Do not use the 
family linen, etc. 

Blindness spreads through ignorance of the individual, the State's 
and the National Government's indifference to the dangers of gonorrhoea 
and trachoma by not appropriating funds to fight them. The negligence 
of the sufferer from gonorrhoea, his shame and lack of treatment are rea- 
sons for blindness. 

Educate your children in the danger of these diseases, watch their 
morals and have them treated when contaminated. Be free from disease 
Before marriage. 



DISEASES OF THE EAR. 

Number of Diseases. — The number of diseases of the ear is twenty- 
four, but as a majority of them require for their recognition and effective 
treatment more or less peculiar and costly apparatus, only a few of the 
most important require notice in this chapter. For the understanding of 

these, however, a brief re- 
view of the anatomy of the 
ear is necessary. 

Anatomy of the Ear. — 
The external ear, or auricle, 
as anatomists call it, is sup- 
posed by many people to be 
the chief part of the organ 
of hearing, but in reality 
the essential pieces lie in- 
side the head, some, indeed, 
imbedded in the most solid 
bone of the skull, and one 
so hard that it has received 
the name of the petrous or 
rocky portion of the tem- 
poral bone. 

Auditory Canal — Besides the auricle, which is all that portion of the 
ear projecting from the head, the external oar is considered by anatomists 




Section of Right Ear. 



474 



DISEASES OF THE EYE, EAR AET> NOSE. 



THE EAR AND ORGANS OF HEARING 



Figure No. i. 
i, 2, 3. The inner cavity open, show- 
ing the spiral lamina. 
4, 5, 6. Rest of the cells of the inner 
cavity. 
7, 8. Vestibule. 
9, 10. Upper canal. 
11, 12. Lower canal. 
13. Outer canal. 
14, 14. Semicircular membranous 
canal. 
15,16,17. Acoustic or auditive nerve. 

Figure No. 2. 

I, 2. Origin and end of the helix. 

3. Antihelix. 

4. Antitragus. 

5. Tragus. 

6. Lobe of the outer part of the 

ear. 

7. It points to the navicular pit, 

and is in front and over the 
wing. 

8. Shell. 

9. Outer auditive duct. 

Figure No. 3. 

1. Swelling of the upper semicir- 

cular canal. 

2. Swelling of the outer canal. 

3. Swelling of the lower canal. 

4. Upper semicircular membra- 

nous canal. 

5. Outer membranous canal. 

6. Lower membranous canal. 

7. Spaces between the semicir- 

cular membranous and bony 
canals, supposed to be filled 
with coatunni humor. 

8. Common duct formed by the 

union of upper and lower 
membranous canals. 

9. Place where the inner semi- 

circular canal opens into the 
elliptical urn of the vestibule. 

10. Elliptical urn which contains 

the: 

11. Breschid otocones. 

12. Spheric urn containing also 

some : 

13. Otocones. 

14,15,16,17,18. Expansions of the acous- 
tic nerve to the membranous 
canal and the elliptical urn, 
and also the spheric. 

19. Turns of the spiral lamina. 

20. Ladder of tympanum. 

21. Nervous expansion to the back 

swelling. 



22. Vestibule ladder. 

23. Modiolus. 

Figure No. 4. 

1. Thickness of outer covering of 
inner cavity. 

2, 2. Vestibule ladder or upper 

cover of the spiral lamina. 

3, 3. Tympanum ladder or lower 

cover. 

4. Hook of the inner cavity. 

5. Centre of the infundible. 

6. Round opening communicating 

with the tympanum. 

7. Thickness of the outer cover 

of the vestibule. 
9. Oval opening. 

10. Orifice of the aqueduct of the 

vestibule. 

11. Lower semicircular canal. 

12. Upper semicircular canal. 

13. Outer semicircular canal. 

14. Swelling of the lower canal. 

15. Swelling of the upper canal. 

16. Common orifices of upper and 

lower canals. 

17. Swelling of the outer canal. 

Figure No. 5. 

1. Normal size. The other is 

much enlarged. 

2. Zone of acoustic nerve. 

3. Arrangement of filaments in. 

the vesicular zone. 

5. Membranous zone. 

6. Bony texture of the modiolus. 

7. Opening between the two lad- 

ders. 

Figure No. 6. 

1, 1. Zone of the acoustic nerve. 

2, 2. Filaments of the same in the 

bony zone. 

3, 3. Anastomosis in the vesicular 

zone. 

4, 4. Membranous zone. 

5, 5. Fold of outer edge. 

6, 6. Axis of inner cavity. 
7. The modiolus. 

8, 8. Outer bony walls of the inner 

cavity. 

9, 9. Bony layers of the spiral la- 

mina. 
10. Vestibule ladder. 

12. Hook of the inner cavity. 

13. Infundible. 

14. Horse hair passed through 

the course of the spiral 
lamina. 





Pig-. i._ View of the labyrinth in a straight Fig. 2.— View of the left ear in its normal 
position, open to show the distribution of the state, 
nerves. 




. .. Fig. 4. — View of the labyrinth on the left 

Fig. 3.— View, very much enlarged, of the gide open ttiroU ghout. in order to show its 

external phase of the bony labyrinth of the structure enlarged. 

left side, open, exposing the vestibule and its 
contents, etc. 




Fig 5— Figure or imaginary plan of the Fig. 6.— Vertical section of the Inner ( cavitv 

inner ravitv of the ear of the ear, very much enlarged, showing the 

inner cavity ot tne ear. arrangement and connection of the different 

parts. 
THE EAR AND ORGANS OF HEARING 
For an explanation of the illustrations see text on opposite page. 

475 



476 DISEASES OP THE EYE, EAR AND NOSE. 

to include the auditory canal (a) or opening into the head, and the deli- 
cate tympanic membrane or drumhead (b), which is drawn across the 
auditory canal like a curtain, at a depth of about one inch and a quarter 
from the outside. 

The Ear Drum. — The middle ear, as it has been named, called also the 
drum of the ear, is bounded outwardly by the tympanic membrane, and 
inwardly by the bony portion of the labyrinth or internal ear. It in- 
cludes the Eustachian tube (c), which is a fleshy pipe, communicating 
through the head with the upper and back part of the throat, and it con- 
tains the ossicles or little bones of the ear (d, e, and f). 

Ossicles or Little Bones. — The ossicles are three in number, and are 
named from their resemblance to the familiar objects after which they are 
called — the hammer (d), the anvil (e), and the stirrup (f). These re- 
markable little bones play a curiously elaborate part in the mechanism of 
hearing. 

The Labyrinth. — The chief portions of the internal ear, or labyrinth, 
as it is often called, on account of its perplexing structure and function, 
are the cochlea or snail-shell (g), and the semicircular canals (h). The 
appearances of these are sufficiently indicated by their names, and their 
positions can be best understood by looking at the adjoining picture. 

Use of the Auricle. — The object of the auricle in man is to collect the 
waves of sound, just as the broad mouth of an ear-trumpet does, and it 
seems to have no other duty in the process of hearing. In order to pre- 
vent, as far as possible, the entrance of insects with the sound-waves into 
the auditory canal, the exterior opening of this tube is guarded by stiff, 
coarse hairs. 

Ear-Wax. — It is also generally covered with a sticky, bitter substance, 
the ear-wax, secreted by numerous ceruminous glands (i), apparently to 
stop, or disgust, any adventurous creatures which may attempt to make 
their way in toward the drum. This provision is highly necessary, be- 
cause the tympanic membrane is so exceedingly sensitive that a very slight 
touch, even from the foot of a small insect, would cause intense pain. 

Delicacy of the Drum — On account of this great delicacy of the mem- 
brane of the drum, it is unsafe to put any hard object into the ear for 
the purpose of cleansing it. Hence, the corner of a towel is far better 
to wipe out the ear than an earpick or any other solid instrument. 

Wax Plugs. — Sometimes a firm plug of wax accumulates in the ex- 
ternal auditory canal, and causes deafness, which, however, can be en- 



DISEASES OF THE EAB. 477 

tirely and immediately cured if the hardened wax is removed by syring- 
ing with warm water. 

Foreign Objects in the Ear.— When children put beads, grains of com, 
and so forth, into their ears, no attempt should be made to pick them out 
with hairpins or bodkins, lest, on the contrary, they be pushed further 
down the tube. It is much wiser to send for a physician, who is provided 
with suitable, delicate forceps for removing them without risk of such a 
serious addition to the original misfortune. 

Insects in the Ear. — If an insect makes its way into a person's ear, 
notwithstanding nature's safeguards against such an accident, the patient 
should at once lie down on the opposite side and have the affected ear 
filled with olive oil, which will probably kill the creature and cause it to 
float up to the mouth of the auditory canal, where it can be picked out. 
Office of Auditory Canal. — The office of the auditory canal is to convey 
sounds, after they have been collected by the auricle, to the drum-head, 
which is caused to vibrate just as that of a soldier's drum does when it is 
beaten, or rather as the sounding-board of a piano does when the keys 
are struck. The vibrations thus produced are transmitted along the 
chain of ossicles, that is to say, the handle of the malleus or hammer, 
being fastened to the tympanic membrane, moves with it. In thus moving 
it tilts the incus or anvil slightly over, and this motion of the anvil in its 
turn causes a slight oscillation of the stapes or stirrup. 

The Stirrup. — But the stirrup is fastened by its foot-plate to the 
membrane covering a little hole in the bony wall of the labyrinth, called 
the oval window, so that any vibration of the drum-head or tympanic 
membrane is carried along over this chain, or bridge of bones, to the cov- 
ering of the oval window. Behind this latter membrane the whole laby- 
rinth is filled with a watery fluid, which bathes the terminations of the 
auditory nerve in the cochlea. 

The Semicircular Canals. — The exact use of the semicircular canals is 
not understood, but there is little doubt that the fine hairs proceeding from 
cells found in the cochlea are thrown into vibrations by undulations trans- 
mitted from the membrane of the oval window through the fluid contained 
in the cavities of the labyrinth. Then these vibrations of sound are per- 
ceived by the delicate nerve-fibres, in which auditory nerve terminates, 
very much as the undulations which constitute light and color are per- 
ceived by the filaments of the optic nerve, where they terminate in the 
rods and cones of the retina. Obviously, with such a complicated and 
excessively delicate mechanism for carrying on the process of hearing, 



478 DISEASES OF THE EYE^ EAR AND NOSE. 

the wonder is, not that few people hear imperfectly, but that everybody 
is not as deaf to all sound as the world has been in previous ages to the 
teachings of hygiene. 

DISEASES OF THE AURICLE OF THE EAR. 

Ear Tumors. — This outer part of the ear is the occasional seat of 
gouty and other deposits, which give rise to prominences and irregularities 
of its surface ; it may also be affected with a kind of vascular tumor called 
hematoma, and still more frequently be the seat of benignant and malig- 
nant or cancerous tumors, and of various malformations. 

Sizes of the Ear. — In persons of slight and delicate organizations, with 
a scanty stock of vitality, the outer ear is often exceedingly small, although 
it may be perfectly shaped. In persons of large build and actively cir- 
culating blood, the auricle is sometimes relatively large, the lower lobe 
being pendulous and of exaggerated development. 

What Large Lobes Indicate. — As a rule, a large lobe of the ear indi- 
cates a free vascular supply of blood to the brain, and is said to be to 
some extent a sign of epilepsy, and of other kindred nervous diseases. 

Danger from Earrings. — If people choose to run the risk of suffering 
from the dangerous little tumors which are sometimes caused by the 
barbarism of wearing earrings, they should be very careful to diminish 
the chance of injury as much as possible by having the auricle pierced 
with a clean, bright instrument, and by preventing the cartilage, which 
sometimes comes quite low down in the lobe of the ear, from being 
wounded. 

Boxing and Pulling Ears. — Children should never be punished by 
"boxing" or pulling the ears. The former piece of brutality might in- 
stantly burst the tympanic membrane, causing deafness for life, and the 
latter is liable to originate severe inflammation of the auricle, leading to 
the same unfortunate result. 

ECZEMA OF THE AURICLE. 

Symptoms. — The symptoms of this affection are the same as of acute 
eczema and the reader is referred to the article on that subject. There 
is also a chronic form in which the skin is thickened and crusts are formed. 

Causes. — 1. Detention, when it is due to nerve-irritation. 

2. Discharges from the ear which irritate the auricle. 



DISEASES OF THE EAR. 479 

3. Hoods by pressing the auricle against the side of the head and pre- 
venting the evaporation of the perspiration. 

4. A chronic form sometimes found in old people is due, likely, to 
a weakened "tone" of the tissues. 

Treatment. — The treatment is the same as in eczema of other parts 
of the body. Where it is possible, the cause should be removed. Cleanli- 
ness is essential, but water is contra-indicated and the crusts should be 
removed by olive oil. The ammoniated mercury ointment, which is 
official and to be had at all drug stores, should be applied twice daily after 
thorough cleansing. Cod-liver oil and iron are often used as internal 
remedies. 

HEMATOMA OF THE AURICLE. 

Definition. — This is a swelling of the auricle in which there is an 
infusion of blood between the cartilage of the auricle and the perichon- 
drium. It is frequently caused by traumatism and often occurs in the 
insane. 

Symptoms. — The symptoms are swelling and slight pain. 

Treatment — Gruber recommends, if the blood is coagulated, incising 
the tumor and removing the clot. Painting with tincture of iodine is 
advised for the thickening. Cold or warm applications may be tried to 
relieve the pain. 

MASTOIDITIS. 

This is an inflammation with pus filling up the porous portion of 
the mastoid bone back of the ear. It may be primary or secondary, though 
the latter is seldom observed. Among the predisposing causes are inflam- 
mation of the middle ear, exanthematous diseases, la grippe, tuberculosis, 
syphilis and pathogenic infections. There are instances on record where 
it has existed' for months without subjective or objective signs, but as a 
rule it characteristically manifests itself at an early stage. 

Symptoms. — The symptoms of acute or primary mastoiditis are heat, 
redness and swelling of the skin behind the auricle, and tenderness upon 
pressure. This primary disease usually terminates in three or four days 
in recovery or else in an involvement of the deeper structures with the 
formation of an abscess. 

In the secondary form the symptoms vary in different individuals, 
manifesting themselves before or after spontaneous rupture of the drum. 
Tenderness, persistent or remittent pain and redness with swelling over 



480 DISEASES OF THE EYE^ EAR AND NOSE. 

the mastoid and bulging of tke superior and posterior auditory canal, are 
the most prominent symptoms. The temperature varies from normal to 
104 degrees F. and is much higher in infants as a rule than in adults. 
If the case be observed before rupture the drum will be seen bulging in 
the posterior and superior portions. After the rupture of the drum the 
discharge from the ear is usually profuse. 

Treatment. — The treatment of mastoiditis is divided into medical 
and surgical — by medical in this instance being meant minor surgical 
methods and the application of antiphlogistic remedies. When early ob- 
served effort should be made to abort acute inflammation of the mastoid by 
cold application by use of the Leiter coil or cracked ice bags. This should 
be continued for twenty-four hours without interruption. The patient 
should be absolutely confined to bed and given light diet and gentle purga- 
tive. If the pain and inflammation continue after forty-eight hours an 
operation will in most cases be necessary. To relieve elevation of tempera- 
ture, acetanilid in five-grain doses may be repeated hourly until fifteen 
grains have been taken. 

Mastoiditis is of such serious character and is liable to such com- 
plications that if it be suspected the best medical advice obtainable should 
be secured without delay, for none but an expert can properly care for 
the sufferer from this disease and know just whether an operation be 
necessary or not. 

DISEASES AND AFFECTIONS OF THE AUDITORY CANAL 

BOILS OR FintUNCULOSIS. 

Character. — This is one of the most painful maladies that flesh is heir 
to. It is rendered so frightfully painful by the fact that it is shut in 
between a layer of strong cartilage and solid bone. Probably the most 
common cause of abscess in the ear is taking cold, although picking the 
ears with hard, sharp instruments sometimes seems to excite it. As it is 
impossible to tell which side of the auditory canal the abscess is going to 
form, early in the case, lancing must be deferred. 

Treatment — As a rule, all that can be afforded in the way of relief 
is gained by hot poultices made out of ground flaxseed, bread and milk, 
or little bags of hops dipped in hot vinegar and changed very frequently, 
or as soon as they grow cool. As soon as the abscess is well localized it 
should be opened by a physician, thereby relieving the patient of a great 
deal of suffering. In the meantime some respite and sleep may be ob- 



FOREIGN BODIES IN THE EAR. 481 

tained by the use of opium suppositories containing one grain each used 
every four hours, or hypodermic injections of one-eighth to one-half of a 
grain of morphia. 

BONY TUMOR OR EXOSTOSIS. 

Causes. — An exostosis or bony tumor occasionally springs from the 
walls of the auditory canal, pushing the mucous lining before it, and 
filling up part or all the calibre of the tube. It is most frequently met 
with in people of a rheumatic or gouty tendency. Until chiseled away 
it is sometimes very painful and a serious obstacle to hearing. 

WAX OR IMPACTED CERUMEN. 

Causes — This is the name given to that condition in which the canal 
is partially or completely filled with ear-wax. The wax may be very hard 
and may be mixed with dirt and dust. It is caused sometimes by the 
shape of the canal, and on the other hand is often due to one's occupation. 

Symptoms. — Deafness, dizziness and buzzing in the ear are frequently 
complained of, but to make sure that impacted wax is present it should 
be seen. It appears as a dark mass in the canal. 

Treatment. — If the wax is soft, it may be removed by repeated syring- 
ings with warm water. If it is hard, the canal should be filled with warm 
olive oil and then the syringing tried. An instrument of any kind should 
never be introduced into the canal for its removal by the unskilled hand. 

FOREIGN BODIES IN THE EAR. 

Symptoms.— Inanimate foreign bodies, such as beads, buttons, grains 
of corn, etc., give rise to the same symptoms as impacted wax. In the 
case of grains, water tends to swell them and so makes their removal more 
difficult. In such cases the surgeon should be. called upon. 

Use of Syringe — Insects occasion great pain which may simulate 
intense neuralgia, or, by a reflex action, may refer the pain to the teeth 
and so lead one astray. The syringe should be used and heated water is 
very grateful to the patient, soothing the inflamed part. Great care is 
necessary that the water is not hot enough to do injury. 
31 



4:82 DISEASES OF THE EYE, EAR AND NOSE. 

DISEASES OF THE TYMPANIC MEMBRANE OF THE EAR 

EARACHE. 

Character. — Inflammation of the drum-head is an acutely painful 
affection, sometimes attended with .fainting fits in its early stages, and 
usually resulting in deafness because the membrane is left thickened, and 
therefore incapable of properly responding to the vibrations of sound. 

Treatment. — Leeching, followed by blisters behind the ear, or on the 
nape of the neck and opium internally or hypodermically, to mitigate the 
suffering, which is often very severe, will prove of great value. Hot 
applications to the ear in the shape of bags of hops, a stove lid wrapped 
in flannel, or the hot-water bottle may be sufficient to give relief. 

Treatment of Children. — In young children a hot foot bath will relieve 
by dilating the small blood-vessels of -the lower extremities and so drawing 
some of the blood from the inflamed area. As hot water as can be borne 
may be dropped into the ear. A two per cent, solution of cocaine will 
generally relieve the pain. 

PERFORATION OF THE TYMPANIC MEMBRANE. 

Causes. — This is especially liable to occur during the course of scarlet 
fever from suppuration of the middle ear, and if neglected leads to per- 
manent deafness. Hence, in scarlatina, the ears of a child should be 
carefully examined daily with the little conical ear-speculum, if there 
is the slightest complaint of pain in them, in order to prevent this disaster 
by early puncture of the drum-head, which allows the escape of the im- 
prisoned pus, and so saves the organ of hearing. Still, when the per- 
foration remains in the drum-head the auditory sense is often only slightly 
impaired. 

Treatment. — Suppurating or running ears need, above all things, 
that cleanliness should be maintained as much as possible. If pus remains 
in the middle ear, a chronic inflammation is kept up and normal tissue is 
destroyed — eaten away as one might say. Hearing becomes more and 
more difficult and life is constantly in jeopardy, for the bone may become 
affected and the brain finally exposed to infection and a brain-abscess 
develop. Cleanliness may be maintained usually by washing out the ear 
with a hot solution of carbolic acid two or three times daily. A two per 
cent, strength is sufficient. If this fails to cure the ear, which would 



DISEASES OF THE NOSE. 483 

be evidenced by a cessation of all symptoms, especially pain and discharge, 
a specialist should be at once consulted. Dead or necrosed bone may be 
present, or granulation tissue — "proud flesh," — and should be removed as 
soon as possible. 

Thickening of Tympanum — Thickening and condensation of the tym- 
panic membrane are liable to occur in advanced life, the delicate skin 
forming the drum-head undergoing a slow process of change, by which it 
loses its elasticity and becomes firm and hard almost like the nail of the 
finger. Of course, in this condition the vibrations into which it should 
naturally be thrown are rendered very imperfect, and the hearing is 
correspondingly defective in old people who are the subjects of this de- 
generation. 

DISEASES OF THE EUSTACHIAN TUBE. 

Causes. — The Eustachian tube is liable to inflammation from exten- 
sion of disease from the throat, even such a simple irritation as that of 
a common cold. It is also subject to obstruction and contraction, so that 
the air cannot pass freely through it into the cavity of the tympanum, 
as it should do in health. When this takes place, the vibration of the drum 
is interfered with, there is pressure within the cavity, and consequently 
a sense of fullness and deafness is experienced, which is very oppressive. 

Treatment. — This distressing condition can often be greatly relieved 
by calling in a skillful aurist, who may pass a probe or hollow tube along 
the Eustachian canal into the middle ear, and so restore the communica- 
tion of the latter with the external air. 

Diseases of the Middle Ear — Diseases of the middle ear and of the 
internal ear comprise inflammation, ulceration and abscess. All these 
are very painful, difficult to recognize with certainty, and, as a rule, 
beyond the power of any but the most skillful treatment. In every case 
an experienced aurist should therefore be immediately called in, and until 
he arrives the severity of the pain may, perhaps, be held in check by some 
of the means suggested when speaking of abscess of the auditory canal. 

DISEASES OF THE NOSE. 

Anatomy of the Nose — The organ of the sense of smell is much more 
extensive than people who have never studied anatomy imagine. Instead 
of being merely a triangular projection of some two or three inches long, 
and an inch or an inch and a half high, occupying the middle of the face 
it is a large double cavity reaching far back into the head, and communi- 



4-8 ± DISEASES OF THE EYE, EAR AND NOSE. 

eating by the posterior nares or hinder nostrils with the upper part of the 
throat. The external portion of the nose is composed at its upper third 
of small bones, which are continued at its lower part by plates of 
cartilage. 

Nose Bones and Cartilages. — These cartilages and bones are covered 
on the outside with a thin skin, and on the inside with a mucous mem- 
brane, which in the deeper recesses of the cavity is identical and con- 
tinuous with that of the mouth and throat. The external division between 
the two nostrils is carried upward and backward by a flat, very thin bone 
named the vomer; and the sides of the two cavities, which are continuous 
with the exterior nostrils, are partly filled up with soft, spongy processes 
of bone, three of which are called the turbinated bones, because they are 
rolled up like a scroll. 

The Mucous Membrane. — These turbinated bones are covered, like the 
rest of the nasal cavities, with a mucous membrane, named the Schnei- 
derian membrane, richly supplied with blood-vessels, which approach 
very near its soft and delicate surface. It is from these small, but active, 
little blood-vessels that the hemorrhage usually comes in bleeding from 
the nose. 

The Olfactory Nerves — The nerves of smelling, called the olfactory 
nerves, enter the upper part of the nose through openings in the sieve-like 
bone, which forms the roof of the nasal fossa. After passing into the 
nose, these olfactory nerves divide up into a great number of tiny branches, 
which run along under the surface of the Schneiderian membrane, and are 
spread out upon the superior and middle turbinate bones, and on the sides 
of the partition between the two nasal cavities. The great use of the tur- 
binated bones and processes is to furnish a large extent of surface upon 
which these branches of the olfactory nerve can be expanded. 

Functions of the Olfactories. — And this spreading out of the olfactory 
nerve is evidently in order that the sensitive filaments may, on occasion, 
come in contact with as large a number as possible of the exceedingly 
minute, odorous particles which many substances, such as musk or cam- 
phor, are constantly giving off in such abundance. 

How We Smell — These odorous particles have the power of affecting 
the terminal filaments of the olfactory nerves in different ways, which 
we recognize as the agreeable or disagreeable odors of the objects from 
which they originate. The excessive minuteness of such particles mav 
be comprehended from the fact that the apartment of the Empress Jo- 
sephine in one of the French Imperial palaces was found, after twenty- 



NASAL CATARRH. 485 

four years of disuse, to give off a distinct odor of the musk employed by 
that unfortunate lady when she occupied it. 

Uses of the Sense of Smell — The power of distinguishing odors, which 
to some animals, including all those beasts which pursue their prey by 
scent, is one of the most vitally important, chiefly serves as a means of 
gratification or its opposite to human beings. 

Hygienic Office of Smell. — But although the sense of smell does not in 
civilized communities contribute anything toward sustaining life by help- 
ing us to secure food, it has a very useful hygienic office, which should 
never be forgotten, in guarding us against some of the most common and 
dangerous causes of disease, in foul air and polluted water. 

Nose as a Warming Organ. — Besides this the nose has an important 
work to do in warming and, to some extent, purifying the air we breathe, 
as that air is drawn through the narrow and winding passages among the 
turbinated bones. The Schneiderian membrane over which this air passes 
being generally moist, and more or less covered with adhesive mucus, 
helps to catch not only the odorous particles, but larger and more hurtful 
impurities, and so is quite mechanically a valuable protector to human 
health. 

NOSE BLEED OR EPISTAXIS. 

Causes — ISTose bleed may be due to a blow, picking the nose, the pres- 
ence of a foreign body in the nose, or to the use of instruments in the nose. 
Diseased conditions within the nose often occasion it. In girls it may 
replace the natural menstruation. Diseases of the heart, liver and kid- 
neys may give rise to it. 

Treatment. — In cases of slight bleeding, pressure or the snuffing of 
ice-water may suffice. If these fail, cotton dipped in a one to ten thousand 
solution of adrenalin, should be packed into the nostril and kept there 
for ten or fifteen minutes. Iron, tannic acid and alum — the remedies our 
grandmothers used — are now supplanted by this modern drug which does 
not irritate the delicate lining of the nose as the old remedies did. If the 
adrenalin solution does not check the hemorrhage, it may be necessary for 
the physician to plug up both the anterior and posterior nostrils by the 
aid of an ingenious little instrument which has been devised for that 
purpose. 

NASAL CATAHRH 

Forms and Causes. — "Catarrh" is a word derived from the Greek word 
katarheo, meaning to flow down, and is used in medicine to designate a 



486 DISEASES OF THE EYE, EAR AXD 2sOSE. 

particular form of inflammation of the mucous membrane. It has many 
forms and is due to many causes, and no one has ever found nor ever will 
find one remedy for catarrh. This truth should be better and more gen- 
erally known by the intelligent public. 

Causes. — As causes of catarrh may be mentioned: 

1. Climatic influences. Many patients lose their catarrh when they 
change from one climate to another. 

2. Inherited predisposition. One cannot inherit catarrh, but the 
weakness of the mucous tissues may be inherited and so predispose to the 
affection. 

3. Indigestion, constipation, intestinal parasites (worms), heart, 
lung, liver and kidney diseases are often provocative of a catarrhal state 
of the nasal mucous membrane. 

4. Many fevers at their beginning or during their course are accom- 
panied by acute catarrhal disturbance. Typhoid fever, measles, and scar- 
latina are examples. 

5. Deformity within the nasal chambers is one of the most frequent 
factors, and local remedies are of no avail as far as a permanent cure is 
concerned. In these cases the only sensible treatment is the correction 
of the deformities, thus bringing the organ into a condition as near the 
normal as possible. 

Catarrh as the Cause of Tuberculosis. — There is a general belief that 
catarrh is to blame for the great majority of the cases of consumption. 
This needs some modification before it is to be accepted. Surroundings, 
family predisposition, climate, and weak, non-resisting tissues are as 
much to be blamed for the occurrence of this terrible malady. Catarrh 
does, however, play some part as a factor. 

Liability of Infection. — Professor Osier, of Johns Hopkins "Univer- 
sity, says on this subject: "The liability of infection in the cervical and 
bronchial glands in children is probably associated with the common oc- 
currence of catarrhal processes in the throat and bronchi." This means 
that neglect of catarrhal conditions in a child makes that child more likely 
to be infected with tuberculosis, and if the family has a history of tuber- 
culosis there is all the more reason for thoroughness of treatment of the 
existing catarrhal condition. 



FETID CATARRH OR OZENA. 



FETID CATARRH OR OZENA. 



487 



Character. — This is a term applied to a form of catarrh characterized 
by a horrible and peculiar stench and the formation in the nose of crusts 
of dried secretions upon which the fetor depends. 

Causes — In some cases it is due to a constitutional disease, as syphilis. 
In the majority of instances, however, it is the continuation of a catarrhal 
inflammation, in which the mucous membrane shrinks — atrophies — and 
the secretions therefrom are changed, becoming more tenacious and con- 
centrated. 

Symptoms. — These are the crusts and the peculiar fetor mentioned 
above. 

Treatment. — Cleanliness is the great sine qua non — a fact easily re- 
membered when one realizes that the fetor is from the decomposing crust. 
To detach the crusts various washes have been prescribed. A solution of 
bicarbonate of soda is a good solvent and may be prescribed as follows : 

R. — Bicarbonate of soda 2 ounces 

Common table salt 1 ounce 

Menthol 4 grains 

Mix. Directions : Half a teaspoonful in a cup of warm 

water, snuffed up the nose until the nostrils are clear. Use 

twice daily. 

Or, 

R. — Bicarbonate of soda 2 ounces 

Biborate of soda % ounce 

Salicylic acid 1 drachm 

Menthol 4 grains 

Mix. Directions : Same as for preceding prescription. 

Or, 

R. — Liquor antiseptic alka 6 ounces 

Use freely night and morning with an atomizer. 
Or, 

R. — Dobell's Solution. 

Dilute with three or four parts of warm water and use 
as a nose wash. 

Steam Inhalations. — If these washes are not effectual in removing 
the crusts, steam or hot vapor inhalations may be tried. In obstinate 
cases it is often necessary to remove the crusts with some force, either 



488 DISEASES OE THE EYE, EAR AND NOSE. 

with cotton on a probe or with forceps. After the crusts are gotten rid 
of, antiseptics and deodorizants should be employed. Weak solutions of 
potassium permanganate, bichloride of mercury, and when the patient can 
stand the pain, a one-half to a one per cent, solution of formaldehyde. 

Removal of Dead Bone. — When the fetor is due to dead bone, the dead 
bone should be at once removed. 

Treatment of Syphilitic Catarrh. — If a syphilitic taint, either in- 
herited or acquired, is the foundation of the odor, proper constitutional 
treatment should be instituted at once and maintained until long after the 
nasal symptoms have disappeared. 

GRAPE-LIKE TUMORS OR NASAL POLYPS. 

Causes. — Nasal polyps are grape-like tumors which are dependent 
from the upper and outer wall of the nose — on the inside — and are sup- 
posed to be one of the possible results of chronic inflammation of the 
lining mucous membrane. They are rarely seen before the fifteenth year. 

Symptoms. — When small they may present no symptoms. If they are 
large they may cause obstruction to the respiration, pervert the nasal 
secretions, cause headaches, give a nasal twang to the voice, and, in some 
cases, undoubtedly provoke asthmatic attacks. 

Treatment. — The treatment is removal, which may be accomplished 
by twisting the tumor free from its attachment, by cutting it at its base, 
or preferably by using a wire snare. 

ACNE ROSACEA. 

Nature. — This is a skin disease affecting usually the skin-covering 
of the nose, is chronic, and is characterized by redness, thickening of the 
skin, and more or less acne. 

Causes. — These are various. According to Prof. Van Harlingen, 
"in early life it is generally due to anemia and debility, nervous prostra- 
tion or dyspepsia. In later life the use of spirituous liquors is often the 
cause, and, perhaps nearly as often, dyspepsia in some of its forms." In 
women, disturbances of the menstrual function, even pregnancy, may act 
as a causative factor. 

Treatment. — To be successful persistence in treatment is often neces- 
sary. The first thing to be done is to remove the cause. "Uterine and 
menstrual derangements are to be looked after, the stomach and bowels 
kept in good order, and all hygienic measures used to improve the general 



WARTS ON THE NOSE. 489 

health. Alcoholic and malt liquors are to be totally eschewed. Tea and 
coffee should be drunk in moderation and not strong. Inveterate tea 
drinkers are very apt to have red noses." 

The Favorite Drug. — The favorite drug both for internal and external 
use in this disease is ichthyol. Internally it may be administered in pep- 
permint water, equal parts of each, ten drops being the dose and given 
every four to six hours. Locally it may be used as an ointment or as a 
paint : 

R. — Ichthyol I drachm 

Subnitrate of bismuth i drachm 

Ammoniated mercury I drachm 

Vaseline 10 drachms 

Mix. Apply freely before retiring. (Dr. Latoir.) 

R. — Ichthyol I ounce 

Oil of eucalyptus 10 drops 

Oil of bergamot 5 drops 

Mix. Paint on at night; wash off in morning with soap 
and warm water; then apply dusting powder. (Merk.) 

Vleminck's solution is recommended by Stelwagon, diluted one to 
ten parts of water. The formula for the strong solution is : 

R. — Calcis % ounce 

Sublimed sulphur I ounce 

Water 10 ounces 

Boil down to six ounces and filter. Apply locally three 
or four times a day. 

ADENOID GROWTHS. 

These growths resemble proud flesh. They grow in the back part 
of the nostrils, and are generally due to catarrhal conditions. They block 
the nose passages, producing snoring and difficult breathing. The treat- 
ment consists in scraping them away with a scoop, or even with the 
finger, to the great relief of the patient. 

WARTS ON THE NOSE. 

Treatment. — Warts in this locality are often mistaken by the laity 
for cancer and afford the charlatan and the advertising doctor an op- 
portunity to make "cures" of this greatly feared disease. Warts in this 
locality are treated just as in other parts of the body. 



PART V OF BOOK IV 

Tells of the circulatory and absorbent systems of 
the body and the affections to which they are subiect. 



Addison's Disease 506 

Symptoms of 506 

Treatment of 506 

Aneurism 508 

Causes of 508 

Symptoms of 508 

Treatment of 509 

Angina Pectoris 519 

Symptoms 519 

Treatment of .- 5*9 

Arteritis 520 

Symptoms of 520 

Treatment of 520 

Asthma, Heart 520 

Auscultation 496 

Bloody Tumor 508 

Chronic Pericarditis 502 

Treatment of 502 

Valvular Diseases 516 

Symptoms of 517 

Treatment of 517 

Cyanosis 497 

Dilatation of the Heart 5 J 4 

Symptoms of 514 

Treatment of 515 

Embolism 507 

Symptoms of 507 

Treatment of 507 

Endocarditis 502 

Causes of 503 

Diet in 505 

Symptoms of 503 

Treatment of 505 

Enlargement of the Heart 515 



Diet in 



16 



Symptoms of 515 

Treatment of 5*6 

Fainting 518 

Symptoms of 5 T 8 



Treatment of 518 

Goitre 507 

Symptoms of 507 

Treatment of 508 

Grave's Disease 507 

Heart Asthma 520 

Symptoms of 520 

Treatment of 520 

Palpitation of 497 

Pang 519 

Inflammation of the Lymphatic 

Glands 512 

Symptoms of 512 

Treatment of 513 

of the Veins 509 

Leucocythemia 514 

Causes of 514 

Symptoms of 514 

Treatment of 514 

Lymphatic Glands, Inflammation of.512 

Palpitation of the Heart 497, 518 

Symptoms of 518 

Treatment of 519 

Pericarditis 497 

Chronic 502 

Diet in 502 

Symptoms of 500 

Treatment of 501 

Phlebitis 509 

Symptoms of 509 

Treatment of 509 

Splenitis 513 

Symptoms of 513 

Treatment of 514 

Syncope 518 

Tumor, Bloody 508 

Valvular Disease, Chronic 516 

Veins, Inflammation of 509 



ILLUSTRATIONS 

Arteries, The 511 

Heart, The 499 

Heart Cavities, Right Side 502 

491 



Internal Organs 504 

Valves of the Heart 516 



CURATIVE MEDICINE 



PART V. 

DISEASES OF THE CIRCULATORY AND ABSORBENT SYSTEMS 

New Medical Views. — Affections of this class were, until recently, 
supposed to present symptoms of very much the same general character, 
and therefore to constitute a class of maladies which possessed consider- 
able unity in their intrinsic nature. They are now, however, found to 
consist of a variety of distinct affections producing very different and 
sometimes opposite symptoms. Thus hypertrophy produces increased 
and dilatation diminished force of the circulation. In order, therefore, to 
appreciate the value and familiarize ourselves with the nature of each 
class of symptoms, it is necessary to study the several affections in an 
isolated form. We are thus enabled, on meeting with a compound case — 
one consisting of a complication of several of the simple affections — to 
analyze or unravel the symptoms, ascertain the relative importance of 
each class, and in this manner establish rational and secure principles of 
treatment. In conformity with this view, the various articles on the 
diseases of the circulatory and absorbent systems, instead of being as- 
sembled under the present head, are for facility of reference, diffused 
alphabetically throughout the work. 

ACTION OF THE HEART. 

Hearing the Heart-Beats — If we apply the ear, with or without the 
stethoscope, to the cardiac region of a person in health, we perceive most 
distinctly a series of sounds of a very marked and peculiar kind, sub- 
divided into uniform parts by a brief interval of silence after every second 
sound. Two sounds follow each other instantly, or within so short a space 

(493) 



494 DISEASES OF THE CIRCULATORY SYSTEM. 

that the ear separates them rather by difference in their quality than from 
the intervention of any notable cessation of sound; then ensues a brief 
but well-marked pause, which is again succeeded by the first of the time 
sounds. This series of sounds may be perfectly well represented, as to 
rhythm, by musicial notation. The relative duration of the sounds and 
pause is represented by Lawrence to be nearly as follows: the whole 
being divided into four parts, two of these are occupied by the first sound, 
and one by the second sound and the pause respectively. 

Difference in the Sounds — The two sounds differ in kind as well as 
in duration. The first is nearly double the length of the second, of a 
graver and more subdued tone, rather louder at its commencement than 
at its termination, as if it was about to die away, when suddenly inter- 
rupted by the second. The second is brief, smart and clear, like a gentle 
tap with the pulp of the finger on a solid table, or like the sharp sound 
produced by the pulling back of a valve, the cracking of a whip, or the 
lapping of a dog. Exactly synchronous with the first sound, there is per- 
ceptible, in most cases, a well-marked impulse or shock communicated 
evidently by a body in motion within, in the walls of the chest. Every 
one acquainted with anatomy and physiology will at once conclude that 
the sounds and impulse just described are produced by the motions of 
the heart; and this conclusion will be justified and confirmed by an ex- 
amination of the pulse in the extremities. It will be found, in all healthy 
subjects, that there is an invariable connection between the sounds and the 
pulse ; every stroke of the latter corresponding very accurately with every 
repetition of the twin sounds ; as, under every variation of circumstances 
as to loudness, frequency, and so forth, the same exact relation is per- 
ceived, it cannot be doubted that there exists an essential physical con- 
nection between the causes of the sounds and the pulse. 

Rhythm of the Heart — The first motion of the heart which interrupts 
the interval of repose is the auricular systole. It is a very slight and 
brief contractile movement, more considerable in the auricular appendix 
than elsewhere, and propagated with a rapid vermicular motion toward 
the ventricle, in the systole of which it terminates rather by continuity of 
action than by the sucession of a new movement. The ventricular systole 
commences suddenly and is accompanied with a considerable diminution 
of the volume of the organ. Synchronous with the systole are the first 
sounds — the impulse of the apex against the ribs and the pulse in vessels 
near the heart; in the radials the pulse follows at a barely appreciable 
interval. 



ACTION" OF THE HEART. 495 

The Diastole Motion. — The systole of the ventricles is followed by 
their diastole, during which they return, by an instantaneous expansive 
movement, sensible to the touch and sight, to the same state (with respect 
to size, shape, position, and so forth) , as during the previous interval of re- 
pose. This movement, or diastole, is accompanied by the second sound, by 
an influx of blood from the auricle, by a retractile motion of this cavity 
most observable at its sinus, and by a retrocession of the apex of the heart 
from the walls of the chest. Next succeeds the intervals of repose, dur- 
ing which the ventricles remain at rest, in a state of fullness though 
not of distension, through the whole period intervening between the 
second and the first sounds; but the auricle remains at rest during the 
first portion only of the period, the remainder being occupied by its next 
contraction, with which recommences the series of actions described. 

1. The ventricular systole occupies half the time of a whole beat. 

2. The ventricular diastole occupies one-fourth or one-third. 

3. The interval of ventricular repose occupies one-fourth, or rather 
less, during the latter half of which the auricular systole takes place. 

Causes of the Motions. — The auricles, which are always in a state of 
fullness, arrive, during the first half of the period of ventricular repose, 
at the state of distension, by which they are stimulated to contract. The 
object of the contraction at this movement is to propel a small additional 
quantity of blood into the ventricles for the purpose of bringing them 
from the state of fullness to that of distension; an object which could 
not be accomplished without a contraction, as the blood could not other- 
wise force its way into the ventricles against the resistance offered by 
their elasticity. The cavities, then, being brought to the state of dis- 
tension, are by this stimulated to contract; they expel a greater or less 
proportion of their contents ; in small animals — frogs, for instance — they 
expel the whole ; which is proved by the ventricle being full. In larger 
animals they do not appear to expel the whole, but the fact does not 
admit of demonstration. During the act of expulsion, the apex is tilted 
up, in consequence of the retraction of the ventricles toward the base 
and upon the auricles, which, in a state of extreme distension, are placed 
like a fulcrum beneath them. 

Causes of Diastole Motion. — The diastole appears to be occasioned by 
several concurrent causes, viz. : 

1. That power of the muscle by which it reverts from the state of 
contraction to that of relaxation, and in virtue of which it exercises a 
degree of motion. It may be called elasticity. 



496 DISEASES OF THE CIRCULATORY SYSTEM. 

2. The distension of the auricles, which is greater at this moment 
than at any other, as they have been filling during a longer period'; 
namely — that of the ventricular contraction, or half a whole beat. 

3. The weight of the ventricles collapsing on the distended auricles 
underneath them. 

4. The width of the auricular-ventricular orifice, which allows the 
blood to shoot in instantaneously and with great facility. 

It is obvious that, as so many powerful causes conspire to promote 
the influx of the blood, an auricular contraction for this purpose would 
be superfluous. The escape of blood from the auricles during the diastole 
causes the slight retraction observable in them at the same moment. The 
expelled blood being instantly replaced from the vena cava, distension of 
the auricles recommences, and the same series of actions is renewed. 

Causes of the Sounds. — The ventricular systole is the cause of the 
first sound, by the impulse which it communicates to the blood within it, 
thereby exciting sonorous vibrations of the fluid. If the sound of the 
muscular contraction contributes at all to the first sound it can only be 
in a very slight degree. The ventricular diastole is the cause of the 
second sound, by the reaction of the walls on the blood, and the con- 
sequent production of sonorous vibrations, when its cause is abruptly 
arrested by the completion of the diastole. Hence this sound is loud, brief 
and clear. The auricles are not concerned in the production of the 
two sounds, as they take place when these cavities are motionless; nor 
do they appear to be productive of any sound, as no third sound is 
audible. 

Auscultation or Sounding. — We now proceed to examine more mi- 
nutely the phenomena produced by the actions of the heart, in health and 
disease, with the view to deduce therefrom such diagnostic signs as they 
are capable of affording. It is hardly necessary to premise that the aus- 
cultatory diagnostics of cardiac diseases are founded precisely on the same 
principles as those which apply to diseases of the lungs. 

GENERAL SYMPTOMS OF HEART DISEASE. 

Physical Signs. — Disturbance of the functions of the heart must neces- 
sarily produce decided effects throughout the whole circulatory apparatus. 
Appreciable modifications of the arterial pulse of the state of the veins 
and capillaries show that the circulation is embarrassed. The pulse irregu- 
lar, unequal and intermittent, as are the pulsations of the heart very 



PERICARDITIS. 497 

small; but when there is considerable hypertrophy of the left ventricle, 
the pulse is also hard and vibrating, presenting sometimes a peculiar 
fremitus, which is most distinct in the carotid, subclavian and radial 
arteries. In some cases the arterial pulsations succeed one another, stroke 
by stroke, and this reduplication of the pulse is coincident with a regurgi- 
tant murmur heard on auscultating the heart. The insufficiency of the 
aortic valves is characterized by a bellows-murmur at the base, accompany- 
ing the second sound of the heart, and by a bounding pulse with flexuosity 
of the radial artery. 

Symptoms. — When disease of the heart has reached a pretty advanced 
stage, the existing impediment to the venous circulation is indicated by 
swelling of the veins near the heart ; those, for example, of the neck and 
face ; and this turgescence is particularly obvious in the external jugular 
veins, where it is sometimes accompanied by undulatory pulsations, an- 
alagous to and synchronous with the arterial pulse. This is the venous 
pulse indicative of hypertrophy of the right ventricle. 

Further Symptoms. — In addition to the embarrassment of the venous, 
there is embarrassment of the capillary circulation, which declares itself 
by a livid tint of the skin, swelling of the face, puffiness of the eyelids, a 
bluish color of the lips, and more or less injection of the skin of the 
extremities. 

Palpitation. — As palpitation is under all circumstances dependent on 
over-excitement of the nerves of the heart, the phenomenon is always es- 
sentially the same. The varieties which it presents arise merely from 
differences in the causes and from the different routes which these causes 
pursue in order to arrive at and convey their stimulus to the heart. 

Blue Skin — Cyanosis is a morbid appearance which consists in the 
skin assuming a blue, purple or violet color, especially in those parts where 
the cutaneous capillary vessels are superficial, as on the cheeks and lips. 
It is generally accompanied by difficult respiration, palpitation of the heart 
with diminution of the natural temperature, an irregular or intermitting 
pulse, and is often attended with dropsical symptoms, the face especially, 
in addition to the purple color, being bloated and edematous; all these 
symptoms are much aggravated by any exertion. 

PERICARDITIS. 

Intensity of the Disease. — Its intensity varies considerably in different 
cases, being sometimes excruciating and sometimes slight or even wanting. 
32 



498 



DISEASES OF THE CIRCULATORY SYSTEM, 



THE HEART 



Figure No. i. 

i. External or muscular tunic of 
the upper right cavity of the 
heart (right auricle). 

2. External or muscular tunic of 

the left upper cavity (left 
auricle). 

3. External or muscular tunic of 

the right lower cavity (right 
ventricle). 

4. External or muscular tunic of 

the left lower cavity* (left 
ventricle). 

5. Upper cava vein, or conduit 

which carries the blood from 
the upper part of the body 
to the heart. 

6. Under cava vein, or conduit 

from the lower part of the 
body. 

7. Pulmonary artery. 

8. Aorta. 

9, 10. Coronary arteries. 

11. Division seat between the right 

and left ventricles. 

12. Series of vessels for feeding 

the external part of the 
heart. 

13. Position of the valves of the 

heart. 

Figure No. 2. 

1. Back part of the right auricle. 

2. Back part of the left auricle. 

3. Back part of the right ven- 

tricle. 

4. Back part of the left ventricle. 

5. Opening of the upper cava 

vein. 

6. Aorta. 

7. Pulmonary artery. 

8. Lower cava vein. 

9. Vessel for feeding the walls 

of the heart. 
10. The same. 



11. Position of the valves of the 
heart. 

Figure No. 3. 

h 2, 3, 4, 5> 6, 7, 8, 9, 10. Parts 
and vessels of the heart as 
demonstrated in Figures Nos. 
1 and 2. 

11. Windpipe (larynx). 

12. Cartilages and seat of the 
vocal cords. 

13, 14. The lungs in their upper part 

called the apex. 
15. Branches, in the lungs, of the 

greater blood-vessels. 
16, 16. Base of the lungs, showing 

the exterior surface. 

Figure No. 4. 

1. Cavity of the auricle. 

2. Cavity of the ventricle. 
3,3,3,3. Muscular tunics. 

4. Tricuspidal valve. 

5. Pulmonary artery., 

6,6,6. Inner tunic of the heart. 

7. Mitral valves. 

8. Auricular-ventricular opening. 

9. Dividing wall. 

10. Aorta. 

11. Cava vein. 

Figure No. 5. 

1,2,3. Pericardium. 

4. Muscles of the wall of the 

heart. 

5. Plaits of the lining of the 

heart. 

6. Tendon cords. 

7. Fleshy columns. 

8. Seat of the valves. 

9. Opening facing the auricle. 

10. Walls surrounding the mitral 

valve. 

11. Mitral valve. 

12. Semilunar valves. 




Fig, 1. — Front vertical view 
of the heart with its injected 
veins. 





Fig 2.— Back vertical vievr 
of the heart with its injected 
veins 



Fig. 3.— View of the bronchia and veins of the lungs, exposed by 
dissection, as well as the relative position of the lungs to the heart. 




Fig. 4.— Vertical view of the auricula- 
ventricular and arterial valves of the 
heart. 




Fig. 5.— Three-quarters view of the left 
ventricle after removing front walls. 



THE HEART. 

For an explanation of the illustrations see text on opposite page. 

499 



500 DISEASES OF THE jDIBCULATORY SYSTEM. 

There is also more or less tenderness on pressure over the region of the 
heart, and its action is notably increased. With these local symptoms are 
associated those pertaining to the system at large which accompany symp- 
tomatic fever. As the affection is almost always developed in connection 
with other diseases, the symptoms of the latter are of course combined with 
those of the former. 

Diagnosis. — The diagnosis or recognition of pericarditis has been ren- 
dered prompt and positive by means of auscultation and percussion. Soon 
after the attack the exudation of fibrine occasions a friction sound with the 
heart's movements, and this is proof of the existence of the disease. 
Afterward, when considerable liquid has been effused into the sac, the 
friction sound may cease, but it is practicable to determine the presence 
and the quantity of liquid within the sac by physical signs, which are 
obtained only by auscultation and percussion. The danger in cases of 
pericarditis depends, other things being equal, on the intensity of the 
inflammation, the quantity of exuded fibrine and the amount of effused 
fluid. Aside from these conditions, much depends on the diseases with 
which it is associated. 

Symptoms. — When developed in connection with rheumatism, it ends 
in recovery in the majority of cases; but occurring in connection with 
diseases of the kidneys, with pleurisy or pneumonia, and in cases of 
pyemia, it ends in death much oftener than in recovery. When death is 
not sudden, the disease destroys life by slow asthenia or exhaustion. 

As a rule from the outset we have acute inflammatory fever, a 
pungent, burning, lancinating pain in the region of the heart, shooting to 
the left scapula, shoulder, and upper arm, but rarely descending below 
the elbow, or even quite to it. The pain is increased by full inspiration, 
by stretching the left side, and especially by pressure between the pre- 
cardial ribs, and by forcing the epigastrium upward underneath the left 
hypochondrium. When the inflammation is only subacute the pain is 
more or less dull, and does not lancinate. There is inability of lying on 
the left side, and sometimes in any position but one, which is most com- 
monly on the back, dry cough, hurried respiration, palpitation of the 
heart, the impulse of which is sometimes violent, bounding and regular, 
though its beats may at the same time be unequal in strength, at other 
times it is feeble, fluttering and irregular, pulse always frequent, and gen- 
erally, at the outset, full, hard, jerking and often with a thrill. 

Causes. — The most frequent causes are blows or excessive pressure 
in the pericardial region, inflammation propagated from the lungs or 



PERICARDITIS. 501 

pleura, and far above all, rheumatism. From this cause children and 
young persons suffer much oftener than others. The remaining causes 
are those of inflammation in general, viz., cold, febrile excitement, and so 
forth. 

Treatment. — As regards treatment, acute pericarditis claims in gen- 
eral the measures indicated in other inflammatory affections. The anti- 
phlogistic treatment, in as energetic a form as circumstances will allow, 
should be employed with the utmost promptitude. The loss of a few hours 
at first may be irretrievable, and hence hesitation and indecision may seal 
the fate of the patient. These measures, however, are in many cases to 
be modified by the circumstances pertaining to the diseases with which 
this is associated. 

Strength of the Remedies. — The strength of the remedies employed 
must in each case be apportioned to the vigor of the patient's constitution j 
but the object is the same in all, expeditiously to prostrate the action of 
the heart, and for a time to keep it prostrate by preventing the re-estab- 
lishment of reaction. If this object can be accomplished for the first 
twenty, thirty or forty hours, the disease frequently does not rally, but 
remains perfectly under the control of remedies. 

Additional Treatment. — In addition to the above measures diluent 
cooling drinks — as four scruples of bitartrate, or two of nitrate of potassa 
in a quart of water, and flavored at pleasure — should be allowed in un- 
limited quantity, in order by diluting the blood to render it less stimulant 
to the heart. Nauseating doses of tartrate of antimony, as one-sixth to 
one-eighth of a grain every two hours, may be employed with advantage. 
Colchicum often proves useful, especially so when the disease is of rheu- 
matic origin. Calomel, trusted still by some and abused by others, may 
be confined to open asthenic cases in previously good constitutions. Where 
the rheumatic diathesis is marked, alkalies will be indicated. Carbonate 
or bicarbonate of potassium, or bicarbonate of sodium, may be given in 
scruple or half doses, with as much of rochelle salts, three or four times 
a day. 

Continued Treatment. — Should pain continue in the advanced stages 
of the disease, blisters may be resorted to, and repeated in quick succes- 
sion, with great advantage. For the stage of effusion we have occasion- 
ally found a third or a fourth necessary, combined with the use of diur- 
etics, as squills, juniper, sps. ether, nit., and so forth, varied and con- 
tinued until absorption occurs. Tonics will often promote the same end. 

Convalescence — An individual who has recently been affected with 
pericarditis is peculiarly liable to a recurrence of it, especially if it has 



502 



DISEASES OF THE CIRCULATORY SYSTEM. 



resulted from rheumatism, and if the reparation has been incomplete. 
In this case, should rheumatism return, it rarely fails to be accompanied 
with a renovation of the pericarditic symptoms. 

Diet. — A very spare unstimulating diet and extreme tranquillity must 
be imperatively enjoined until the action of the heart has become per- 
fectly and permanently natural. This should consist wholly of the weak- 
est slops, as barley, water gruel, weak tea, arrow root, and so forth. 

Chronic Pericarditis. — Chronic pericarditis may be a sequel of the 
acute affection, or the inflammation may be subacute from the first. In 
some cases the inflammation continues with an abundant exudation of 
lymph, agglutinating the in- 
ner surfaces of the sac, and 
proving fatal by slow ex- 
haustion. In other cases a 
large accumulation of liquid 
takes place, amounting to 
several pounds in weight, 
and to the exhaustion inci- 
dent to the persistance of 
the inflammation is added 
the compression of the heart 
thus occasioned. In both 
varieties of the disease, as 
a rule, proves fatal sooner 
or later. 

Treatment of Chronic 
Pericarditis. — A rapidly de- 
pressing case of pericard- 
itis, with cold, blue skin 
and feeble, irregular pulse, 
will require, instead of the 

above, a supporting or stim- Cavities of Right Side of Heart> with their Valves . 
ulating treatment from the 

first ; with dry cups and blisters instead of local or general bleeding ; and 
quinine, ammonia and whiskey, instead of sudorifics or laxatives. 




ENDOCARDITIS. 

Signs of the Disease. — Inflammation of the internal membrane of the 
heart. In this affection the inflamed membrane is in contact with the 



BNDOCAKDITIS. 503 

blood contained within the cavities of the heart ; hence, although fibrinous 
exudation takes place as in pericarditis, the exuded lymph is in a great 
measure washed away from the membrane and carried into the circula- 
tion. A portion, however;, adheres to the membrane, roughening the sur- 
face in contact with the blood, and giving rise to an abnormal sound (an 
endocardial or bellows murmur), which is an important physical sign of 
the disease. Moreover, upon the little masses of lymph which adhere to 
the membrane, coagulated fibrine from the blood contained in the cav- 
ities of the heart is apt to be deposited, and in this way are produced the 
so-called vegetations or warty growths, which being sometimes detached 
and carried into the arteries with the current of the blood, are arrested 
in vessels too small to allow of their further progress, become fixed and 
occasion an obstruction which may lead to hemorrhage (hemorrhagic in- 
farctions), and to the impairment of nutrition within a circumscribed 
area beyond the point at which the obstruction is seated. These movable 
plugs or emboli, as they are termed, play an important part in affections 
proceeding from disturbance of the circulation and nutrition in different 
organs of the body, more especially the brain. 

Local Effects. — The local effects of endocarditis are also of much im- 
portance as laying the foundation for progressive changes, especially in 
the valves of the heart, constituting what are called valvular lesions. 
The inflammation in endocarditis is generally limited to the left side of 
the heart; that is, to the endocardial membrane lining the left ventricle 
and the left auricle. 

Causes. — Like pericarditis, this is very rarely a primary disease, and 
in the great majority of cases it occurs in connection with acute articular 
rheumatism. It is evidently due to the same internal agency which in 
rheumatism causes the inflammation within the joints; this agent, being 
a morbid principle in the blood, is supposed to be lactic acid. 

Diagnosis. — Its development is attended with little or no pain or other 
subjective symptoms referable to the heart; the diagnosis rests wholly 
upon physical evidence attained by auscultation. The roughening of the 
endocardial membrane within the left ventricle causes, as already stated, 
an adventitious sound or murmur, and the production of this murmur, 
while a patient is under observation, constitutes the proof of the presence 
of the affection. 

Symptoms. — The symptoms produced are blueness and coldness of 
the skin, the result of the disease affecting the valves of the heart so as 
to render them more or less incompetent to perform their functions, and 



504 DISEASES OF THE CIRCULATORY SYSTEM. 



HUMAN INTERNAL ORGANS. 



THE LUNGS. 

Upper Left-Hand Plate. — This handsome plate shows, at the top, the windpipe 
(trachea) entering the lungs. It divides into two branches, one for each lung, and 
each branch subdivides, so as to carry air to every part of the lung. 

Lobes. — The plate shows the two great parts of the lungs, right and left lobes. 
These are filled with the air cells. Notice in the lobes the immense number of 
veins which form the circulatory system of the lungs. 

Heart. — The heart is seen in its true position, to the right of the centre. 

Pulmonary Vein. — To the left of the centre is seen the great pulmonary vein, 
carrying the lung-blood to the left auricle of the heart. 

Pleura. — The pleura membrane is seen surrounding the entire lungs and wall- 
ing them in. 

THE LIVER. 

Upper Right-Hand Plate. — The liver is the largest gland in the body. Situated 
on the right side, and partly covers the stomach. 

Lobes. — The plate shows its two lobes on upper surface and five on under 
surface. 

Vessels. — The entire circulatory system is shown — portal vein, hepatic artery, 
hepatic duct, lymphatic and smaller veins. To the left, in pear-shape, is the 
gall bladder. 

THE HEART. 

Lower Left-Hand Plate. — The plate shows the cone-shaped heart, situate in 
the chest, between the lungs, its apex toward the left. Though supplying blood to 
the whole body, it yet has its own circulation, as seen by its veins. 

Cavities. — It has four cavities, an auricle and ventricle on each side. The right 
auricle receives the venous blood and pumps it into the right ventricle. The right 
ventricle throws its blood into the left auricle. The left ventricle pumps it into 
the aorta and thence through the body. The upper section of the plate shows the 
aorta and the great pulmonary vein. 

THE STOMACH. 

Lower Right-Hand Plate.— -The plate shows the stomach when one is in a re- 
clining position. 

Veins. — The numerous veins show how well it is nourished. 

Liver. — To the left is the liver. Above it is the opening through which food 
passes from the gullet (oesophagus). At the opposite end is the pyloric gate, 
through which the partly digested food passes into the duodenum (twelve-inch 
bowel). 

Muscles. — Around the stomach, in brown and white, are "-seen the powerful 
abdominal muscles. The white represents streaks of fatty matter. The stomach 
is usually about twelve inches long and four inches in diameter. 




Lungs & Heart in Position 



SectionofLiver 




The Heart ShowingThe Great Arteris. The Stomach - front view figure, n Reclining Position. 

Human Interna/ organs. 



ENDOCARDITIS. 505 

diminishing the size of the mitral or aortic orifice so as to produce more or 
less obstruction to the passage of blood. Obstruction of the flow of blood 
through the orifices within the heart, and regurgitation, lead to enlarge- 
ment of the organ and to various morbid effects in other organs; indis- 
tinctness of the heart sound, feebleness and irregularity of the pulse, 
nausea and vomiting, anxiety of expression and fainting. 

Treatment. — In every case the important question is, less the state 
of the particular valves than the amount of interference with the func- 
tional action of the heart. In young persons remarkable recoveries some- 
times take place. In other instances, adaptation of the heart itself, and 
of the general system by degrees, is effected, so that quite good health, and 
even capacity for exercise, may be attained, while the physical signs of the 
local organic change remain. Sudden death is less common in heart dis- 
ease than is popularly supposed. 

The Circulation. — The circulation should be kept as tranquil as pos- 
sible by a quiet life and a moderate unstimulating diet. The food, how- 
ever, should be rather nutritious, comprising a little animal food or soup 
twice a day, in order to keep the muscular system in general, and that of 
the heart in particular, in tone. The same may be promoted by a clear, 
bracing, dry air. The general health and strength may likewise be im- 
proved by the occasional exhibition of bitters, mineral acid and chaly- 
beates, with aromatics. The stomach, in particular, should be kept in 
good order, as its derangements, even a little flatulence or acidity, have a 
surprising effect in disturbing the action of the heart. The same may be 
said of the biliary secretion, when there is an unequal distribution of 
venous power, indicated by hysterical symptoms, and so forth, antispas- 
modics will be found useful. 

Value of a Bath. — Attacks of dyspnoea are best relieved by immers- 
ing all the extremities in warm water, a blanket being thrown around the 
patient to promote perspiration, and fresh, cool air being admitted to 
satisfy the craving for breath. While this is being done he should take 
an antispasmodic draught, composed of either laudanum, camphor, am- 
monia, and asafetida, combined according to circumstances. It may be 
repeated two or three times, at intervals of from half an hour to an hour, 
according to circumstances. 

Diet. — For the avoidance of attacks the more important of the meas- 
ures of management relate to a proper regulation of the habits of life as 
regards diet, exercise and so forth. While excessive muscular exercise 
is to be avoided, such an amount as is taken, without discomfort, may be 



506 DISEASES OF THE CIRCULATORY SYSTEM. 

highly useful by improving the general condition of the system; while 
excesses in eating and drinking are hurtful, a deficient alimentation is not 
less so. In brief, the great end of treatment is to render the system 
tolerant of the lesions as much and as long as possible, and this end is 
promoted by such a course of management, hygienic and medicinal, as 
conduces to the general welfare of the economy 

ADDISON'S DISEASE. 

Nature. — Certain forms of general anemia which are neither attri- 
butable to excessive antecedent hemorrhages, nor to profuse or long con- 
tinued intestinal fluxes, and which cannot by symptoms be connected with 
any diathesic state or marsh miasmatic influences, forms of general 
anemia, in fact, which appear to supervene under the influence of non- 
recognizable causes, in which besides the debility and languor of the pa- 
tient, are characterized by a bronzed hue of the integuments, and which 
is most strikingly apparent on the skin of the hands, penis, groin, scrotum 
and axilla. 

It has been termed by Addison the bronzed disease. 

Symptoms. — The malady begins slowly, and its existence is not at 
first perceived. The patient has difficulty in fixing with precision the 
date at which he experienced its earliest symptoms. Its first manifesta- 
tions are general discomfort, an enfeebling of the physical and moral 
faculties, and a state of real languor. The arterial pulsations are small 
and feeble, the pulse full, soft and easily compressed. The appetite is 
capricious, the patient shoAving repugnance to animal food, or a dimin- 
ished appetite. At first digestion proceeds in a normal manner ; at a later 
stage this function is disturbed by intractable vomiting. This symptom 
is accompanied by pain, or at least by a painful sensation in the epigastric 
region. The patient wastes away, and yet the most minute examination 
fails to discover any sign of organic change sufficient to account for the 
great disturbance of health and extreme anemia which exist. Finally 
there is a state of extreme debility. 

Treatment. — In the treatment, having no specific remedy, we are 
obliged to direct our measures against the symptoms of anemia ; ferrugi- 
nous medicines, preparations of cinchona, and a tonic regimen are indi- 
cated. Decided advantage has followed the use of a combination of 
glycerine, in two-drachm doses, with fifteen or twenty minims each of 
chloroform and tincture of chloride of iron. 



GOITRE. 507 

OBSTRUCTION OR OCCLUSION OF THE ARTERIES 

EMBOLISM. 

Symptoms. — When the right half of the heart has received an em- 
bolus and the pulmonary artery is obstructed, collapse of the lungs, partial 
or entire, follows. Pleurisy, hemorrhage or bronchitis may also occur, 
or the symptoms may be great anxiety and dyspnoea, with reduction of 
the temperature of the body, a systolic murmur may be heard on ausculta- 
tion ; the rhythm of . the heart becomes irregular, and pulsation of the 
jugular veins may be noticed. Giddiness may be present, with blueness 
and edema of the hands, feet, or both. Where emboli have become 
broken up and decomposed, septicemia results, commonly known as 
pyemia. 

Treatment. — The objects we should have in view in the treatment of 
a vessel occluded by an embolus are, to favor the venous circulation 
through the limb by its elevation, and to establish the arterial collateral 
circulation by maintaining the warmth of the limb by means of cotton 
carefully wrapped round it over oil lint. Pain can be relieved by seda- 
tives, while the powers of the patient are to be maintained by nutritious 
diet, by stimulants carefully administered and by tonics. When gangrene 
has taken place the parts may be covered with some antiseptic material, 
as carbolic acid in a watery or oily solution, one part to thirty, or with 
powdered chloral. When the line of demarcation has formed and the 
gangrenous part can be removed by amputation, such an operation may be 
performed. 

GOITRE (GRAVE'S DISEASE). 

Goitre may be simple or exopthalmic. Simple goitre is a local affec- 
tion with only symptoms such as dyspnoea, or the cough as of a broken- 
winded horse and difficulty in breathing on slight exertion. Exopthalmic 
goitre is a disease of the nervous system characterized by protrusion of 
the eyeballs, enlargement of the thyroid gland and palpitation of the heart, 
a peculiar thrill in the blood-vessels and a general deterioration in muscular 
and brain power. The veins and arteries of the thyroid glands are en- 
larged. As a rule the development of the disease is gradual. The goitre is 
elastic and rather soft. The protrusion of the eyeballs follows the swelling 
of the gland. The disease is more common with women than with men. 



508 DISEASES OF THE CIRCULATORY SYSTEM. 

Recovery occurs in a fair number of cases, but the course is slow. Although 
occasionally sporadic, it is essentially an endemic disease in cold and damp 
countries, as in the deep valleys of the Alps, the Pyrenees, the North 
American Rockies, the Cordilleras of South America, and the chalky 
districts of Derbyshire, England. 

Treatment. — Simple goitres are to be treated on ordinary principles, 
viz., by attention to the general health, the inhalation of fresh air and by 
tonic medicines. Filtered or distilled water should always be taken, more 
particularly in districts where chalk, lime and magnesia abound. Iodine 
has always been held in high repute in this disease, in the form of com- 
pound solution of iodine, three drops in a glass of milk, three times 
a day. For some years we have employed tonics alone by the mouth, 
and have ordered the air in the room to be kept iodized by means of 
solid iodine put into a box With a perforated lid; the metal thus evapo- 
rates steadily into the room where the patient sits and sleeps, and in this 
way it becomes absorbed. 

ANEUBISM OR BLOODY TUMOR. 

Causes — A low form of inflammation of the arterial walls is with- 
out doubt the most common predisposing cause, while over-action of the 
heart and circulation is the exciting one. Direct injury to an artery 
(traumatic) is an occasional cause. 

Symptoms. — The early symptoms of aneurism are very uncertain. 
It often happens that the patient's attention is first directed to some swell- 
ing, although it may be only that of local throbbing, some weakness or 
stiffness of an extremity, or some nerve pain preceding the discovery of 
the disease; yet such symptoms are not constant. When, however, you 
are consulted for pain which shoots down the course of a nerve running 
in contact with a large artery, you should allow the thought of aneurismal 
pressure to pass through your mind, and, when this is associated with the 
presence of a tumor connected with the vessels, the suspicion of its being 
aneurismal should be excited. If this tumor be soft and pulsating, and 
becomes tense on the application of pressure to the trunk of the artery on 
the distal side, and placid, non-pulsatile and vanishing on pressure in the 
vessel below, the chances of its being aneurismal amount almost to a 
certainty. Should it expand again readily on the removal of pressure, 
this expansion is accompanied with a peculiar thrill on the readmission 



PHLEBITUS OK INFLAMMATION OF THE VEINS. 509 

of blood into the sac, with a bellows murmur or aneurismal bruit, synchro- 
nous with the pulse. 

Treatment. — The spontaneous cure of an aneurism is caused by the 
coagulation of the blood in the sac; how to induce this coagulation by 
natural processes is our aim ; therefore, it is necessary to have a feeble cir- 
culation through it ; for this purpose, rest in the recumbent position is an 
essential point of practice, and should be maintained in every case. When 
the force of the circulation is too strong and the powers of the patient are 
good, bleeding under this circumstances is not only rational but scien- 
tific. Medicines do not seem to have much influence in the coagulating 
process, though the acetate of lead has been found useful and iodide of 
potassium. The local treatment is based on similar principles, the aim 
being to diminish the circulation through the sac. This may be effected 
by the following means, viz., by compression in one of its forms of the 
artery above the aneurism, indirect; by compression of the aneurism 
itself, direct; by the Hirnterian operation, viz., the application of a liga- 
ture to the artery on its cardiac side ; by imitating the rare natural process 
of closure of the artery on its distal side by the application of a ligature, 
or by pressure, or by the artificial production of an embolic plug, by 
Fergusson's method of manipulation, and last of all it may be laid open 
and both ends tied. The treatment by electro-puncture, injection, and the 
introduction of some foreign body into the sac may be adopted in excep- 
tional cases. 

PHLEBITIS OK INFLAMMATION OF THE VEINS. 

Symptoms. — The most prominent symptom of an obstructed vein is 
edema of the parts below the obstruction, some fullness of the superficial 
veins, local pain and tenderness; constitutional disturbance of variable 
degrees of severity generally preceding. When superficial veins are in- 
volved the symptoms may be chiefly local, but in the case of deep veins 
constitutional disturbance is certain to accompany local action. Among 
the superficial veins the saphena of the leg and thigh is most commonly 
affected, and is often a sequelae of a varicose condition. Under these cir- 
cumstances the tortuous, dilated, indurated vein becomes a marked object, 
set as it were in a frame of hardened inflamed skin and a cellular tissue. 

Treatment. — The two great indications for treatment in these cases 
are to favor venous circulation of the part, and to improve the general 
condition of the patient. 



510 



DISEASES OE THE CIRCULATORY SYSTEM. 



THE ARTERIES 



Figure No. i. — Arteries of the palm 
of the hand and front of forearm. 

3. Deep part of the raised pronator 

of the radius. 

4. Long supinator muscle. 

5. Long flexor of the thumb. 

6. Square pronator. 

7. Deep flexor of the fingers. 

8. Cubital flexor of the wrist. 

9. Annular ligament, with the ten- 

dons that pass under the centre 
of the palm of the hand ; the 
member is on the tendon of the 
long palmary muscle divided 
near its insertion. 
10. The brachial artery. 

12. Radial artery. 

13. Recurring radial artery joining 

the end of the upper deep one. 

14. Superficial veins. 

15. Cubital artery. 

16. Superficial palmary arch from 

which spring digital branches to 
three and one-half fingers. 

17. Magna artery of the thumb and 

radial artery of the index. 

18. Back cubital recurring artery. 

19. Front interosseous artery. 

20. Back interosseous artery passing 

through the interosseous mem- 
brane. 

Figure No. 2. 

1. Primitive carotid artery dividing 
itself into carotid external and 
carotid internal. 

3. Occipital branch to the back part 

of the skull. 

4. Upper hyoides artery. 

5. Lower pharyngeal artery. 

6. Masseter artery. 

7. Submental artery. 

8. Lower coronary artery. 

9. Upper coronary artery. 

10. Deep branch. 

11. Back cervical artery. 

12. Continuation and fold of the oc- 

cipital. 

13. Descending branch for muscles 

of the neck. 

14. Posterior auricular. 

15. 15. Temporal artery. 

16. Parietal branches. 



17. Frontal branches. 

19. Orbitary branches. 

20. Subclavian artery. 

Figure No. 3. 

Thoracic aorta. 

The three branches from left to right 
are the unnamed ones. 

The primitive left carotid and the sub- 
clavian left one. 

The small branch in the curve is the 
bronchial one. 

Figure No. 4. 

1. The liver. 

2. The stomach. 

3. Upper gut. 

4. Pancreas. 

6. Great mesenteric artery. 

7. Gastric branch. 

8. Spleen. 

9. Pyloric branch. 

10. Pancreatic branch. 

11. Hepatic artery. 

12. Duodenal branch. 

13. Cystic artery. 

14. Branches to the stomach. 
15, 16. Spleenic arteries. 

17. Gastro-epiploic artery. 

18. Descending aorta. 

19. Great mesenteric artery. 

Figure Np. 5. 

1. Cheek arteries. 

2. Coeliac axis. 

3. Gastric artery. 

4. Hepatic artery dividing itself into 

right and left branches. 

5. Spleenic artery. 

6. Supra-renal artery on right side. 

7. Right renal artery, which is 

longer than the left. 

8. Lumbar arteries. 

9. Upper mesenteric artery. 

10. The two spermatic arteries. 

11. The lower mesenteric. 

12. The middle sacras. 

13. The common iliac. 

14. Internal iliac of the right side. 

15. External iliac. 

16. Epigastric artery. 

17. Circumflex iliac artery. 

18. Femoral artery. 




THE ARTERIES. Figure No. 5. 

IwE explanation of the illustration, see text on opposite page. 

511 



512 DISEASES OF THE CIECULATORY SYSTEM. 

The first is attained by elevation of the limb, the foot being raised 
higher than the hip, and by the application of warmth. The second can 
be carried out by the administration of a simple nutritious diet, tonics, 
such as quinine, bark or iron, and stimulants carefully adjusted to the 
wants of the individual case. 

Pain must be allayed by both local and general means, as poppy 
fomentations, and the internal use of sedatives. Leeching should never 
be resorted to, nor the use of mercury. When suppuration appears it 
must be dealt with on ordinary principles, but it is well, as a rule, to 
evacuate it as soon as it has declared itself. 

INFLAMMATION OF THE LYMPHATIC VESSELS AND GLANDS. 

Symptoms. — 1. The absorbent glands with their ducts are liable to in- 
flammation, adenitis or angeioleucitis, and this action is the result of the 
absorption of some septic material. It is almost always associated with a 
wound, punctured or open-inflamed suppurating, healing ; with some point 
of irritation or suppuration, even a papule or pustule; with some centre 
from which morbific elements may be taken up. In what is called a 
simple wound the inflammation of the absorbents may be acute, but in 
poisoned it is violent and diffused. The inflammation always follows the 
course of the absorbents, leading from the centre of absorption toward 
the glands; that is, toward the body, and it never spreads backward. 
When it has reached the glands, the diseased action ceases to spread, that 
is, it expends its force upon the group of glands in which the absorbents 
naturally end, and does not extend through another series of absorbents 
to a second group. When pyemia follows or complicates the case, it may 
be open to question whether the poisonous fluid circulating in the lym- 
phatics has not been allowed to pass into the blood through its usual chan- 
nels, viz., through the inflamed glands onward, and set up inflammation 
in the tubes and glands, was taken directly into the blood through the 
venous channels, thus giving rise to blood-poisoning. 

2. Pain and tenderness in some of the glands are generally early 
symptoms, and with these, or some following them, will be seen a band 
of redness varying in diameter, leading from the wound or infecting 
centre toward the gland. This red line may be continuous or interrupted ; 
it may be a thin streak or a broad stripe of redness, and in some instances 
so radiate into the surrounding tissues as to simulate erysipelas. The 
whole line of redness is very painful, and with these local symptoms there 



DISEASES OF TTTE SPLEEN. 513 

will also be some febrile disturbance. The red lines follow the course of 
the absorbents and not of the veins. 

Treatment. — When any indications of absorbent inflammation show 
themselves the wound or sore should be well cleansed and any collection 
of pus let out. The effected limb should be raised, the foot, when in- 
volved, brought higher than the hip ; the hand or elbow than the shoulder, 
and warm poppy fomentations should be applied along the whole course 
of the lymphatics up to the group of glands in which they terminate. As 
soon as suppuration appears the abscess must be opened, whether this 
follows directly upon the inflammation or subsequently. A saline purge 
should be administered ; sedatives should be given to allay pain. When 
suppuration has taken place tonics may be administered. In chronic 
cases, where induration in the track of the ducts remains, mercurial oint- 
ment and friction are sometimes valuable. 

DISEASES OF THE DUCTLESS GLANDS. 

The glands without any outlet ' in the body are three in number, 
namely : the thyroid, situated in the front of the neck ; the spleen, located 
in the left side below the heart, and the supra-renal capsules, which are 
placed one over each kidney, deep in the loins on either side of the spinal 
column. Although the functions of these organs are still undetermined, 
many of their diseases are well known. 

DISEASES OF THE SPLEEN (SPLENITIS). 

Symptoms — Diseases of the spleen may be acute or chronic. The 
acute symptoms are a sensation of cold and partial rigor, a feeling of 
weight, fullness and pain in the left side extending to the left shoulder, 
increased on pressure and coughing; thirst; some degree of nausea; dry 
cough with the usual symptoms of pyrexia. Wandering pains in the 
limbs, sometimes ending in collections of pus under the integuments of 
the thigh, arm, and so forth, are not uncommon in chronic splenitis. In 
the latter periods of the disease the debility and emaciation become very 
great; the complexion darkens and the appetite fails. Hectic, more or 
less violent, comes on with diarrhoea or vomiting of unconquerable per- 
tinacity and blood is frequently discharged both upward and downward. 

There is a simple enlargement of the spleen from mere temporary 
congestion, as when brought on by sudden mental emotion or by oscilla- 
tions of the circulation from internal causes. In temperate climates the 
33 



514 DISEASES OF THE CIRCULATORY SYSTEM. 

more permanent enlargement or hypertrophy of this organ, not being 
accompanied by the same violence of constitutional disease as in the latter, 
is usually of a passive character and is owing to relaxation of fibre. The 
most frequent causes of enlarged spleen are ague (ague cake) and remit- 
tent fever. The most characteristic symptoms are a sense of weight in the 
left side with or without evident swelling ; inability to lie on the right side 
with ease; debility; disordered stomach; dry cough and absence of fever. 

Treatment. — -The indications of treatment are: first, to remove the 
cause ; secondly, to restore the organ to its natural condition ; and thirdly, 
to improve the general health. If ague be the exciting cause it must be 
combated by appropriate remedies, warm and brisk purgatives should be 
given once or twice a week so as to affect the upper bowels. Mercurials 
should be omitted. The bowels being kept more open than ordinary, the 
nascent irritative stage having gone by and the case being strictly pas- 
sive, tonics are to be had recourse to and especially the acids with prepara- 
tions of iron. 

leucocythemia. — Leucocythemia or white-cell blood is a disease of 
the circulating fluid often associated with enlargement of the spleen and 
supposed to be caused in part by the morbid condition of that organ. The 
great characteristic of this malady, as its name indicates, is the pre- 
ponderance of white corpuscles in the blood. 

Symptoms. — The general or constitutional symptoms are a slowly pro- 
gressive anemia, weakness and emaciation, with incapacity for exertion, 
shortness of breath and digestive derangements. The bodily temperature 
is often somewhat raised and sometimes persistently elevated. The urine 
may be normal in appearance but less urea appears to be secreted in it. 
In the later stages there is a tendency to dropsy and to hemorrhage from 
various surfaces, especially the mucous membranes. The only certain 
mode of determining this remarkable disease is by a microscopic examina- 
tion of the blood. 

Treatment — No specific for leucocythemia has yet been discovered. 
The constitution requires generous support, if not stimulation. Tincture 
of the chloride of iron in doses of ten or fifteen drops three times a day 
sometimes acts admirably. 

DILATATION OF THE HEART. 

Symptoms — Dilatation of the heart is indicated, upon physical ex- 
ploration, when, with extended impulse of the heart we have dullness on 



"enlargement of the heart. 515 

percussion beyond the usual limits. If true hypertrophy or muscular 
thickening he present the impulse is very forcible as well as extended. 
The heart-sounds are apt to be clear, though not loud, in attenuated dila- 
tation; rather loud, but dull-toned, in enlargement with thickening. It 
is most often induced by valvular obstruction or regurgitation, com- 
pelling unusual and continued efforts to sustain this circulation. Some- 
times, however, it is more truly idiopathic, following causes of over- 
action of a heart otherwise sound, thus, violent exercise, self -abuse, coffee, 
tobacco, alcohol, and so forth, are, with good reason in predisposed cases, 
accused of producing it. 

Treatment. — In the treatment avoidance of such exciting causes and 
particularly of violent exercise, alcohol and venery, is the main principle. 
Robust or plethoric patients may bear and be benefited by occasional leech- 
ing or cupping over the heart. Acetate of lead as an astringent cardiac 
sedative has proved useful in the dose of one grain thrice daily, with care 
to avoid saturnine poisoning. Digitalis here acts as a tonic to the heart, 
through ganglionic influences, lessening rapidity of action when that de- 
pends on debility, and veratrum viride as a sedative and palliative in 
violent acceleration of the pulse, as in muscular hypertrophy and in some 
forms of palpitation. 

ENLARGEMENT OF THE HEART. 

Symptoms. — Enlargement of the heart and its extent are easily deter- 
mined by means of physical signs, palpation and percussion. By the touch 
it is found that apex beat is more or less lowered and carried to the 
left of its normal situation. Between the apex and the base of the organ 
are found impulses not perceptible in health. By percussion the bound- 
aries of the organ are readily ascertained in the great majority of cases. 
The vocal resonance also, as heard with the stethoscope, enables the physi- 
cian to define the limits to which the organ extends. Palpitation and aus- 
cultation furnish signs by which predominant hypertrophy may be differ- 
entiated from dilatation. If hypertrophy predominates the impulses of 
the heart as felt by the hand are strong, and often there is a heaving move- 
ment extending over the region of the heart. The first sound of the heart, 
over the apex, is abnormally loud, long and booming. On the other hand, 
if dilatation be considerable or great, weakness of the organ is denoted by 
feeble impulses and by diminished intensity, together with shortness and 



510 



DISEASES OF THE CIRCULATORY SYSTEM. 



a valvular quantity of the first sound of the heart in the situation of the 

apex. 

Treatment. — In addition to purgatives we have seen the most decided 
advantage result from diuretics, and not only when there was dropsy, but 
equally when there was none. Their mode of operation appears to be 
ultimately the same as that of purgatives, viz., they drain off the serous 
portion of the blood. We have found many patients, conscious of the 
benefit which they derived from this class of remedies, to be in the con- 
stant habit of taking cream 
a* of tartar, brown tea and other 

similar popular medicines. 
One patient, affected with 
contraction of the mitral 
valve to the size of an ordin- 
ary pea, by these means 
warded off dropsy beyond the 
slightest 'edema of the feet 
for ten years. When decided 
dropsy appears it must be 
combated by the most efficient 
diuretics, the acetate, or tar- 
trate and nitrate of potash, 
squill, digitalis, spirits of 
nitre, ether, and so forth, as 
no class of remedies is more variable and uncertain than this. When one 
fails another should be resorted to. 

Diet — The treatment consists of a highly nutritious diet, into which 
fatty articles should enter sparingly, together with the employment of 
hygienic measures and remedies designed to give tone to and to invigorate 
the heart. 

CHRONIC VALVULAR DISEASE. 

Diagnosis. — The diagnosis of valvular disease has been rendered very 
complete by means of auscultation. With very rare exceptions it gives 
rise to adventitious sounds or murmurs, the characters of which, as re- 
gards their situation, their transmission in different directions, and their 
relations to the heart sounds, enable the physician not only to determine 
their existence but to localize them and to distinguish between those which 
involve obstruction and regurgitation. When valvular disease has ad- 




Bird's-Eye View of the Valves of the Heart. 



CHRONIC VALVULAR DISEASE. 517 

vftnced sufficiently to produce obvious symptoms referable to either ob- 
struction or regurgitation, or to both, they will destroy life sooner or later. 

Whether the disease of the valves be cartilaginous, osseous, or con- 
sist of vegetations, the general symptoms are the same if the degree of 
contraction be equal. The general symptoms are cough, copious watery 
expectoration, dyspnoea, orthopnoea, frightful dreams- and starting from 
sleep. Edema of the lungs, pulmonary apoplexy, passive hemoptysis 
(sputa stained with dark or grumous blood), turgescence of the jugular 
veins, lividity of the face, anasarca, injection of almost all the mucous 
membranes, passive hemorrhages, especially of the mucous membranes, 
engorgement of the liver spleen, and so forth, and congestion of the brain 
with symptoms of oppression, sometimes amounting to apoplexy. 

The preceding illustration represents a hardened section of the 
heart, cut transversely across the organ so as to show how the pocket-li^e 
valves come together in the middle of the openings in order to close those 
orifices. At LAV are seen the two flaps of the mitral valve, which shuts 
off the return current of the blood as it is being driven by the strong 
left ventricle into the aorta, and at Ao are depicted the three flaps of the 
aortic valve, which is closed by the return current of the blood from the 
great aorta after it is pumped into that large blood-vessel by the ventric- 
ular contraction. It is plain to be seen that if the edges of these valves 
are rough or ragged or perforated, they cannot shut tightly and will allow 
some leakage to occur. 

Symptoms — When the disease is combined with hypertrophy or dila- 
tation, as is commonly the case, the symptoms are more severe than those 
of hypertrophy or of dilatation alone, the paroxysms of palpitation and 
dyspnoea in particular being more violent, more obstinate and more easily 
excited. The action of the heart is irregular. The pulse is small, weak, 
intermittent, irregular and unequal. 

Treatment — Since we can neither replace or repair the damaged 
valves of the heart, the principles of treatment for chronic valvular 
disease are, in general terms, such as diminish the force and activity of the 
circulation, occasional venesection to a moderate extent, an unstimulatiug 
and rather spare, though sufficiently nutritious diet, a tranquil life, with 
respect both to the body and the mind, and a good state of the digestive 
organs and alimentary canal. 

When there is dropsy diuretics are of the greatest utility. They are 
remarkably beneficial in an anterior stage of the disease ; for, by drawing 
off the serous portion of the blood, they diminish the quantity without 



518 diseases of the circulatory system. 

deteriorating the quality of the fluid, and thus relieve palpitation and 
dyspnoea and obviate infiltration, without materially reducing the patient, 
When diuretics do not remove dropsy and purgatives have failed, the 
practitioner is compelled to resort to puncturing. We say compelled, be- 
cause the remedy is a last and dangerous resource. The danger, however, 
may be considerably diminished by making small punctures with a grooved 
needle, and allowing the fluid to ooze slowly during four or ^ve days or a 
week. When incisions are made with a scalpel or lance, the fluid is 
evacuated quickly, as in twelve or forty hours, and the patient, according 
to our observation, generally dies. 

PAINTING OR SYNCOPE. 

Complete and, commonly, sudden loss of sensation and motion with 
considerable diminution or entire suspension of the pulsations of the heart 
and respiratory movements. 

Symptoms. — It is to be distinguished from an epileptic or apoplectic 
fit by the fuller and apparent failure of the pulse and respiration, as well 
as by the previous history, if that can be obtained from friends or by- 
standers. 

Treatment. — Syncope is, commonly, an affection of no eonsequence, 
but sometimes it is an index of diseased heart. Generally recovery from 
a swoon is rapid if the patient is laid flat upon the ground, without any 
pillow, the clothing loosened from the neck and a little cold water 
sprinkled in the face and the application of volatile substances to the 
nostrils are all that will be required during the fit. If recovery is delayed 
a turpentine injection or one containing a little whiskey and water should 
be administered, and the electro-magnetic current may be transmitted 
through the walls of the chest to stimulate the failing powers of the lungs 
and heart. 

PALPITATION. 

Symptoms — All excessive or consciously disturbed action of the heart 
is commonly thus designated. Over-action in particular may have either 
one of the following origins: Nervous or hysterical, dyspeptic, rheumatic 
or gouty, hypertrophic. 

All of the above forms of merely functional disturbance of the heart, 
and especially the purely nervous, may be known from hypertrophic over- 
action, or the conscious impulse of dilatation of the heart, by the fact 



ANGINA PECTORIS OR HEART PANG, 519 

that they are not increased by moderate exercise ; are often, indeed, much 
diminished thereby. 

Treatment. — The treatment must vary according to its cause. If 
nervous, invigoration of the system and enrichment of the blood are most 
probably required, by iron and other tonics and regimen. Dyspepsia will 
require appropriate treatment ; as a part of which exercise in the open air 
will not be counter-indicated at all by sympathetic palpitation. 

ANGINA PECTORIS OR HEART PANG. 

Symptoms. — It is a disease of an intermitting character in which the 
patient has intervals of comparative ease or perfect health between par- 
oxysms of greater or less suffering. It is characterized by sudden attacks 
of severe pain, extending from the heart along the left arm, with a sense 
of stricture in the chest, prostration and alarm. The pain is rarely con- 
fined to its primary and principal site in the cardiac region, but increases, 
in different instances, very variously both in direction and extent. It 
shoots upward or downward or to the right side and almost always through 
the left side of the chest toward the shoulder and axilla and very fre- 
quently into the left arm. 

Treatment — The violence of the patient's sufferings and the belief 
in the nervous or spasmodic nature of the pain, suggested by its sudden 
invasion, would naturally lead the medical attendant, in the first place, to 
attempt to afford relief by anodynes ; such attempts, however, have gener- 
ally been attended with less success than might have been expected. In 
angina, as in toothache or tic douleureux, gastralgia, colic, or other violent 
pains, nature seems as if she scorned to be controlled by art, although so 
much under the influence of similar applications when less needed, as in 
the case of milder pains. Antispasmodics, cordials, carminatives, and so 
forth, have been much recommended and employed ; and, upon the whole, 
with better success than anodynes. The inhalation of one or two drops of 
nitrate of amyl sometimes relaxes the spasm and affords prompt relief. 
Small doses of nitro-glycerine and hypodermic injections of from one- 
eighth to one-half grain of morphia also partly relieve the pain after a 
little longer delay. But although these or other means may afford relief, 
or may even ward off death, it is evident that every kind of treatment 
confined to the paroxysm is of very slight importance. Compared with 
that which is to be employed in the interval, the former can, at most, 
afford temporary relief; the latter may cure the disease. 



520 DISEASES OF THE CIRCULATORY SYSTEM. 



HEART ASTHMA. 

Symptoms. — Asthma from disease of the heart often imitates the 
characters of the other varieties, and this perhaps for a very simple reason ; 
that the lungs are in much the same state as in those varieties. Thus the 
asthma is humid or humeral when there is permanent engorgement of 
the lungs, causing copious sero-mucous effusion into the air passages, as 
in cases of contraction of the mitral valve. It is dry when the engorge- 
ment is only transitory, as in cases of pure hypertrophy. It is continued 
when there is a permanent obstruction to the circulation, and may be con- 
vulsive when the heart has sufficient power to palpitate violently. 

Treatment. — Numberless remedies have been tried; among them 
stramonium, nitrate of amyl, chloroform inhalations, and so forth. 
Arsenic enjoys full favor and deservedly holds an important rank as a 
therapeutic agent. 

DISEASES OF THE ARTERIES. 

The larger blood-vessels, both arteries and veins, are liable, like the 
heart itself, to various structural changes in disease, which, of course, lead 
to more or less serious disturbances in the circulation of the blood. 

Symptoms — Arteritis or inflammation of the substance of a blood- 
vessel, commonly commencing with the inner coat of the artery and ex- 
tending through the whole structure of the wall of the tube, is a rare af- 
fection and scarcely ever detected before death. 

Fatty and calcareous degenerations of the arteries are much more 
common, and consist in the deposit of fatty or chalky material in the 
arterial walls, generally in patches varying in size from a mere speck to 
an inch or more in diameter. This condition is commonly spoken of as 
a hardening of the arteries. 

Treatment. — These diseases do not occur until after middle life, and 
no satisfactory treatment has been found. 



PART VI OF BOOK IV 

Treats of the diseases of the respiratory system, their 
causes, symptoms and treatments. 



Acute Bronchitis 533 

Acute Larjmgitis 526 

Symptoms of 526 

Treatment of 526 

Acute Phthisis .543 

Symptoms of 543 

Treatment of 544 

Aphonia 5 2 9 

Treatment of 529 

Asthma 5 2 3 

Causes of 523 

Hay 525 

Symptoms of .523 

Treatment of 524 

Bends, The 551 

Bronchial Catarrh 530 

Bronchitis 532 

Acute 533 

Capillary 532 

Chronic 533 

Diet in 533 

Simple 532 

Treatment of 53 3 

Capillary Bronchitis 532 

Symptoms of 532 

Catarrh, Bronchial 530 

Caisson 551 

Cause of 551 

Symptoms of 552 

Treatment of 552 

Catarrhal Laryngitis 526 

Catarrh, Nasal 525 

Chronic Bronchitis 533 

Causes of 533 

Treatment of 534 

Chronic Laryngitis 526 

Symptoms of 527 

Treatment of 528 

Chronic Pulmonary Consumption . .544 

Symptoms of 544 

Treatment of 546 



Cold in the Head 525 

Compressed Air Disease 551 

Consumption 543 

Causes of 543 

Chronic Pulmonary 544 

Galloping 543 

Hoff Prescription for 547 

Coryza 525 

Cough 530 

Causes of 530 

Symptoms of 530 

Treatment of 530 

Croup 528 

Cold, Rose 525 

Diseases of the Respiratory System. 523 

Distension of the Lungs 537 

Dropsical Laryngitis 526 

Emphysema 537, 550 

Causes of 537 

Symptoms of , 53 7 

Treatment of 538 

Fever, Hay ; 525 

Galloping Consumption 543 

Hay Asthma 525 

Hay Fever 525 

Causes of 525 

Symptoms of 525 

Treatment of 525 

Hoff Prescription for Consumption. .547 

Hydrothorax 550 

Inflammation of the Larynx 526 

of the Lungs 534 

Laryngitis 526 

Acute 526 

Catarrhal 526 

Chronic 526 

Dropsical 526 

Laryngoscope. The 528 

Larynx, Th e 529 

Inflammation of 526 

Loss of Voice 520 



521 



522 



INDEX TO PART VI OF BOOK IV. 



Lung Distension 537 

Lungs, Inflammation of 534 

Nasal Catarrh 5^5 

Causes of 5 2 5 

Symptoms of 525 

Treatment of 525 

Outdoor Sleeping in Tuberculosis. .541 

Paralysis of the Vocal Chords 528 

Phthisis, Acute 543 

Pulmonary 543 

Pleurisy 548 

Causes of 548 

Diet in 550 

Symptoms of 548 

Treatment of 549 

Pneumonia 534 

Causes of 534 

Diet in 537 

Symptoms of 534 

Treatment of 536 

Pneumothorax 550 

Pulmonary Phthisis 543 

Respiratory System, Diseases of... 523 



Rose Cold 525 

Simple Bronchitis 532 

Symptoms of 532 

Throat Ulcers : 528 

Treatment of 528 

Tuberculosis 538 

Cause of 539 

Outdoor Sleeping in 541 

Symptoms of 539 

Treatment of 539 

Tumors in Vocal Cords 528 

Ulcers, Throat 528 

Vocal Cords 528 

Paralysis of 528 

Tumors in 528 

Voice, Loss of 529 

Illustrations — Book iv — Part vi — 

Lungs and their Diseases, The 535 

Muscles of the Larynx 529 

Positions of the Vocal Cords 528 

Vocal Apparatus 527 

Vocal Cords, Positions of 528 



CURATIVE MEDICINE 



PART VI 
DISEASES OF THE RESPIRATORY SYSTEM 

ASTHMA. 

Causes. — An exciting cause may be an impurity of the blood. More 
commonly it arises from indigestion, bronchitis or valvular disease of the 
heart. Hay asthma is caused by the inhalation of particles such as arise 
from dried hay. The pollen from flowers and also from dogs, cats and 
other animals frequently give rise to it. 

Symptoms. — This disease comes on in paroxysms. The paroxysm may 
be preceded for a variable time by a sense of oppression and constriction 
about the chest, with wheezing respiration. In many instances, however, 
it develops without any warning and most commonly at night. The pa- 
tient awakes suddenly, scarcely able to breathe, and is forced to assume 
the sitting jDosture, or even to stand erect, with the shoulders raised and 
fixed, the head thrown back, the mouth open and all the extraordinary 
muscles of respiration brought into play to assist those powers of the 
system which are usually sufficient for the purpose. The face, in severe 
cases, wears an aspect of terror, the eyes are widely opened, the skin is 
pale and dusky and often bedewed with sweat. The feet and hands are 
cold and the pulse small and quick. The breathing, however, is not hur- 
ried, but inspiration is short and jerky and expiration inordinately pro- 
longed. On percussion, the resonance of the chest is found to be increased 
and auscultation shows the vesicular breath-sounds are weak or suppressed 
and attended with whistling or cooing noises called rales. Toward the 
end of an attack, which may last for several weeks, cough comes on witli 
the expectoration of small, firm, solid pellets of mucus, in rare cases mixed 
with blood. The duration varies greatly, the paroxysm passing off in a 
few minutes or lasting for many days. When it continues long, or is left 

(523) 

i 
I 



524 DISEASES OF THE RESPIRATORY SYSTEM. 

to itself, it is apt to subside gradually ; but if brief or cut short by treat- 
ment, it often ends abruptly. 

Diagnosis. — The diagnosis rests upon the paroxysmal and usually 
sudden nature of the onset, the absence of moist rales as determined by 
auscultation, and the complete recovery of patients in the intervals of their 
attacks. The cooing and whistling sounds heard all over the chest show 
the absence of any serious obstruction in the larynx and trachea, and the 
muscular effort being made for the purpose of inflating the lungs chiefly 
in asthma, from heart disease, instead of also in expiration as in the 
spasmodic form, which we are now considering, is another indication of 
value. 

Treatment — 1. Among the most certain treatments are the inhalation 
of chloroform or ether and the hypodermic injection of an eighth or a 
quarter of a grain of morphia, either of which, in a majority of instances, 
may be depended on to relax the spasm and afford prompt relief. 

2. Some of the most reliable internal remedies are chloral in fifteen- 
grain doses, which should be employed with great caution, or not at all 
if the heart is organically affected; ten or fifteen drops of tincture of 
lobelia or of ipecacuanha, as a nauseant or emetic, belladonna, valerian 
and strong black coffee. 

3. The inhalation of the vapor of stramonium leaves, produced either 
by burning them on a red-hot shovel or smoking them in a pipe, and of 
the smoke of soft bibulous paper which has been soaked in strong salt- 
petre water and then dried, often affords relief, and, perhaps, as often 
fails in its desired object. 

4. The treatment during the interval between the paroxysms must be 
directed toward building up the general health and fortifying the nervous 
system against the exciting causes of the disease. In some instances the 
action of small doses of lobelia is highly beneficial, and in others, patients 
who have been for years great sufferers from asthma enjoy a complete 
immunity from the malady as long as they keep themselves under the 
influence of iodide of potassium by taking from five to ten grains of it 
three times daily. 

5. If medicinal treatment for the prevention of asthma proves unsuc- 
cessful, a change of climate and particularly a sea voyage should be under- 
taken, and it is claimed by some physicians in Colorado that the air of that 
region is almost a specific against asthmatic complaints. 



^OSE CATARRH. 525 



HAY FEVER. 



Symptoms. — Hay asthma or rose cold, commonly called hay fever, is 
a very prevalent form of asthma which comes on with symptoms of 
ordinary but severe cold in the head, constant sneezing, great discharge 
from the nose and in many cases intense difficulty of breathing. Many 
sufferers from this curious malady are perfectly well until a certain day 
in one of the months of June, July or August of every year, when they 
wake up in the morning, perhaps, with the symptoms above described. 

Causes — As already remarked, this form seems to be due to the 
inhalation of pollen from certain grasses or flowers, but when once com- 
menced it may continue for several days, or even weeks, after its sup- 
posed cause has been removed. 

Treatment. — The inhalation of sulphate of quinine in powder has 
been highly recommended in this affection, but the air (and other attrac- 
tions) of various watering places seems to be the most popular and satis- 
factory remedy. The White Mountains or certain seaside resorts are 
looked upon by some patients as absolutely necessary for their health and 
comfort during an attack of this complaint. Adrenalin used in an atom- 
izer three to six times a day will afford great relief. 

Various Forms of Asthma. — Under the title of industrial asthma have 
been grouped several kinds of pulmonary disease, incident to different 
trades and occupations. These include saw-grinder's asthma, miner's 
asthma, potter's asthma and miller's asthma, caused by the mechanical 
irritation of minute particles of dust in the respired air. 

NOSE CATARRH. 

Symptoms — This disease, so well known to every one as a common 
"cold in the head," is often epidemic, and is characterized at first by 
chilliness with sneezing and later by an abundant discharge of fluid from 
the nose. When severe it is attended with slight fever, pain and sense of 
weight in the head, pain in the limbs, prostration of strength, irritability 
of temper and inactivity of mind. 

Causes. — Its origin can generally be traced to some imprudent viola- 
tion of the laws of hygiene, such as exposure to draughts, insufficient 
clothing, sudden cooling when heated, and so forth. 

Treatment. — The number and diversity of the infallible remedies for 
a common cold is sufficient evidence of their generally unsatisfactory 



526 DISEASES OF THE RESPIRATORY SYSTEM. 

nature, but as the natural duration of the disase is from three to five 
days, the third or fourth medicine which receives twenty-four hours' trial 
often gains the credit of accomplishing a cure. If, as is usually the case, 
the bowels are constipated, a saline purgative, such as a Seidlitz powder 
or a bottle of citrate of magnesia, will usually relieve the headache, and 
then light diet, abstinence from fluids for a -day and ten grains of Dover's 
powder at bed-time often seem to hasten the departure of this unwelcome 
guest. 

LARYNGITIS OR INFLAMMATION OF THE LARYNX. 

Three Forms. — This disease, which is one of the accompaniments of a 
common cold whenever hoarseness of the voice comes on, presents itself 
under three forms: First, the acute or edematous; second, the subacute 
or catarrhal, and third, chronic laryngitis. The first of these varieties 
may, if not properly treated, prove quickly fatal, by closing up the 
avenue of entrance for the air to the lungs and thus causing death by 
suffocation. 

Symptoms of Acute Form. — Acute or dropsical laryngitis may com- 
mence as a slight catarrh, quickly followed by high fever. Speech, cough 
and respiration are all soon modified. The voice at first metallic, soon 
becomes whispering. The cough primarily clear and shrill, then harsh 
and croupy, is also reduced to little more than a whisper, and a peculiar 
noise like a loud whisper accompanies both inspiration and expiration, 
which are, from the beginning almost, laborious and wheezing. As soon 
as the dropsical swelling comes on and still further narrows the opening 
of the glottis, the effort to breathe becomes exceedingly painful and 
difficult and the patient's countenance expresses great anxiety. 

Treatment — 1. Since acute laryngitis in the adult may destroy life in 
a few days, or even hours, it should be treated actively from the first onset 
by bleeding, if the patient is robust, or by leeching, active purgation with 
five- or ten-grain doses of calomel and jalap and calomel in grain doses 
every two hours to the extent of producing slight salivation as rapidly as 
possible. 

2. If the inflammatory swelling proceeds or if dropsy comes on and 
interferes with the respiration sufficiently to cause lividity or blueness 
of the lips, the operation of opening the windpipe should be at once per- 
formed. It is better to open the trachea or windpipe sooner than is abso- 
lutely necessary, than to postpone the operation until the blood, has been 
rendered very impure by want of a proper supply of oxygen ; yet even up 



LARYNGITIS OR INFLAMMATION OF THE LARYNX. 



527 



to the last gasp and for, perhaps, a minute afterward, life may be saved 
by the surgical operation. 

3. For children the danger to life from this malady is comparatively 
slight, so that bleeding and calomel may generally be dispensed with, and 
emetics, snch as syrup of ipecacuanha or Coxe's hive syrup, in ten-drop 
doses every three hours for a child of three years old, with the inhalation 
of warm opiate vapors, as, for example, that from the spout of a tea- 
pot, in which has been 
placed with a small quan- 
tity of boiling water fif- 
teen or twenty drops of 
laudanum, are generally 
sufficient. 

Subacute Form — The 
subacute form of laryngi- 
tis rarely passes into the 
acute variety, and is, 
therefore, of but little im- 
portance. If severe, the 
same treatment by expec- 
torants, nauseants and an- 
odynes, recommended in 
acute laryngitis of chil- 
dren may be employed. 
Complete rest of the voice 
should be enjoined and 
inhalations of the various 
anodyne and astringent 
sprays are of great service 
in chronic cases. 

Chronic Laryngitis 
Symptoms. — Chronic laryn- 
gitis is accompanied with 
actual thickening of the 
vocal cords, which, if the 

deposit be not subsequently absorbed, produces a permanent change in the 
voice. The respiration is usually but little affected, yet there may be a 
little tickling cough, an expectoration of small fragments of mucus and 
an almost constant desire to clear the throat. 




Image of Vocal Apparatus as Seen in the Laryngoscopy 
Mirror Held Far Back in the Mouth. 



528 



DISEASES OF THE RESPIRATORY SYSTEM. 



Treatment. — Rest, by the avoidance of speaking above a whisper, a 
warm, moist atmosphere and medicated inhalations, are the important 
elements of treatment in this affection in its simple form. 

The Laryngoscope. — By means of a small, metallic looking-glass, 
called a laryngoscope, a view of the epiglottis, the glottis itself, and, in 
favorable instances, the interior of the larynx, with some of the upper 
rings of the trachea, may be obtained. Such a view is given in the ac- 
companying illustration. 

Treatment of Throat Ulcers. — When, by means of the laryngoscope, 
the existence and seat of an ulcer can be established, it 
should be touched with a strong solution of nitrate of 
silver, in the hope of thereby promoting a tendency to 
heal ; or inhalations of astringent solutions, such as that 
of the sulphate of zinc, or of copper, and of carbolic 
acid may be employed. 

TRITE CROUP OR PSEUDO-MEMBRANOUS CROUP. 

For a full description of the causes and treatment 
of this disease see Diseases of Children. 




Changes of Position 
of the Vocal Cords. 



DISEASES OF THE VOCAL CORDS. 

Tumors in Vocal Cords. — The development of new 
growth or little tumors within the cavity of the larynx 
is a cause of local obstruction to the breathing, which 
is happily rare. The three different kinds which have 
been met with are, first, the warty growths, having a 
firm structure, and attached to the inner surface of the 
laryngeal .cavity by a broad base; second, polypoid 
growths, similar to those already mentioned as occurring in the nose, of 
a soft and jelly-like consistence attached to the mucous membrane by a 
pedicle or stem; and, third, cysts or hollow bags, containing, in some in- 
stances, parasites. 

Paralysis of Vocal Cords. — Paralysis of the vocal cords, resulting in 
aphonia or loss of the voice, is a very grave misfortune under certain cir- 
cumstances, as, for example, to clergymen or lawyers. 

Changes in Vocal Cords. — The changes in position which these vocal 
cords undergo in the different processes in which they are concerned, will 



DISEASES OF THE VOCAL CORDS 



529 



probably be understood by reference to the accompanying diagram. At 
A is shown the appearance of the chink of the glottis, formed by the edges 
of the vocal cords, as it appears when examined by the laryngoscope 
whilst the patient is engaged in singing. B exhibits the condition in 
which it usually appears during easy and quiet respiration; and at C 
is represented the arrangement during forced inspiration or drawing a 
long breath. 

Muscular Arrangement of Larynx. — The figure in the margin illus- 
trates the arrangement of the muscles of the larynx, as seen after the 
membrane and elastic tissue constituting the vocal cords has been removed. 
lit represents the large and firm thyroid 
cartilage; Ary the upper ends of the aryte- 
noid cartilages, to which the posterior ends 
of the vocal cords are attached; V indicates 
the position of the vocal cords. At Arp is 
represented the band of muscle called the 
posterior arytenoid muscle, which has the 
duty of pulling the arytenoid cartilages to- 
gether, and so narrowing the slit of the 
glottis between the vocal cords as to cause 
the production of just the right sound for 
any particular note in singing. The mechan- 
ism of hoarseness in the voice or cough is 



ywr 




Muscles of the Larynx. 



simply as may be understood with ease from 

this diagram, that the edges of the vocal cords becoming thickened by 
congestion or slight inflammatory action can no longer vibrate quickly 
enough to produce the higher notes of the voice. 

Loss of Voice. — In paralysis of the muscles of the glottis, which, small 
as they are, the explanation given a few pages back shows to be very im- 
portant, not only is the power to produce audible voice sounds lost, but 
breathing is rendered difficult, and great distress is produced by the 
inability to take a long breath. Aphonia, or loss of voice, is of two kinds, 
the simulated and the true. An imitation of the real disease is generally 
hysterical in its character, and though it may last for a long time, is never 
really permanent ; it may sometimes be recognized by the aid of the 
laryngoscope. 

Treatment. — True aphonia is due to actual palsy of these little laryn- 
geal muscles, is generally dependent upon some serious injury or disease, 

and therefore in most instances incurable. The treatment of the pre- 
34 



530 DISEASES OE THE RESPIRATORY SYSTEM. 

tended aphonia is that of hysteria. In bad cases chloroform may be given 
with advantage. During the intervals between the attacks, the bitter 
tonics, cod-liver oil and iron, and treatment for any uterine derangement, 
as described in the chapter on Diseases Peculiar to Women, should such 
disorder exist, are strongly indicated and will generally accomplish a cure 
in the course of time. 

COMMON COUGH OR BRONCHIAL CATARRH. 

Character. — This every-day disease is a subacute inflammation affect- 
ing the larynx, trachea, and larger bronchial tubes, sometimes commenc- 
ing with nasal catarrh and traveling down, as it were, to the pulmonary 
organs. At other times, or in other patients, it appears to originate in the 
larynx, and does not affect the nasal passages at any time during its 
course. 

Predisposing Causes — The predisposing causes to this common affec- 
tion are enumerated as being the loose, flabby texture of tissue in certain 
individuals, especially those who are the subjects of the scrofulous dia- 
thesis, and rickety children; second, a previous attack, and third, effem- 
inate modes of life. 

Direct Causes. — The directly exciting causes are: 

1. Chilling of a portion of the skin, and especially the change of 
temperature of a portion of -the body produced by sitting in a draught of 
air whilst perspiring freely, or with damp clothing or wet shoes. 

2. Irritants acting directly on the mucous membrane lining the air- 
passages, such as dust, acrid vapors, or hot and cold air, and the grinders, 
millers and stone-cutters. 

3. Obstruction to the current of the blood through the great branches 
of the aorta below the origin of the bronchial arteries, such as may be 
caused by abdominal dropsy, accumulation of gas, or of refuse matter in 
the intestines. 

4. As a result of morbid states of the blood, as seen when bronchial 
catarrh is a premonitory symptom of typhoid fever, measles and small-pox. 

Symptoms. — The general symptoms of a common cold on the breast 
are so well known to every one that it is not worth while to occupy space 
in describing them, and yet, frequent as is popular acquaintance with this 
disease, few persons realize the terrible dangers which attend upon a 
neglected cough. 

Treatment. — 1. The most important thing in relation to this malady 



COMMON COUGH OE BRONCHIAL CATARRH. 531 

is to prevent its occurrence. This could probably be accomplished in four 
cases out of five by the exercise of a troublesome amount of prudence, 
which, however, would be well expended were young people willing to 
make the effort to escape this frequent cause of early death. When, how- 
ever, a person is unfortunate enough to contract a cough by his own im- 
prudence or otherwise, it may often be cut short by bringing on a free 
perspiration. A good way to accomplish this is to take a hot mustard foot- 
bath and ten grains of Dover's powder on retiring for the night, wrapping 
the throat up in flannel if it feels sore, and being very careful not to undo, 
and more than undo, the beneficial work of this treatment by uncovering 
oneself in the night, or by imprudent exposure the next day. 

2. If this method is not resorted to early enough, or if it fails and 
the cough goes on unchecked, ten-drop doses four times a day of anti- 
monial, or ipecacuanha wine, and nitrate of potash, or muriate of am- 
monia in quantities of five grains every three or four hours, are generally 
useful. 

3. By the third or fourth day great advantage may be derived from 
the use of a mixture of half a teaspoonful each of syrup of squills and 
syrup of wild cherry with one-twelfth grain of cyanide of potassium every 
six hours. If this remedy agrees with the patient it may be taken more 
frequently or in sufficient doses to quiet the cough through the night, but 
it must be used with great caution, as it contains ingredients which are 
poisonous in over-doses, or ammonia chloride, 1^ drachms ; Brown's mix- 
ture, 4 ounces. One to two teaspoonfuls every three hours. 

4. Should the disease persist notwithstanding the employment of 
these various medicines, counter-irritation with croton oil and tincture of 
iodine applied to small spots on the upper part of the chest in front, or 
croton oil alone rubbed on the back, also with great caution, should be re- 
sorted to without that further delay during which the catarrhal irritation 
of the bronchial tubes might become chronic, as it is commonly phrased, 
and the cough get such a hold that it cannot be shaken off. 

Auxiliary Treatment. — A very important part of the treatment is the 
breathing of a continuously warm, moist atmosphere, and for children 
especially, the prescription of one warm room is probably more conducive 
to recovery than any one of the medicines suggested. Particularly ought 
young children, in whom previous experience has shown there exists any 
tendency to croup, to be guarded against the development of that dan- 
gerous affection by even the slight additional exposure of passing through 



532 DISEASES OF THE RESPIRATORY SYSTEM. 

a cool entry to their meals. At the same time the apartment to which the 
invalid is confined must not be kept too warm, and due attention should 
be paid to its proper ventilation. 

BRONCHITIS. 

Character. — This disease, an inflammation of the bronchial tubes, or 
air-passages leading to the pulmonary vesicles, is characterized by hoarse- 
ness and moderate cough, with heat and soreness of the chest in front, all 
these being more or less intense according to the severity of the attack. 
In every common cough there is always some bronchitis, but the element 
of danger lies in the extension of the inflammatory action to the smaller 
bronchial tubes or bronchioles, and the approximation consequently to 
that fatal form of the malady termed capillary bronchitis. 

Simple Bronchitis Symptoms. — Simple bronchitis is usually ushered in 
with a slight chilliness, general discomfort, and some febrile disturbance. 
A sense of constriction about the chest and some deep-seated soreness 
beneath the breast bone soon follow. The respiration is slightly increased 
in frequency, but no urgent dyspnoea is generally present, unless the 
patient is a sufferer from some chronic affection of the heart or lungs, as, 
for example, valvular disease of the former organ. Cough is uniformly 
present in bronchitis, is worse after sleep, and, as a rule, paroxysmal. The 
expectoration is at first scanty and viscid, but soon becomes more abundant, 
white and frothy, and still later yellowish or muco-purulent. In this 
latter stage the cough is looser, less painful, and the phlegm is expec- 
torated more easily. 

Capillary Bronchitis Symptoms. — Capillary bronchitis usually develops 
out of the simple form, and therefore its onset can hardly be said to be 
characterized by any well-marked symptoms. Occasionally, however, a 
sharp chill defines the date of its attack. "When developed, the patient 
breathes with difficulty, the complexion is dusky, and the countenance be- 
trays anxiety. The superficial veins are over-filled, as a consequence of 
the obstruction to the pulmonic circulation, and the movements of the 
sides of the nostrils are exaggerated. The respiration and pulse are quick- 
ened, the former very much so, and out of proportion to the latter. The 
cough is almost constant, and the expectoration, at first frothy, and after a 
time yellowish, is expelled with considerable difficulty. Troublesome 
pains in the intercostal muscles, brought on by the unremitting exertion of 
coughing, are of frequent occurrence, the temperature rises to a consider- 



BRONCHITIS. 533 

able elevation, and the restlessnesses extreme; the renal excretion is scanty, 
and sometimes a little albuminous. In fatal cases the prostration becomes 
intense, the skin livid, cold and clammy. Dropsy of the feet and legs may 
come on, and at last fitful drowsiness or muttering delirium precede coma 
and death. 

Acute Bronchitis Diagnosis.— The diagnosis of acute bronchitis is or- 
dinarily not difficult. Capillary bronchitis must be distinguished from 
pneumonia, which can generally be done by the greater amount of fever 
and disturbance of the respiration as well as the dullness on percussion, 
tubular breathing, and irregular distribution over the chest of the latter 
affection. In acute tuberculosis, or galloping consumption, the violence 
and irregularity of the fever, the rapid collapse of strength, and the ex- 
treme dyspnoea, out of all proportion to the physical signs, indicate the 
nature of the case in most instances. 

Treatment. — 1. A threatened attack of bronchitis may sometimes ap- 
parently be cut short by a hot foot-bath and dose of Dover's powder, as 
already suggested, and a full dose of ten grains of salicin or of quinine 
will perhaps aid the good work of this treatment. 

2. After the disease is fully developed the remedies are chiefly pal- 
liative, and consist of opiates, such as morphia, belladonna, or preferably, 
in many cases codeia, in half-grain doses, to quiet the cough and promote 
the expectoration. The softening of the secretion, and easing of the inces- 
sant cough, are also promoted by keeping the patient in a moist atmos- 
phere, as suggested in regard to croup. 

3. Pain in the chest can often be relieved by mustard-plasters and 
stimulating liniments, or painting with tincture of iodine. Half tea- 
spoonful doses of the syrups of squills, ipecacuanha and lobelia, every 
two, three or four hours, according to the urgency of the symptoms, are 
probably useful, and the iodide of potassium, in five-grain doses, if well 
borne by the patient without irritating the mucous membranes of the eyes 
and throat, as it sometimes does in a singular way, is highly recommended. 

Diet. — There is no need of restricting the diet in this disease, and 
any wholesome food which the patient craves may be allowed. In the 
treatment of the capillary bronchitis of young children it is necessary to 
use opiates with much greater caution, and the occasional administration 
of an emetic, to aid in clearing out the accumulated mucus, is important. 
Counter-irritation by mustard or turpentine may be tried, and dry cup- 
ping often gives great relief. 

Chronic Bronchitis. — Chronic bronchitis is a very common malady, 



534 DISEASES OF THE RESPIRATORY SYSTEM. 

its frequency increasing with the coming on of old age. It may be chronic 
from the outset, or be the result of the acute form. Chronic lung diseases 
generally are apt to lead to it. and so does the abuse of alcohol. 

Treatment. — Chronic bronchitis, especially when in the form called 
dry catarrh, is often relieved by iodide of potassium and colchicum. 

PNEUMONIA OB INFLAMMATION OF THE LUNGS. 

Causes. — This disease, called also lung fever, is the most serious of 
the common acute diseases of the pulmonary organs. Long continued 
exposure to cold is apt to be the exciting^cause of pneumonia; but there 
are some reasons for supposing that it is, at least in many instances, a 
local manifestation of a general disease, perhaps contagious in its char- 
acter. It often comes on in the course of other grave maladies and adds 
very much to their fatality. 

The Stages. — The three stages through which this complaint passes 
in typical cases, are, first, that of congestion, where the lung is engorged 
with blood; second, that of red-hepatization, in which the inflamed lung 
is dark red and solid like a piece of liver, sinking in water and breaking 
down readily under the pressure of the finger; and, third, the stage of 
grey-hepatization, in which the affected pulmonary tissue is still dense, 
but of a yellowish-grey color. w 

Symptoms. — 1. The symptoms of an ordinary attack of pneumonia, 
coming on from exposure to cold, in a robust adult, are quite character- 
istic. The disease usually sets in with a single severe and prolonged chill, 
after which the temperature of the body rapidly rises to a high point and 
this rise is accompanied by the customary symptoms of fever. Pain is 
commonly felt about the region of the nipple on the affected side and is 
sharp, stabbing and aggravated by movement in breathing or otherwise, 
and also by pressure. 

2. There is, likewise, well-marked dyspnoea, characterized by ex- 
tremely frequent, shallow breathing, quite different from the kind of 
dyspnoea observed in bronchitis and in asthma; the rapidity of respira- 
tion ranges from twice to four times the frequency of health ; that is, from 
about thirty to sixty per minute ; and this increase in the number of the 
respiratory efforts is partly due to fever, partly to impurity of the blood 
and partly to the pain which prevents drawing a full breath. The sides 
of the nostrils are commonly in active movement at every inspiration. 

3. The third prominent symptom is cough, generally frequent, hack- 




Consumption; intervesicular changes. 



Fig. 1. — Pleuropneumonia. 




Fig. 3. — Surface of the breast in a normal condition; con- 
tours of cardial torpor to the left of the breast bone. The 
spaces included in the dotted lines represent the intermediate 
spaces. 



Fig. 4. — Croupous or vesicular 
pneumonia. Estate of consolida- 
tion. 



THE LUNGS AND THEIR DISEASES 



53(3 DISEASES OF THE RESPIRATORY SYSTEM. 

ing and constrained on account of the suffering which it causes. It is 
dry at first, but on the second or third day the patient commences to 
bring up at each paroxysm of cough, some of the peculiar, viscid material 
of exactly the color of rusty iron. This expectoration does not occur in 
young children, is often absent in secondary pneumonia and in the pneu- 
monia of the aged. The fever usually attains its height on tho second or 
third day, 

4. The pulse is usually strong and full at the outset, but later on in 
the attack it becomes small and weak, partly as a result of the imperfect 
filling of the arteries from obstruction of the pulmonary circulation and 
partly from cardiac feebleness. The cheeks are flushed to a very marked 
degree and an eruption of little blisters, a variety of herpes, is sometimes 
present upon the lips, which are of a dusky hue. Prostration, feebleness, 
headache, restlessness and delirium at night are common. The tongue is 
dry and coated, the thirst is eager, but the appetite for food is lost and 
the bowels are costive. 

5. In favorable cases, these symptoms which have been detailed 
gradually increase up to the fifth, sixth, or seventh day and may then 
rapidly subside, the temperature falling to the natural standard two or 
three days later, and the solidified portions of the lung clearing out occa- 
sionally with wonderful celerity. The cough and dyspnoea speedily abate, 
and the sputum becomes yellow and muco-purulent. When the malady 
ends fatally, death usually occurs about the end of the first or early in 
the second week, and results from failure of the action of the heart, or 
else from pulmonary embarrassment. 

Treatment. — 1. There is no doubt that the intense pain accompanying 
the onset of pneumonia can be promptly relieved by blood-letting; but 
since the tendency of the disease is toward death by debility and it is im- 
possible to say in any given case how far over the pulmonary structure the 
inflammation will extend, we can never feel sure that the loss of the vital 
fluid abstracted will be safely borne by the patient. In very robust per- 
sons, in the prime of life, it is proper to bleed ; because the chance of dim- 
inishing the violence of the attack thereby is at least equal to the danger 
of seriously decreasing the strength. In less vigorous individuals, leech- 
ing or cut-cupp"ing, and in patients of feeble constitutions, dry-cupping 
will generally afford considerable relief. 

2. Large doses of quinine, even as much as twenty or twenty-five 
grains, may be given at the first onset, in the hope of cutting short the 
disease and later on for the purpose of reducing the fever, which in itself 



EMPHYSEMA. 



537 



is a great cause of danger, as already explained. Opiates in the form of 
Dover's powder, the hypodermic injection of morphia, or of codeia in 
half-grain doses, when the latter medicine suits the patient, are of great 
service in diminishing suffering, procuring sleep and allaying cough. 

3. Toward the latter part of a severe attack the chief treatment is 
that of nutrition and stimulation, and as there is often in this disease a 
great tolerance by the nervous system of alcohol, such as we see in typhoid 
fever, immense amounts of milk-punch, or diluted brandy and whiskey, 
are sometimes consumed with apparent benefit. Alcoholic stimulants 
should never be given to the extent of producing symptoms of intoxica- 
tion, but short of this point they are of great service in keeping up the 
action of the heart and thus preventing the fatal effect of cardiac failure. 

4. Since the immediate cause of death in many examples of fatal 
pneumonia is the over-distension of the right side of the heart, with conse- 
quent separation of fibrin in the partially stagnating blood constituting 
heart-clot, it is advisable to diminish this tendency to coagulation of the 
blood in the heart and the production of a thrombus by the administra- 
tion of five grains of carbonate of ammonia every three or four hours, 
which, however, ought not to be continued for more than a day or two. 

Diet — During convalescence from inflammation of the lungs danger 
from relapse is not nearly so great as in many other maladies, such, for 
example, as diphtheria, and hence free indulgence of the appetite for all 
wholesome food and out-door exercise, as. soon as the strength permits, 
may be allowed. 

EMPHYSEMA (LUNG DISTENSION). 

Varieties — The two varieties of emphysema are, first, the vesicular, 
in which the vesicles are distended and dilated, and the interlobular, in 
which the air has escaped from the air-cells in consequence of their 
rupture, and diffused itself through the connective tissue of the pulmonary 
substance. This condition is commonly the result of accidents leading to 
great straining in the respiratory muscles, as in the violent paroxysms of 
whooping-cough and of asthma, and men or animals who are the subjects 
of emphysema are popularly and very accurately described as "broken 
winded." 

Symptoms. — The symptoms of emphysema are in direct proportion to 
the amount of lung-tissue affected, and consist of dyspnoea which re- 
sembles that of asthma and is unlike that of valvular disease of the heart 
in being especially marked during the effort at expiration. Cough is 



538 DISEASES OF THE RESPIRATORY SYSTEM. 

usually present, but is not attended with expectoration, unless the disease 
is complicated with chronic bronchitis, as is frequently the case. In bad 
cases of emphysema the interference with the aeration of the blood is so 
great that the complexion is dusky and the patient languid and dull. 

Treatment. — The treatment of this disease is limited to palliating the 
symptoms as much as possible, and remedying the maladies, such as 
chronic bronchitis or asthma, with which it is frequently complicated. 
Anodynes, which appear urgently called for to relieve the pain and dis- 
tress must be employed with caution on account of the imperfect aeration 
of the blood, which is already an element of danger. Dry cupping be- 
tween the shoulders is often of service, and the use of quinine, iron and 
strychnia, as directed in anemia, is beneficial by improving the general 
health. Change of residence to a warmer and more equitable climate than 
that of the northern United States is probably the best remedy we can 
urge upon patients afflicted with emphysema. 

TUBEKCULOSIS. 

How We Get Tuberculosis. — We can get tuberculosis only by receiving 
into the body the little germs known as the tubercle bacilli. The consump- 
tive infects another, or gives tuberculosis of the lungs to another, by 
means of the tubercle bacilli in the material coughed up from the diseased 
lungs, which often contains millions of these germs. The germs get out 
of the body of a person who has tuberculosis, not only in the material 
which is coughed up, but also in the little drops, too small to be seen, 
which are sprayed out when persons with tuberculosis cough or sneeze. 

Great care should be taken to destroy all material coughed up by 
the consumptive, and to avoid careless coughing and sneezing. If this is 
not done, and the sputum is discharged on the floor or carpets or clothing, 
the germs may live for months, especially in dark, damp, unventilated 
bedrooms, living rooms, and workrooms. 

The germs will live in the darkness and dampness for a long time, 
and are stirred up in dusting and sweeping these rooms, and float in the 
air and may be breathed into the lungs, or may fall upon articles of food 
and be taken into the body in that way. 

The disease is often called CONSUMPTION, for the reason that 
during its progress the patient loses weight rapidly, and hence seems to be 
consumed. Tuberculosis may infect any other part of the body besides 
the lungs, such as the bones, joints, intestines, glands, brain, spinal cord, 



TUBERCULOSIS. 



539 



and the skin, but of all forms of inflammation, that of the lnngs is most 
common. The tubercle bacillus is the only cause of the disease. Twenty- 
five hundred of these germs placed end to end would not be one inch in 
length. These germs may gradually spread through the greater part of 
one or both lungs, destroying the usefulness of those organs until finally 
the patient dies of the disease. 

Many people think that pulmonary tuberculosis comes from a cold 
or some other disease, or is inherited. This is not correct. The reason 
why people develop tuberculosis after a prolonged cold or pneumonia or 
other exhausting disease is because their systems have run down to such 
an extent that they are not strong enough to resist the tubercle bacilli 
when taken into their bodies. These germs are widely distributed, and 
practically all people breathe them in at times. If their systems are in 
excellent condition, the germs do not gain a foothold and start the disease. 
Any condition that weakens the body predisposes one to consumption. 

Symptoms — There are a number of symptoms which might lead 
a person to suspect that he has pulmonary tuberculosis, namely: loss of 
weight, loss of appetite, loss of color, fever in the afternoon, cough and 
expectoration lasting for several weeks, spitting of blood or streaks of 
blood in the sputum, chills, night sweats, difficulty in breathing, and pains 
in the chest. 

In incipient tuberculosis the commonest symptoms are loss of weight 
with cough and expectoration. When these symptoms occur it does not 
necessarily mean that tuberculosis exists, but it would be wise for a person 
having them to consult a physician. 

Medicines — There is no medicine that will cure consumption. It 
is a waste of time and money to use so-called "Consumptive Cures." All 
advertised cures of this nature are frauds. Doctors who advertise should 
be avoided as much as medicines which are advertised. Reputable doctors 
do not advertise. 

Treatment. — The treatment for tuberculosis is rest, with plenty of 
fresh air, and enough good wholesome food. No medicine is necessary 
except in cases where other diseases are present. The disease may be 
cured at home in many instances if it is recognized early, and proper 
means are taken for its treatment. When a number of a family is found 
to have consumption and cannot be sent to a sanatorium, arrangements 
for taking the cure at home should be made as soon as the disease is 
discovered. 

It is important, in the treatment of tuberculosis, to breathe air that 



540 DISEASES OF THE RESPIRATORY SYSTEM. 

is fresh and pure, to eat an abundance of good food, to stop heavy work 
and worry, and to take a bodily and mental rest by lying down before and 
after the noon and evening meals. To obtain the first, the patient must live 
out of doors. This means "that as many hours of the day and night as 
possible should be spent in the open air, and in order to carry out this 
treatment some place must be provided which is not only protected from 
wind, but also from rain and snow, as nothing except the most severe cold 
weather should prevent the patient from living and sleeping there. The 
outdoor shelter should be large enough for a bed, a reclining chair, and 
a table. It should overlook pleasant and sanitary surroundings if possible, 
as it is to be the home of the patient for months, and will give better 
results if comfortable and attractive. 

Tenement house dwellers and-persons living in apartment houses in 
large cities should make every effort possible to give the open air treatment 
to a member of the family who contracts tuberculosis. First, consider the 
possibility of moving into the suburbs or nearby small towns. If this 
cannot be done, try to obtain from the landlord the use of the roof, and 
build a small shack there. If this is beyond the means of the family, use 
one room with a window opening on the street or large court for the 
patient, and then place the head of the bed beside the window and cover 
it with a window tent. The cost of a window tent is about $10, and if it 
cannot be obtained, take two large heavy cotton sheets, sew them together 
along the edge, tack one end of the double sheet to the top of the window 
casing and drop the lower end over the outer side of the bed, fastening 
the bottom of the sheet to the bedrail with tape. There will be enough 
cloth hanging on each side of the window to form the sides of the tent, 
and these should be fastened to the window casings. A window tent 
can be made at home for about $3 by using 12 or 15 yards of heavy denim 
or light canvas. One straight piece of denim should be hung from the 
top of the window casing to the outer side of the bed, and the openings 
between this and the side window casings filled in with sides cut and 
fitted from the balance of the cloth. By these methods the patient gets 
fresh air from the window and the room is kept warm in cold weather 
as a place for dressing and toilet purposes. During mild and warm 
weather the tent can be removed and the window kept open both at top 
and bottom. 

How to Arrange a Porch. — If the family lives in a small town or in 
the country, it will usually be found that a porch is the most convenient 
way of providing open-air quarters. In selecting a site for the porch, 



TUBERCULOSIS. 541 

it is well to remember that the patient should be placed out of doors 
in such a way that the cure can be taken with comfort at all seasons of the 
year. For the winter months the best place is on the south side of the 
house, as there will be found the greatest amount of sunshine. If this 
cannot be done, choose first the east, or second the west side, but not the 
north side except as «? last resort, for it is a windy and cold position in 
winter. The back of tLe house is usually better than at the front, if the 
porch cannot be seen from the street. The most important tiling is to find 
a sheltered spot, for wind ic much harder to hear than intense cold. If 
the house has permanent veraadas, and you cannot afford a special porch, 
use a veranda, and obtain privacy by putting up canvas curtains or bam- 
boo screens. 

How to Build a Cheap Porch. — A useful porch can be built for $12 
or $15 with cheap or second-hand lumber, and if only large enough, to 
receive the bed and a chair will still be effective for the outdoor treatment. 
The roof can be made with a canvas curtain or a few boards and some tar 
paper. The end most exposed to the wind and rain and the sides below 
the railing should be tightly boarded to prevent draughts. A window can 
be used for the approach, but it will be more convenient if it is cut down 
to the floor and a small Dutch door put in below the window sash. Second 
and third story porches are supported from the ground by long 4 by 4 
posts, or, when small, they can be held by braces set at an angle from 
the side of the house. 

Bed and Bedding for Outdoor Sleeping — An ordinary iron bedstead 
with woven wire spring 3 feet 6 inches wide and a moderately thick 
mattress are all that are necessary except for cold weather. A good 
hair mattress is best, but when this cannot be obtained, a cotton-felt 
mattress can be bought for $4, or a wool mattress for about $10. Over 
the mattress place an old blanket or a cotton bed-pad, the same width as 
the mattress, and on this the ordinary bed sheets or blanket-sheets. For 
those who like heavy bed covering as many blankets as desired may be 
used. Those who prefer light covering can use^ down comforts, or lamb's 
wool or cotton-filled comforts, or the material for wool or cotton quilts 
can be obtained for about $2 and warm covering made at home. Very 
cheap, light, but warm covering can be made by using paper blankets 
placed between two thicknesses of outing flannel or bed covers. These 
paper blankets are sold for fifty cents each and wear for about six months. 
A woolen horse blanket with an outside of canvas can be used as a 
covering to protect the bedding in wet and stormy weather* 



542 DISEASES OF THE RESPIRATORY SYSTEM. 

Sleeping-Bags. — In very severe weather a sleeping bag may be used, 
and this is made by sewing blankets together around the edges, leaving 
the top open, using as many layers as desired. The blankets should be 
7 feet long by 4 feet wide. 

Arrangement of Pillows — Place two pillows in form of an inverted V, 
with the apex at the top of the bed and the head at the point where the 
two pillows meet. This position allows the shoulders to nestle between 
the pillows and protects them from the cold wind. 

How to Prepare the Patient for the Night — In cold weather the out- 
door sleeper should get into the bed in a warm room and have some one 
roll him out of doors. If this is impossible, use a warm dressing-gown 
in going back and forth from the dressing room to the porch, and warm 
the bed by placing in it for a few minutes before retiring a hot water 
bag, hot bricks, soapstones or bottles filled with hot water. In some 
cases it is well to leave a hot stone or bottle wrapped in flannel at one 
corner of the bed, where it will throw off heat slowly during the night. 

All covers except the top blanket or comfort should be tucked in 
under the bed-pad. The topmost cover is then tucked under the mattress 
to keep the under covers from sliding off when the sleeper is restless. 

Clothing Worn at Night. — A woolen undershirt, a sweater and a 
long outing flannel nightgown or bathrobe are usually worn, but in very 
cold weather some patients wear a pair of drawers made of flannel, a 
pair of bed-socks or knitted slippers, and a woolen abdominal bandage. 
Never cover the head with the bedclothes. The patient can wear a knitted 
skull-cap long enough to be pulled down to the end of the nose and over 
the ears, or a knitted helmet which covers the whole of the head, face and 
neck, with the exception of a small opening for the nose and mouth. Care 
should be taken not to interfere with the inhaling air or to allow the 
breath as it is expelled from the nose or mouth to come in contact with 
the cloth and form icicles. Chapping of the face during the night can be 
prevented by using cold cream or vaseline about the nose and lips. 

General Directions. — Rest is a most important part of the open air 
treatment, and exercise must be regulated by the doctor. Always have at 
hand an extra wrap, and never remain out if chilled. Cold weather 
should have a bracing effect, and when it does not, go into a warm room 
and get a hot drink, preferably milk, remaining indoors until comfortably 
warm. When going out again use more wraps and keep behind a shield 
or screen that breaks the force of the wind. Always be cheerful and 
hopeful; never waste your strength in anger or being cross. Lead a 
temperate life, go to bed early and get up late; do not use alcohol in 



CONSUMPTION". 543 

any form except when prescribed by your doctor. Do away with tobacco 
if possible, and use only weak tea and coffee in small quantities. ".Never 
swallow the matter coughed up, but always destroy every particle by 
spitting in a paper or cloth which can be burned. Never allow the hands, 
face, or clothing to be soiled by sputum, and if this happens by accident, 
wash the place soiled with soap and hot water. Men who have consump- 
tion should not wear a mustache or beard unless it is trimmed close. 
Particular care must be taken, when sneezing and coughing, to hold in 
the hands before the face a cloth which can be burned. Soiled bed-clothes, 
night-dresses, other washable garments and personal linen should be 
handled as little as possible until they are boiled prior to their being- 
washed. The dishes used by the patient must be boiled after each meal. 

All this means care and work, but must be done both as a protection 
to the household and in order to bring about a speedy cure for the patient. 

Deep or full breathing is especially recommended to those who have 
consumption or any weakness of the lungs. See article on deep breathing. 

CONSUMPTION OR PULMONARY PHTHISIS. 

Character. — Tubercular phthisis or true pulmonary consumption is 
that form in which the peculiar tubercular matter is deposited in the lungs 
in small masses or tubercles, varying in magnitude, but generally about 
the size of a mustard seed. Such tubercles become centres of irritation, 
inflammatory action and suppuration, or formation of abscess, and these 
processes end by destroying a smaller or larger spot of the lung-substance, 
and leave a cavity or vomica in the pulmonary structure. 

Causes. — The disease is constitutional, and according to the researches 
of Dr. Koch, the celebrated Berlin microscopist, contagious, the whole 
malady being the result of development in the lung of a very minute bac- 
terium, named by Dr. Koch the bacillus tuberculosis. In America it is 
usually developed between the time of puberty and the twenty-fifth year, 
and in nine cases out of ten seems to be primarily lighted up by a cold 
or some depression of the nervous system. 

Early Indication — Hemoptysis or spitting of blood, usually in small 
quantity and only serious as a symptom of very grave import, is often 
one of the earliest indications of pulmonary consumption. 

Galloping Consumption — Acute phthisis or galloping consumption is 
the most rapid form of this terrible disease, and has been known to prove 
fatal in the short space of six weeks. It usually commences with chills 
and fever of the hectic type. Cough, dyspnoea on very slight exertion and 



544 DISEASES OF THE RESPIRATORY SYSTEM. 

out of all proportion to apparent amount of disease in the lungs, is 
almost a characteristic of the complaint. The expectoration soon becomes 
profuse, and is frequently tinged or streaked with blood. This blood is 
never mixed throughout the sputum so as to give it the color of rusty iron, 
which is so indicative of pneumonia. The pulse is frequent and feeble, 
the tongue red and furred, the appetite poor or absent entirely, and there 
is often a tendency to diarrhoea. 

2. In the rapid progress of the disease there is, after a few weeks, 
great exhaustion, profuse sweating, speedy emaciation and restlessness, 
amounting in persons of nervous temperament to delirium. Acute phthisis 
coming on in this way is almost without exception fatal, but in rare cases 
there may be a decrease in the violence of the symptoms, and the patient 
enjoys a temporary improvement, only, however, to pass into the ordinary 
condition of chronic consumption. 

Treatment. — The treatment of some of the very few cases which have 
ever been reported as cured was that of rest in bed, a liberal supply of 
fluid nutritious food and stimulants, frequent application of iced cloths 
to the chest to subdue the fever, these being at once removed if there was 
any tendency to faintness thereby produced, hypodermic injections of 
atropia to check tl^e sweating, and pills or powders containing two grains 
of quinine, a half grain of digitalis, and opium in amounts of from a 
quarter to half a grain, four, five or six times daily. 

CHRONIC PULMONARY CONSUMPTION. 

Symptoms. — 1. The onset of chronic pulmonary consumption is gener- 
ally gradual, and marked by one or more of the symptoms of progressive 
debility and by loss of flesh, chronic dyspepsia, diarrhoea, alterations in 
the voice, and in females suppression of the monthly periods. In more 
than half the cases spitting of blood occurs, and a cold or cough is ap- 
parently the starting-point in very many instances. A dull, aching pain 
just below the collar-bones in front or the shoulder-blades behind is very 
often complained of, even whilst the amount of tubercular deposit is small, 
and is probably due to little spots of pleuritic inflammation. Muscular 
pains in various parts of the frame are often present. The short, dry, 
hacking cough of early phthisis is usually referred to some irritation about 
the larynx or trachea, but is, in reality, due to irritation of the bronchial 
mucous membrane. 

2. Weakness of the voice and hoarseness are very common, and a 



CHRONIC PULMONARY CONSUMPTION". 545 

purplish mark upon the edges of the gums, where they come in contact 
with the teeth, is often observable, and is thought by some physicians to 
have considerable diagnostic value. In at least fifty per cent, of the 
patients spitting of blood appears early, and recurs at various intervals, 
giving the first positive evidence of the existence of consumption. Very 
rarely, however, is the expectoration of blood in the early stage of con- 
sumption directly dangerous to life. 

3. Among the other symptoms loss of strength is one of the most 
constant. The patient soon finds that slight exertion, such as ascending a 
little hill, or even a short flight of stairs, causes fatigue, hurries the 
breathing and often gives rise to palpitation. The uterine functions in 
women are apt to be disturbed, and the liver becomes congested and 
tender. The tongue gets red and irritable, and little sores called apthse 
form upon its sides and on the mucous membrane of the fauces. 

4. Hectic fever coming on toward evening and giving a deceptive 
appearance of the flush of health to the emaciated countenance develops. 
There is a total loss of appetite with great thirst, and the loss of flesh is 
almost visible from day to day. The hair grows thin and loses it attach- 
ment to the scalp. The debility is extreme and exhaustive night sweats 
make their appearance. In females there is a total cessation of the 
menses, which is a most discouraging evidence of failure in vital power. 
An unmanageable diarrhoea often sets in and conspires with the other 
causes of debility to utterly prostrate the unfortunate invalid. The lower 
limbs become very painful, and dropsical swelling of the feet and ankles 
appears, constituting what is vulgarly called the bloating consumption. 

5. Toward the close, cough and abundant expectoration become, if 
possible, even more troublesome. Great nervous restlessness, cramps in 
the legs, pain about the loins, distress in passing water, utter prostration 
and the ever present difficulty of getting the breath, tend to render the 
last few nights of existence most agonizing. 

Diagnosis of Consumption. — It is so important that the diagnosis of 
consumption should be made at the earliest possible period, when the 
chance of life by change of climate is greatest. After the disease is fully 
developed, and the abundant expectoration, great loss of flesh and strength, 
night sweats, and associated sore throat from laryngeal tuberculosis mani- 
fest themselves, there is often no room for doubt that consumption has 
developed, even without the aid of auscultation and percussion ; but in the 
incipient stage just grounds for suspicion are furnished by the presence 
of slight hacking cough which has resisted the usual remedies, a little 
35 



546 DISEASES OE THE EESPIRATORY SYSTEM. 

spitting of blood, provided the patient can be sure that it does not come 
from the gums or from the back part of the nose, and marked dyspeptic 
symptoms with loss of flesh and strength out of proportion to the length 
and apparent severity of the illness. 

Treatment. — 1. The treatment of consumption consists in the pallia- 
tion of symptoms and the administration of tablespoonful doses, thrice 
daily, of cod-liver oil, the phosphates or hypophosphites of iron, lime, and 
the alkalies ; the internal and external use of iodine, and last but not least, 
of persistent counter-irritation over the diseased spot in the lung, gen- 
erally near its top and just below the collar-bone, with tartar emetic oint- 
ment. Nearly all the cases of recovery from well-defined phthisis, coming 
under the observation of the writer, have been apparently due in large 
measure to this system of treatment. 

2. In the second stage of consumption — that is, after the deposit of 
tubercular matter has begun to soften and before any large cavities have 
formed — the prospect of cure by this or any treatment is diminished; 
but even from the third stage — that of the formation of large cavities and 
extensive destruction of lung-tissue — recoveries occasionally occur. 

3. The palliative treatment of consumption further consists in re- 
lieving the cough and pain in the chest by expectorants and anodynes, 
improving the appetite and strength by tonics and stimulants, controlling 
the diarrhoea with astringents and correcting the derangements of diges- 
tion with antacids and other anti-dyspeptic remedies. 

4. Most patients afflicted with phthisis will find themselves for a time 
benefited by, first, a cough mixture composed of acetate of morphia, cyan- 
ide of potassium, syrup of squills, and syrup of wild cherry or syrup of 
tolu, as already suggested, used chiefly at night to promote sleep in the 
nocturnal hours and allow the expectoration necessary to relieve the lungs 
from their accumulated load of sputum to be carried on in the daytime; 
or elix. of terpen, hydrate and codeine ; second, by a pill of two grains of 
quinine, half a grain of digitalis, and one-fortieth of a grain of strychnia, 
with the addition of half a grain of iron, should the condition of anemia 
exist and there is no tendency to spitting of blood to forbid its employ- 
ment; third, by a mixture of a teaspoonful of syrup of krameria, iive 
grains of prepared chalk, twenty drops of compound spirit of lavender 
and ten of wine of opium, to check diarrhoea when that appears; and 
fourth, by powders containing five grains each of bismuth, soda, charcoal 
and pepsin, or ten of lacto-peptine, with wineglassful doses of the infu- 



* > 



HOFF PRESCRIPTION FOR CONSUMPTION. 547 

sions of gentian or columbo, as may be found best adapted to the par- 
ticular case as stomachics. 

5. For patients with whom morphia or opium disagrees, codeia, lactu- 
carium, chloral, bromide of potassium, or hyoscyamus may perhaps be 
substituted, and in some instances morphia, where illy borne alone, be- 
comes quite acceptable to the stomach when associated with one one- 
hundredth of a grain of atropia, or with twenty grains of bromide of 
potassium. 

6. When obstinate diarrhoea torments the invalid, the metallic astrin- 
gents, such as half a grain of sulphate of copper, or one-quarter of a grain 
of nitrate of silver, thrice daily, are frequently useful, or ten-grain doses 
of subnit. bismuth succeeds in controlling the intestinal disorder when all 
other remedies prove unavailing. The profuse and debilitating night 
sweats may often be checked by sponging with finely-powdered alum and 
whiskey, by full doses of quinine, or by hypodermic injections of the 
sulphate of atropia. 

7. Seeing, however, that the prospect of curing consumption by 
medical treatment is so mournfully gloomy, it becomes doubly important 
to urge that every patient whose circumstances will admit should resort 
to a change of climate. And this migration ought to be made with 
scarcely a day's delay after some amply competent authority has de- 
termined by thorough examination the necessity of such a change in the 
colder seasons of the year. 

THE HOFF PRESCRIPTION FOR CONSUMPTION. 

Professor HofT, of Vienna, claims most beneficial results from the 
following formula: 

Arsenic Acid . . 1 part 

Carbonate of Potash 2 parts 

Cinnamyllic Acid 3 parts 

Heat this until a perfect solution is obtained, then add twenty-five 
parts cognac and three parts watery extract of opium which has been dis- 
solved in twenty-five parts of water and filtered. 

Dose: At first take six drops after dinner and supper, gradually in- 
creasing to twenty-two drops. 

As long as the patient shows signs of improvement the dose should 
not be increased. It is sometimes beneficial to reduce it. 

Professor Hoff claims that the physiological action of this remedy is 



548 DISEASES OE THE RESPIRATORY SYSTEM. 

peculiar, in that it does not arrest secretion in the respiratory or intestinal 
tract, while it has marked power to control inflammation and irritation. 
It stops all unnecessary and injurious coughs, relieves the soreness, quiets 
the irritation and brings rest. He claims that the results are usually 
highly satisfactory, that the cough diminishes more or less rapidly, dream- 
less sleep follows, the sputum becomes looser and the appetite increases. 
He claims that it supersedes cod-liver oil in more ways than one, not the 
least of which is that it is palatable, consequently it does not disorder di- 
gestion or produce nausea. By its use the cough is at once ameliorated, 
the perspiration is diminished, the patient is strengthened, thereby en- 
abling him to expectorate the loosened mucus with greater ease, and fre- 
quently the consumptive steadily improves and regains health. 

Professor Hoff claims that mild cases have been quickly cured and 
partial cures have been effected in severe cases, the appetite and weight 
increasing steadily and there being a steady lessening of fever, night 
sweats, insomnia and asthmatic symptoms. He points out that in using 
the treatment the patient must keep the kidneys in order. The duration 
of treatment depends upon the condition of the patient. Professor 
Hoff declares that mild cases are sometimes cured in a few months while 
those more severe may require a year or two. It is essential that the solu- 
tion be taken after eating, when the stomach is full. 

PLEURISY. 

This disease is an inflammation of the pleura, or delicate membrane 
which surrounds each lung. 

Causes. — Pleurisy presents itself under two forms — the acute and the 
chronic. Its common cause is exposure to cold, but sometimes it arises 
from injury, as, for example, from the pleura being wounded by the 
jagged end of a broken rib; or, secondarily, adjacent inflammation, such 
as takes place around a nodule or tubercular deposit in consumption, or 
in the course of some other disease, for instance, Bright's disease or 
scarlet fever. 

Symptoms. — 1. The onset of acute pleurisy may be insidious, but gen- 
erally, when arising from its usual cause, exposure to a very severe cold, it 
is rather sudden and marked by repeated chills. As soon as the patient 
reacts from these, the temperature begins to rise and thus furnishes a 
distinguishing symptom which often enables the complaint to be dis- 
criminated from pneumonia. 



PLEURISY. 



549 



2. At the same time, or very soon after the rise in temperature, pain, 
cough and dyspnoea are observed. The pain is almost always referred to 
the affected side, a few inches below the nipple, and is sharp and darting, 
described as resembling a stab with a keen knife, especially on trying to 
take a deep inspiration or to cough. As a rule, the difficulty of breathing 
is slight and mainly due to the pain in the side and to the febrile excite- 
ment in the system. The cough is short, hacking, and accompanied with 
little or no expectoration; the pulse is quickened; the tongue is some- 
what furred, the appetite impaired, but the thirst is increased, and the 
bowels are confined. 

3. After a variable period, averaging, perhaps, between one and two 
weeks, the attack usually terminates in recovery, with or without a con- 
traction of the wall of the chest on the affected side, according as the 
lung is able to expand after being compressed by the effused fluid ; or the 
malady may end in the chronic form of pleurisy, or very rarely in the 
uncomplicated affection it may have a fatal result. 

4. In chronic pleurisy the effused liquid remains in the pleural sac, 
without becoming absorbed. It is especially apt to become purulent in a 
short period in children, or in persons whose health is impaired from any 
cause. When this degeneration takes place there is always more or less 
febrile disturbance of a hectic type set up in the system generally. The 
skin of the affected side after a while becomes, over the seat of the 
effusion, reddened, tender, swollen and dropsical. The finger nails are 
often clubbed, as in consumption, and night-sweats are not infrequent. 
Cough is apt to be troublesome and may be accompanied by an expectora- 
tion of muco-pus, which in rare cases possesses a putrid odor. 

Diagnosis. — The diagnosis of pleurisy without the aid of auscultation 
and percussion, must often be difficult, at least for the first few days of 
the attack, but it can sometimes be made from pneumonia by the lower 
grade of fever, the small amount of dyspnoea, and the total absence of 
rusty expectoration. It can be distinguished from bronchitis by the 
small amount of cough, and the sharpness of its pain, and from acute 
phthisis by the strength being but slightly diminished. 

Treatment. — 1. The treatment of pleurisy in the first stage, when 
acute pain is the most prominent symptom, is bleeding, leeching or cup- 
ping over the affected side, if the patient is robust and previously in good 
health. In persons of feeble constitution it is better to apply ten or 
twelve dry cups, and then use hot poultices with laudanum for the further 
relief of pain, than to deplete the system, or turpentine and sweet oil. If 



550 DISEASES OF THE RESPIRATORY SYSTEM. 

suited to the patient, hypodermic injections of morphia are of great ser- 
vice. After the second day free watery purgation by a tablespoonful of 
rochelle salts, epsom salts, or a bottle of citrate of magnesia, and a restric- 
tion of the amount of fluid taken into the stomach, are advisable, in order 
to limit the tendency of effusion into the pleural sac as far as possible. 
If the febrile movement runs very high, veratrum viride or aconite, in 
three to five-drops doses of its tincture, may be given to reduce the pulse 
and heart's action, but this is rarely necessary. 

2. In the second stage after effusion has occurred, the chief indica- 
tion is to reduce the amount of this serous liquid as speedily as possible, 
and for such a purpose diuretics and saline purgatives or elaterium, in 
quantities of half a grain every three hours, or so as to cause abundant 
watery discharges, may be given; counter-irritation by iodine and small 
blisters being kept up over the diseased side of the thorax. If the liquid 
is effused in large amount and causes much interference with respiration, 
it may be necessary to draw it off by means of an aspirating apparatus. 

Diet. — As the cure progresses tonics, good nourishing food and early 
exercise in the open air in suitable weather, are highly important. 

Hydrothorax. — This is the name applied to that diseased condition 
where there is an accumulation of water or serous fluid in the cavity of 
the chest. It may be the result of pleuritic inflammation, but not un- 
frequently occurs in dropsy without inflammatory action. Sometimes it 
increases to an enormous amount, pressing on the lungs and displacing 
the heart, with such great interference to the respiration and circulation 
as to prove the immediate cause of death, unless removed by aspiration, or 
exhaling the breath through an opening in the pleura. 

Pneumothorax. — This is the term applied to the morbid state in which 
air has entered and partly occupies the cavity of the pleura, compressing 
the lung in the same way though less forcibly than does a watery effusion. 
This accident sometimes occurs from the rupture of the vesicles of the 
lung through the pleural membrane into the cavity of the pleural sac. 
At other times it results from some injury to the chest, such as a gun-shot 
wound or the fracture of a rib. Where closure of the aperature by which 
this air found an entrance can be secured, it may be necessary, in order 
to relieve the oppression of breathing, to pump out the air by means of 
the aspirating apparatus. 

Emphysema. — This is the accumulation of air under the skin in the 
subcutaneous connective tissue ; it is a curious result occasionally met with 



CAISSON OR COMPRESSED AIR DISEASE. 551 

from wounds of the pleura, such as those produced by compound fractures 
of the ribs and other causes. This distension of the integument with air 
may progress until all semblance of humanity is lost and yet entire 
recovery takes place. It may almost always be prevented by proper at- 
tention to the primary injury. 

Other Diseases of the Pleura — The membrane of the pleura may be 
affected with cancer, simple tumors, tubercle and parasitic growths, but 
these are very uncommon, except as secondary manifestations of extensive 
disease of the same kind in other portions of the body, in which cases the 
latter are consequently the proper subjects of whatever treatment becomes 
needful. 

CAISSON OR COMPRESSED AIR DISEASE. 

This is a disease occurring among laborers, engineers or any persofi 
compelled to work for any length of time in tunnels, jetties, foundations 
for bridges, etc., where it is necessary for a caisson to be used containing 
compressed air. It is, therefore, not a germ disease, but causes sickness 
among laborers by the constant breathing into their lungs this compressed 
air. 

The latest theories in regard to how this compressed air affects the 
system of healthy persons are that the tissues and fluids of the body be- 
come saturated with the gases of the atmosphere to a degree which depends 
upon (1) the amount of pressure of the compressed air in the caisson; 
(2) the length of time they are exposed to it; (3) the activity of the cir- 
culation and the ability of the individual's tissues as regards the rapidity 
with which the gases are absorbed. 

No matter how high the compressing of the air in the caisson is, 
symptoms do not occur until the man leaves the caisson and breathes the 
atmospheric air. 

The disease is principally due to the formation of air bubbles (chiefly 
nitrogen) within the body brought about by decompression (meaning that 
the atmospheric air removes the pressure from the lungs when the person 
is relieved from the compressed air in the caisson). This relief takes 
place so rapidly that the gases formed in the blood cannot be carried to 
the lungs and thrown off as gradually as they entered; as a result, gases 
in the form of air bubbles, form in the blood and tissues and damage them 
by the force of their expansion. 

When a man is in a caisson working under compressed air, the first 



552 DISEASES OF THE RESPIRATORY SYSTEM. 

effects lie notices are more of a functional nature than the symptoms of 
caisson disease, they are practically mechanical due to the pressure of the 
contained air. He feels that the ear-drum membranes are forced inward, 
which cause discomfort, perhaps pain. They may rupture. Eise of tem- 
perature with sweating due to the heat caused by the compressed air. It 
is difficult to force the air out of the lungs. Whistling or whispering can- 
not be done, and the attempt causes a sensation of numbness in the lips, 
which also do not move. The voice is changed and is done through the 
nose. A sensation of well being and excitement is felt by the laborer. 
The skin does not change its color nor is the normal rate of the pulse 
altered. 

The Symptoms of Caisson Disease. — These never occur while the man 
is in the caisson, but usually come on in fifteen minutes to twenty-four 
hours after he has left the caisson and breathes normal atmospheric air. 
Pains in the knees and elbows are the most frequent symptoms ; they also 
occur at times in abdomen. The pains in the knees cause the person to 
bend his knees and the attitude has been termed "the bends." Dizziness 
occurs and is spoken of by the laborers as the "staggers." Nausea and 
vomiting may come on. Difficult breathing develops in some men and is 
spoken of as "chokes." Prostration and collapse occur rarely and the 
patient becomes unconscious. These symptoms have been followed by 
death. Itching of the skin occurs, supposed to be due to the presence of 
air bubbles in the sweat glands in the skin. 

Workers in compressed air who have followed such labor for years 
are usually apt to suffer from deafness, "bends" or severe pains in the 
knees. Temporary or permanent paralysis of the legs and arms are a rare 
complication. 

Treatment for this Disease. — There is, of course, no home treatment. 
Most of the large contractors who builds tunnels, bridges, etc., have their 
own physicians at hand to treat all laborers overcome upon removal from 
the caisson. Special treatment is necessary under the cafe of specialists 
in this disease. 

There is no method of preventing this disease as long as men must 
work under compressed air. It attacks the healthiest of men who are 
free from disease and well nourished at the time of going to work. 



PART VII OF BOOK IV 

Treats of the Digestive System and the diseases 
affecting the different parts, giving the best and 
newest treatments. 



Abdominal Dropsy 593 

Atrophy of the Liver 592 

Abscess of the Gum 559 

Abscess of the Liver 591 

Treatment of 592 

Abscess of Tonsil 565 

Acute Gastritis 567 

Acute Stomatitis 556 

Esophagus, Diseases of 566 

Anus, Fissure of 589 

Aphthous Stomatitis 556 

Treatment of 556 

Appendicitis 575 

Treatment of 577 

Appendix, Inflammation of 575 

Function of 575 

Ascites 593 

Treatment of 593 

Baby's Sore Mouth 555 

Bowels, Inflammation of 574 

Cancer of the Lip 555 

Cancer of the Tongue 560 

Treatment of 560 

Cancer of the Stomach 571 

Treatment of 571 

Cancrum Oris 557 

Cirrhosis of the Liver 592 

Clergymen's Sore Throat 561 

Colic 587 

Hepatic 592 

Liver 592 

Colitis 574 

Treatment of 574 

Congestion of Liver 591 

Constipation 583 

Treatment of 583 

Costiveness 583 

Dentition, Difficult 559 

Diarrhoea 581 



Difficult Dentition 559 

Diseases of the Lip 555 

Dropsy, Abdominal 593 

Dysentery 579 

Treatment of ." 580 

Dyspepsia 568 

Treatment of \ .569 

Enteritis 574 

Treatment of 574 

Epulis 559 

Falling of the Anus 589 

Fissure of the Lip 555 

Fistula in Ano 589 

Follicular Stomatitis 556 

Gall-Stones 590, 592 

Treatment of 590, 593 

Gangrenous Stomatitis 557 

Gastritis, Acute 567 

Treatment of 567 

Gullet, Stricture of 566 

Gum, Abscess of 559 

Gum Boil 559 

Treatment of 559 

Gum, Inflammation of 558 

Gum Tumors 559 

Hare-lip 555 

Hemorrhoids 588 

Hepatic Colic 592 

Hernia 584 

Inflammation of the Appendix 575 

Bowels 574 

Gum 558 

Mouth 555 

Stomach 567 

Tonsils 561 

Intestinal Obstruction 578 

Treatment of 579 

Worms 586 

Jaundice 590 



553 



554 



INDEX TO PART VII OF BOOK IV. 



Lip, Cancer of 555 

Diseases of 555 

Fissure of 555 

Ulceration of 555 

Liver, Abscess of 591 

Atrophy of 592 

Colic 592 

Liver Complaint 594 

Treatment of 595 

Liver, Congestion of 591 

Trea'trhent of 591 

Liver, Cirrhosis of 592 

Diseases of 590 

Waxy 592 

Mercurial Stomatitis 558 

Mouth, Inflammation of 555 

Noma 557 

Palate, Perforation of 559 

Parasitic Stomatitis 557 

Perforation of Palate 559 

Treatment of 560 

Peritonitis 573 

Treatment of 573 

Piles 588 

Treatment of 588 

Pin- Worms 587 

Prolapsus Ani 589 

Putrid Sore Mouth 557 

Quinsy 565 

Treatment of 565 

Round- Worm 586 

Rupture 584 

Treatment of 585 

Tape-Worms 587 

Teething 559 

Throat, Sore 561 

Thrush 557 

Tongue, The 562 

Cancer of 560 

Ulceration of 560 



Tongue-Tie 560 

Treatment of 560 

Tonsillitis 561 

Treatment of 564 

Tonsils, Inflammation of 561 

Abscess of 565 

Tumors of the Gum 559 

Salivation „• 558 

Simple Stomatitis 556 

Treatment of 556 

Sore Mouth, Baby's 555 

Putrid 557 

Sore Throat 561 

Clergymen's 561 

Stomach, Cancer of 571 

Inflammation of 567 

Ulcer of 571 

Stomatitis 555 

Acute 556 

Aphthous 556 

Causes of 555 

Follicular 556 

Grangrenous 557 

Mercurial j 558 

Parasitic 557 

Simple 556 

Symptoms of 556 

Ulcerative 557 

Ulcer of the Stomach 571 

Symptoms of 572 

Treatment of 572 

Ulceration of the Lip 555 

Ulceration of the Tongue 560 

Treatment of 560 

Ulcerative Stomatitis 557 

Treatment of 557 

Waxy Liver 592 

Worms, Intestinal 586 



ILLUSTRATION 

The Tongue 563 



CURATIVE MEDICINE 



PAET VII. 
DISEASES OF THE DIGESTIVE SYSTEM 

In considering the maladies of the digestive system frequent refer- 
ences must be made to the anatomy of the alimentary tract, and to the 
physiology of digestion. 

IIP DISEASES. 

Among the common diseases of the lips are ulceration and fissure, 
which may often be induced to heal by light applications of nitrate of 
silver solution, in conjunction with diligent improvement of the general 
health. Cancer of the lip is not uncommon among men in advanced life, 
but is less frequent in females. It should be operated on in accordance 
with the rules already laid down, in discussing the subject of cancer. 
Hare-lip is a curious malformation, in which the upper lip has failed to 
develop in such a way as to unite in the centre previous to birth, and the 
child is left with a deep cleft, sometimes reaching all the way from the 
edge of the nostril. This malformation can generally be remedied by a 
surgical operation. 

STOMATITIS OR INFLAMMATION OF THE MOUTH. 

This is commonly met with in young infants, and is called "baby's 
sore mouth. " It consists of an inflammation of the mucous membrane 
of the mouth and tongue. 

Causes. — These may be : 

1. Mechanical, chemical, thermal or parasitic. 

2. Poisons, as mercury or lead. 

3. In certain debilitating diseases, as consumption or diabetes. 

4. It is most commonly found in young children, in connection with 

(555) 



556 DISEASES OF THE DIGESTIVE SYSTEM. 

digestive disturbances, due to artificial feeding and bad hygienic sur- 
roundings, especially during the summer months. 

General Symptoms. — There are six chief subdivisions of stomatitis, and 
seven general symptoms common to all varieties. These are heat, pain 
and redness of the mouth, increased salivation, foul breath, restlessness 
and disinclination to nurse. 

VARIETIES OF INFLAMMATION OF THE MOUTH (STOMATITIS) 

I. ACUTE OR SIMPLE STOMATITIS. 

This is the most common form in inflammation of the mouth, and is 
usually the result of the action of irritants. It is frequent at all ages and 
is especially common in unhealthy subjects suffering from digestive dis- 
turbances. 

Symptoms. — General redness. There may be areas of marked con- 
gestion where irritation is most intense. Mastication is painful. 

Treatment. — In infants the mouth should be carefully sponged after 
each feeding. Chlorate of potash and sulphite of soda as mouth-washes 
and gargles, of the strength of a dram to four ounces of water, are useful, 
or, in severe cases, a dilute solution of nitrate of silver (three or four 
grains to ounce) may be applied, and attention ought to be paid to im- 
proving the general health by the use of tonics, nutritious food, and so 
forth. 

H. APHTHOUS STOMATITIS OR FOLLICULAR STOMATITIS. 

This is characterized by the presence of small raised spots or vesicles, 
which may rupture, leaving small ulcers, surrounded with a red bole. 
This form of stomatitis occurs most frequently in children under three 
years of age. There are usually some digestive disturbances present. 

Treatment. — Correct digestive disturbances ; sterilize the milk ; nurse 
at regular intervals, and cleanse the mouth with a linen rag after each 
nursing. Apply to mouth and gums three or four times a day: 

Boric acid 15 grains 

Glycerine V2 ounce 

Water up to 2 ounces 

If the disease does not yield to this treatment, touch the ulcers with 
solid nitrate of silver stick. 



GANGRENOUS STOMATITIS. 



557 



III. PUTRID SORE MOUTH OR ULCERATIVE STOMATITIS. 

This variety occurs especially in children after the first dentition. 
It is thought by some to be infectious, as it at times occurs in widespread 
epidemics. It attacks both adults and children. 

Symptoms. — It occurs with low condition of nutrition. The gums of 
the lower jaw are chiefly affected. They are swollen, red and spongy. 
There is increased salivation, the teeth become loose, the breath foul and 
mastication painful. In rare cases there is necrosis (decay) of lower jaw. 

Treatment — Correct the hygiene. Touch ulcers with nitrate of silver, 
and use as a mouth-wash a solution of chlorate of potash, fifteen grains 
to the ounce. The best remedy is chlorate of potash, given internally, in 
doses of two grains, three times a day, to a child, and double that amount 
to an adult. 

IV. PARASITIC STOMATITIS OR THRUSH. 

This disease is dependent upon the growth of an irritating fungus 
(Saccharomysis albicaus). The development of thrush over the whole 
lining membrane of mouth and throat is very common shortly before 
death in wasting diseases, such as consumption and diabetes. It may 
occur at any age, but is especially common in children. 

Symptoms. — It begins on the tongue as slightly raised pearly spots, 
which spread and coalesce. The membrane can be scraped off, and is 
readily recognized under the microscope. It may spread to the pharynx, 
oesophagus or larynx. 

Treatment. — Correct the hygiene; treat as any gastric disturbances. 
Tonics are often indicated. Locally, use sulphite of sodium, one dram 
to the ounce of water, or 

Borax i drachm 

Glycerine 2 drachms 

Water 6 drachms 

Apply two or three times a day to gums and mouth. 

V. GANGRENOUS STOMATITIS, OR CANCRUM ORIS OR NOMA. 

This terrible, but fortunately rare, disease is usually seen in debili- 
tated children, between the ages of two and six years. It usually follows 
one of the specific fevers, especially measles and whooping-cough. 

Symptoms — The general symptoms of stomatitis are marked. The 



558 DISEASES OE THE DIGESTIVE SYSTEM. 

mucous membrane is first affected, usually of the gums or of one cheek. 
The process begins gradually. Externally the cheek is swollen hard, red 
and glazed, and inside the mouth is seen an ulcer with a great deal of 
proud flesh or slough. 

Treatment. — Good hygiene ; alcoholic stimulants ; nutritious food and 
tonics, as iron, quinine and strychnia. Locally, there is nothing that will 
do much good, but the actual cautery applied to the surface is said to be 
of some use, as is the application of fuming nitric acid, followed by soda, 
the surrounding parts being protected with lint soaked with oiL 

VI. MERCURIAL STOMATITIS OR SALIVATION. 

This form is very seldom seen at present, except in those who work 
in mercury. 

Causes.- — It may be caused by the administration of mercury in any 
form. It is most commonly produced by large doses, or even small doses, 
of calomel in those who are especially susceptible. 

Symptoms. — Those first noticed are tenderness of the gums, mani- 
fested by forcibly bringing the teeth together, redness of gums near the 
insertion of the teeth, a metallic taste and an increased flow of saliva. If 
the disease is not checked at this stage these symptoms will become ac- 
centuated, and there will be profuse flow of saliva, foul breath, redness, 
swollen and tender gums. In severe cases there may be ulceration of the 
gums. 

Treatment. — The administration of mercury should be suspended as 
soon as there is the first symptom of salivation. Bowels should be opened 
by magnesium sulphate (half an ounce) ; best taken in half a glass of 
water before breakfast. Hot baths should be taken every evening, and 
alkaline waters should be taken in large quantities. Atropine sulphate, 
one one-hundredth of a grain may be taken twice a day, and iodide of 
potassium, five grains, three times a day. 

DISEASES OF THE GUMS 

These generally require the care of a dentist, and when connected 
with affections of the teeth, or their sockets in the alveolar processes, are 
usually so painful that prompt application to a dental practitioner is 
made. 

Inflammation of the Gum. — This, when conjoined with ulceration at 



DIFFICULT DENTITION. 



559 



the root of a tooth, gives rise to horrible suffering which lasts for three or 
four days, when it is usually relieved by the discharge of matter or pus. 
This may be hastened by hot applications. 

Treatment. — The pain can be somewhat mitigated by anodynes, such 
as ten grains of Dover's powder or one-sixth of a grain of morphia, and 
poultices, but the best treatment is the extraction of the offending tooth, 
or the perforation of the alveolar process to the seat of trouble by drilling 
a hole through the spongy bone. 

ABSCESS OF THE GUM OR GUM BOIL. 

This is sometimes followed by ulceration, which may be hard to heal 
unless the whole cause of the difficulty is removed, which can now be 
accomplished under nitrous oxide gas so quickly, painlessly and safely, 
that no time should be lost in resorting to it. One extremely skillful 
operator in Philadelphia has now administered the gas for operations on 
the teeth in over one hundred thousand cases without a single fatal result. 

Hypertrophy and atrophy of the gums are sometimes met with. 

DIFFICULT DENTITION. 

Treatment. — A very common cause of diseases of the stomach and 
bowels, and also of convulsions in children, is to be found in the harden- 
ing or induration of the gums at the time of teething, and this blunder of 
nature's ought to be promptly remedied whenever the gums in infants 
at the time of the first dentition are found to be red, swollen, and hot to 
the touch, by the use of the lancet. This little operation of lancing the 
gums, which, simple as it is, has probably saved the lives of thousands of 
young children. After the incisions are made bleeding should be en- 
couraged, but care must be taken by wiping it off with a handkerchief to 
prevent the infant from swallowing the blood. It is astonishing what 
relief is often afforded to the little sufferer by a timely lancing of the 
gums. 

Gum Tumors. — Tumors of various kinds sometimes make their ap- 
pearance upon the gums, the most common of those which are non-malig- 
nant being the fibrous growths called epulis, often apparently caused by 
the irritation of diseased and neglected teeth. They all usually require 
surgical operations for their removal. 

Perforation of Palate. — Perforation of the hard palate or roof of the 
mouth is sometimes a malformation present from birth, and due to the 



560 DISEASES OF THE DIGESTIVE SYSTEM. 

same kind of arrest of development as hare-lip. At other times it may be 
due to venereal or scrofulous disease. A surgeon can do much to cure 
this deformity by operation, or to remedy the defect if incurable by 
surgical appliances, which substitute most ingeniously the deficient por- 
tions of the mouth. 



DISEASES OF THE TONGUE 

The Tongue is subject to almost all the diseases already spoken of as 
affecting the inside of the mouth, for which similar treatment is required. 
Troublesome little ulcers on the tongue can often be promptly cured by 
holding in contact with the sore a pinch of powdered borax for ten or fif- 
teen minutes. Deeper ulcers may require touching with the solid nitrate 
of silver, and if dependent upon the constitutional taint of syphilis will 
be very difficult to heal without the use of internal remedies also. 

CANCER OF THE TONGUE. 

Cancer of the Tongue appears sometimes to have its origin, late in life 
from the local irritation of the stem of a pipe in habitual smokers, or from 
the sharp corner of a broken or isolated tooth. Hence it is important to 
avoid these exciting causes as much as possible. The operation for re- 
moval of cancer when seated in the tongue is more justifiable than almost 
any other, because, if recurrence should take place in the glands of the 
neck, or still better, in some internal organ, death comes to the victim in 
a much less painful and horrible form. 

TONGUE-TIE. 

Tongue-tie is a malformation in which, from the prolongation of the 
little membranous band, called the frsenum, underneath the tongue, the 
organ, even to its very tip, is in some cases tied down to the lower jaw. 
If, as occasionally happens, it interferes with a baby's nursing, it should 
be operated upon the next day after birth by nicking the band at the 
front edge, and then tearing it back to about the usual position. No cut- 
ting operation should be resorted to, except in this very superficial way, 
on account of a very active little artery which lies at the root of the 
tongue, and which, if wounded, might bleed so as to endanger an infant's 
life before the hemorrhage could be checked. On this account, if nursing 



DISEASES OF THE THROAT. 561 

is not seriously interfered with, it is better to wait some months before 
thus untying the tcngue. 



DISEASES OF THE THROAT 

Sore throat, which may be considered as comprising inflammation of 
the mucous membrane lining both the fauces and the pharynx, as they 
nearly always occur together, is one of the commonest disorders. It is 
occasionally produced by attempting to swallow some irritating article of 
food, or poison, but is ordinarily the result of cold. It also occurs in the 
course of various febrile affections, such as scarlet fever. 

Symptoms. — The symptoms are pain on swallowing, redness of the 
surface, and at first dryness, but after a day or two later excessive 
secretion from the mucous membrane. Subsequently to partial recovery 
from an acute sore throat, the condition may be one of relaxation, the 
membrane remaining loose and flabby, and often thrown into projecting 
folds. This state usually follows cold and sore throat, but may be induced 
by mechanical causes, such as severe, hoarse cough, screaming, shouting, 
or over-straining in reading or singing. It may also be brought on by 
excessive smoking. 

Clergymen's Sore Throat. — One form of this malady, called clergy- 
men's sore throat, is the result of excessive use of the voice in church 
service when the health is already impaired, especially when the air of 
the apartment in which such exertion is made has been rendered impure 
by overcrowding. In bad cases of sore throat, the inflammation may go 
on to ulceration, especially if neglected. The generally relaxed condition 
of the throat is partaken of by the uvula, or palate, as it is incorrectly 
called by many people, and this hanging down lower than it ought, may 
cause a hacking cough by tickling the epiglottis. 

The above is a description of sore throat in general. The most com- 
mon form of inflammation of the throat is tonsillitis. 

TONSILLITIS OR INFLAMMATION OF THE TONSILS. 

Causes. — The disease is most common in the young. It is rare in 

infants. Exposure to cold and wet with bad hygienic surroundings seem 

to be the chief exciting causes. Some writers claim that there is a close 

relation between this and rheumatism, but Osier has not found the rela- 

36 



562 



DISEASES OF THE DIGESTIVE SYSTEM. 



THE TONGUE 



Figure No. i. 

1. Hyoides bone joining many 

muscles of the tongue. 

2.2. Muscles fastened at the cor- 

ners of the jaw-bone to pull 
in the tongue. 

3. Muscle formed by the outer 

edge. 

4. Deep muscle which turns the 

tongue toward the side. 
5, 6, 7. Muscles which facilitate the 
turning of the food in the 
mouth. 
8, 8. Salivary glands. 

9. Muscle of the bottom of the 

mouth. 
10. Cross muscle formed by the 
lip. 

Figure No. 2. 

1, 1. Muscles which form the outer 
border. 

2. Hyoides bone. 

3. 3. Muscles which move the base 

of the tongue. 

4.4. Exterior insertion of trans- 

versal muscles. 

5. 5. Junction line of the transver- 

sal muscles. 

Figure No. 3. 

1. Tonsils or glands of the throat. 

2. Base of the epiglottis or valve 

to close the windpipe in 
swallowing. 

3. Lateral arches. 

4. Muscles joining the tongue to 

the epiglottis. 

5. Blind apertures in the base af 



the tongue called "blind fora- 
men." 

7. Nerve endings like thread. 
8, 9. Fungiform nerve endings. 

10. Apex of the tongue. 

Figure No. 4. 

1. Exterior muscle of the tongue. 

2. Apertures of mucous glands. 

3. Apex. 

4. Under muscles with the cover 

removed. 

5. Periglottis turned back. 

6, 7. Conduits at the base of the 
tongue. 

8. Nerve endings at the base. 

9. Salivary glands. , 

10. Muscles joining the tongue to 
the epiglottis. 
-11,12. Depressions upon the peri- 
glottis. 

Figure No. 5. 

1,2. Salivary conduits. 

3. Wharton conduits. 

4. Sublingual gland. 

5. Branches or arms of the jaw- 

bone. 

Figure No. 6. 

1. Nerve endings of the tongue. 
2, 2, 2. Submucous pellicle. 

3. Muscular larynx (deep). 

4. Band which joins transversal 

muscles. 

5. Transversal bands of the mus- 

cles. 
6, 6, 7, 7. Salivary conduits. 

8. Muscles for pulling in the 
tongue. 




Fig. 1. — View of the muscles of the 
tongue — lower surface 




Fig. 3. — Front view of the upper 
surface of the tongue; as also of the 
arch of the bone of the palate. 




Fig. 5. — View of the lower jaw- 
bone with the tongue turned up. 




Fig. 2. — View of the under surface 
of the tongue with its muscles. 




Fig. 4. — View of the back of the 
tongue, from which, by masceration, 
the periglottis has been removed and 
turned back on the right side. 




Fig. 6. — View of a section of the 
front part of the tongue, seen from 
behind. 



THE TONGUE. 

For an explanation of the illustrations see text on opposite page. 

563 



564 DISEASES OF THE DIGESTIVE SYSTEM. 

tion between the two very striking, except in one point, viz., "that an 
attack of acute rheumatism is not infrequently preceded by an attack of 
inflammation of the tonsils. Personal susceptibility and heredity play an 
important part in its productions. At times it runs through a family, 
or a community, with such rapidity as to suggest an infectious origin. 

Symptoms. — In the mild forms there may be no other symptoms than 
redness and dryness of the throat with painful swallowing. The tonsils 
may be felt as hard lumps just behind the angle of the jaw. 

Symptoms of More Severe Forms. — In the more severe forms it may 
begin with a chill followed by a rise of temperature which in children 
may reach as high as 105 degrees Fahrenheit. Pains in the back and 
limbs are not uncommon. 

Local Symptoms — The local symptoms are those of the mild form 
accentuated. If only one tonsil is swollen the uvula is drawn to the 
affected side. 

Follicular Form — In this variety white patches may be seen covering 
the tonsil. These are due to the accumulation of degenerated epithelial 
and white blood cells in the depressions, or cryps, in the tonsil. 

Diagnosis. — The follicular form must be distinguished from diph- 
theria. The membrane of diphtheria is not in patches, but continuous 
over the surface of the tonsils, and extended up upon the pillars of the 
fauces and uvula, and is greyish-white in color. When this is stripped 
off it leaves a raw, bleeding surface, which is not the case when the con- 
tents of the cryps are expressed in follicular tonsillitis. 

Constitutional Treatment — Bowels must be freely opened with calo- 
mel, one-quarter grain every half hour, for six doses; followed by mag- 
nesia sulphate (epsom salts), one-half ounce, to be given one hour after 
last dose of calomel ; ten grains of Dover's powder at bedtime. Salicylate 
of soda is often beneficial, and may be given as: 

R. — Salicylate of soda 5 drachms 

Iodide of potassium 2% drachms 

Syr. sarsaparilla 1 V2 ounces 

Water sufficient to make four ounces. Take one drachm 

every four hours. The dose must be reduced in children to 

about half. 

Local Treatment. — Gargles of borax, ten grains to the ounce, or salt 
and water, hot. The following will be found very serviceable: 



QUINSY OR ABSCESS OF TONSIL. 565 

R. — Tincture chloride of iron I ounce 

Glycerine i ounce 

Chlorate of potash % drachm 

Shake well before using, and use one drachm of the mixture to one 
ounce of water, as a gargle. Clean teeth after using. 

Sprays of glyco-thymoline or supra-renal extract are good; or swab 
throat with equal parts of tincture of iron and glycerine. 

QUINSY OB ABSCESS OF TONSIL. 

This disease is a cause of great suffering to some persons in youth 
and middle age, but is rare in childhood, and often ceases its molestations 
after individuals commence the decline of life. 

Causes. — Exposure to cold and wet are its common exciting causes. 

Symptoms. — In the catarrhal form of quinsy the inflammation is often 
superficial, and after causing much pain and difficulty of swallowing, sub- 
sides in three or four days without suppuration. In the severer variety 
an abscess or boil forms in the substance of the tonsil, attended with 
great pain and swelling, difficulty of swallowing, a good deal of fever, and 
some loss of strength. The patient often suffers from earache, and is 
somewhat deaf on account of the inflammation extending along the Eus- 
tachian, tube. The breathing through the mouth is much interfered with, 
but the danger of suffocation is apparent only. The disease lasts on an 
average about seven days, but the abscess may break on the fifth day, or 
may linger until the tenth day, unless earlier opened by the lancet. The 
complaint is very apt to recur, and the sufferer from one attack rarely 
escapes without several every winter, until the tendency, which may be 
hereditary, is exhausted. 

Treatment. — The treatment consists in an effort to abort the disease 
by leeching, externally, and the use of guaiacum in teaspoonful doses of 
the tincture four times daily, by the mouth. If these remedies fail, 
poultices of little bags of hops dipped in hot vinegar and sprinkled with 
laudanum, and hypodermic injections of a quarter of a grain of morphia, 
may afford some relief. When suppuration is established, the period of 
suffering can be abbreviated by lancing the swelling in the throat, pro- 
vided the spot where the abscess points is high enough to be felt by the 
finger. The operation is performed by having a long, narrow-bladed 
knife wrapped with sticking plaster to within a quarter of an inch of its 
point, and then passing this down the throat, guarding it with the finger, 



566 DISEASES OE THE DIGESTIVE SYSTEM. 

and guided by the touch, as the patient can rarely open the mouth wide 
enough to admit of seeing, a small incision is made into the softened por- 
tion of the tumor. The relief afforded either by puncture in this way, 
or by spontaneous rupture, is wonderfully great. No after-treatment is 
necessary; but as before mentioned, the complaint is very liable to recur, 
and it often happens, that in persons who are strongly predisposed to it, 
the first imprudent exposure on venturing out will light up the disease 
in the opposite tonsil, with an almost exact repetition of the suffering, 
within two weeks. 

DISEASES OF THE (ESOPHAGUS OR GULLET. 

Inflammation of the Gullet. — This is a rare affection, and usually 
due to swallowing some hot or corrosive liquid, although it may occur from 
the extension of simple or erysipelatous inflammation from the throat, 
or of the former variety from the stomach. Ulceration is also uncommon, 
although it does occur in connection with syphilitic complaints. 

Stricture of Gullet. — This is the most frequent form of disease of the 
gullet. 

Varieties of Stricture — 1. Spasmodic stricture is a narrowing of the 
tube, caused by simple contraction of its muscular fibres. This condition 
is especially met with in hysterical females, and, though alarming at the 
time, seldom proves fatal to life. 

Traumatic Stricture. — 2. This is the variety in which the constriction 
has been caused by irritation and inflammation due to an injury inflicted 
on the surface of the tube, in any part of its length, by the swallowing 
of scalding water or of some corrosive substance, or by a wound. The 
result of such a stricture is to render the act of swallowing always difficult, 
unless relieved by a surgical operation. 

Simple Organic Stricture. — 3. This is occasionally seen, in which there 
is a mere narrowing of the gullet, without any apparent tendency to 
ulceration. The most common and fatal form of stricture is that due to 
cancerous deposit and ulceration. It may cause death by producing a 
complete obstruction, so that neither food nor drink can enter the stomach, 
or by ulcerating into some of the adjoining vital structures. The surgical 
operations sometimes performed for its relief are of very doubtful benefit 
or propriety. 



INFLAMMATION OF THE STOMACH. 667 



ACUTE GASTRITIS, INFLAMMATION OF THE STOMACH. 

The simplest and most common form of inflammation of the stomach 
is characterized by active congestion and excessive secretion of mucus, a 
condition known under the name of gastric catarrh, and very similar to 
that so frequently met with in the throat and air-passages. 

Causes. — The causes of this malady are indigestible food, especially 
in children, irritant poisons, or alcoholic excess. But it may occur in con- 
nection with gout or as a symptom in some of the eruptive fevers. 

Symptoms. — The symptoms of acute gastritis are pains, which are 
often severe over the pit of the stomach, shooting through to the back, 
and increased by taking food, but temporarily relieved by vomiting. 
Tenderness over the pit of the stomach is always present, and nausea 
and vomiting are prominent symptoms, the vomited matter consisting of 
a glairy mucus, stained with bile of a greenish-yellow or bright green 
color. The tongue is coated with fur, whilst the edges and tip are fre- 
quently red and irritated. The bowels are apt to be confined, and the 
urine scanty and high colored. These symptoms often set in with chilli- 
ness, followed by restlessness, hot skin, headache, and other febrile symp- 
toms. In bad cases there may be great prostration, with cold, clammy 
skin, a weak, rapid pulse, some difficulty of breathing, and obstinate 
hiccough. Generally, however, under proper management, these distress- 
ing symptoms subside after a time, although they sometimes pass into 
those of the chronic form of gastritis. 

General Treatment. — The treatment of this disease is, in the first 
place, if consequent upon the introduction of some poison or irritating 
material, to get rid of the offending substance by means of an emetic, 
followed by a purgative, which is perhaps in most cases best administered 
by enema. 

Diet. — The food should be entirely liquid, and given in very small 
quantities ; in fact, most cases would do better if nutritive injections were 
depended on to sustain life for a few days or a week or two. The thirst 
may be relieved by sucking small pieces of ice, but iced champagne is 
sometimes borne by the stomach when everything else is rejected, and 
iced carbonic-acid water is often acceptable. 

Medicinal Treatment. — With the exception of subnitrate of bismuth, 
in quantities of five grains, and drop-doses of diluted hydrocyanic acid, it 
is usually advisable not to provoke the irritable stomach with medicines, 



568 DISEASES OF THE DIGESTIVE SYSTEM. 

the hypodermic injection of morphia being used to relieve the pain, if the 
patient can take morphia, or morphia and atropia, in doses of one-eighth 
of a grain of the former and one one-hundredth of the latter in that way 
without nausea being produced. Thin and light poultices, as, for instance, 
of flaxseed meal and laudanum, laid over the region of the stomach, are 
frequently of service, or if the pain is very severe a few leeches may be 
applied. Convalescence from this malady is generally slow, and requires 
great care in regard to diet and exertion. 

DYSPEPSIA. 

This affection, the great torment of civilized life, is to be considered 
rather as an unnatural functional difficulty than as a structural disease. 

Varieties of — Among its three chief varieties may be mentioned : 

First Form. — The form due to sympathetic relations with other organs 
which are themselves in a morbid state, and which is therefore explainable 
as a reflex action. Of such a type is the nausea and occasional vomiting 
which attends irritation of the brain, lungs, liver or uterus. Sea-sickness 
is believed to be a form of this reflex dyspepsia. 

Second Form — This form is attributable to a scanty secretion of 
gastric juice, and is characterized by slowness of digestion, long retention 
of food in the stomach, prolonged distress after eating, especially with 
feelings of weight and uneasiness at the pit of the stomach, a tendency 
to decomposition of the food in the alimentary canal with the evolution of 
fetid gases and the appearance of undigested food in the evacuations from 
the bowels. The food may be considered to be delayed in the stomach 
when it remains there for more than two or three hours. Dyspepsia of 
this kind is often inherited, but much can be done to aggravate the ten- 
dency by mental over-exertion, prolonged and intense anxiety, especially 
if commencing directly after meals, sedentary habits, gluttony, and the 
use of alcoholic and other stimulants. 

Third Form — This form of dyspepsia appears to be owing to some 
abnormal quality of the gastric juice, and to diminished peristaltic move- 
ment of the stomach, so that food is not sufficiently mixed up with the 
digestive fluids. 

Symptoms — One of the most characteristic symptoms of this con- 
dition is pain at the cardiac end of the stomach, to which the name of 
cardialgia has been applied, on account of the distress being in such close 
proximity to the heart. Many dyspeptics, being also more or less hypo- 



DYSPEPSIA. 569 

chondriacs, imagine from this symptom that they are subjects of organic 
disease of the heart, and suffer intense, yet groundless, mental anxiety on 
that account. The names of heartburn, pyrosis and water-brash are 
applied to slight modifications of this symptom. Tobacco contains a 
poisonous principle which, in many persons, favors the development of 
dyspepsia, and some individuals suffer from smoking even a single cigar. 

General Symptoms. — Inability to absorb liquids occurs in some vari- 
eties of dyspepsia, so that fluid which has been swallowed may be heard 
splashing around in the gastric cavity on any forcible agitation of the 
body, the stomach being usually distended to a great extent. As further 
aids in distinguishing between dyspepsia from deficient secretion of the 
gastric juice, and deficient motion of the stomach, it should be remembered 
that in the former neither flatulence nor constipation are generally pres- 
ent, whilst in the latter variety flatulence is one of the most characteristic 
symptoms and constipation is usually well marked. Some of the worst 
cases of dyspepsia from deficient secretion of the digestive fluid, in which 
pain after taking food and other symptoms are particularly severe, ap- 
pear entirely free from flatulence. The tendency of the fermentation 
which goes on in the slowly digesting food seems to be of a kind in which 
gases are not evolved. In all these forms there is a loss of appetite. The 
tongue is usually broad, pale and flabby. The pulse is weak, soft and 
compressible, and palpitation of the heart frequently occurs. There may 
be dyspnoea on exertion and a short dry cough, the stomach-cough of the 
older authors. The general nutrition, of course, suffers, and the face is 
pallid and bloodless to a greater or less degree. 

Treatment — Diet. — 1. The treatment of dyspepsia must be chiefly 
diatetic, although medicines are not powerless in this complaint. In the 
first place all indigestible food, such as pork, veal and salt meats, and 
richly-made dishes, such as pastry of every description, ought to be 
avoided. In the acid forms of dyspepsia, which are connected with de- 
ficient muscular movement, pastry and saccharine substances are par- 
ticularly harmful, and vegetables and fruit should be partaken of spar- 
ingly. In some instances an exclusive milk diet, persevered in for some 
weeks, has appeared to produce marvelously good results ; but, except un- 
der such a regimen, water ought to be the habitual drink. Cocoa, de- 
prived of its fatty ingredients, is often much to be preferred to tea and 
coffee, and those accessory foods, if taken at all, should be weak, cool and 
well diluted with milk. Kich or effervescent wines should be avoided, 
but the lighter Rhine wines or ale, or extract of malt, are often useful in 



570 DISEASES OE THE DIGESTIVE SYSTEM. 

atonic dyspepsia, with impaired movement of the digestive organs. In 
order to improve the general health all the agencies which favor the im- 
provement of the nutrition and enrichment of the blood, such as abun- 
dant exercise in the fresh air, tepid or cool bathing, and warm clothing 
should be pressed into service. The successful prescription of a famous 
English physician to a rich and indolent patient who came to him com- 
plaining of the tortures of dyspepsia was, "Go and live on a shilling a 
day and earn it." 

Medicinal Treatment. — 2. In the medicinal treatment for dyspepsia 
accompanied by undue acidity, as evidenced by the frequency of heart- 
burn, if the urine is scanty and lets fall an abundant deposit, alkalies, such 
as the bicarbonate of soda or potash in quantities of ten to twenty grains 
thrice daily, are useful, and are best taken three or four hours after a 
meal. In acidity with anemia and debility, mineral acids, such as the 
diluted nitro-hydrochloric in five-drop doses, serve the purpose better. 
Vegetable bitters, of which columbo in doses of a wineglassful of the 
infusion thrice daily generally proves the mildest, and nux vomica or 
strychnia are good digestive tonics, and in slow digestion benefit is some- 
times derived from very minute doses of ipecacuanha. 

A good prescription is : 

R. — Tincture nux vomica 4 drachms 

Tincture cinchona 2 ounces 

Tincture gentian 2 ounces 

Simple elixir 2 ounces 

Teaspoonful three times a day. 

For vomiting, besides the remedies already spoken of under gastritis, 
very small quantities of Fowler's solution of arsenic, in two-drop doses, 
or creosote mixture may be tried. For flatulence the aromatic carmini- 
tives, such as ginger and cardamon, and powders of two grains each of 
charcoal with bismuth, also counter-irritation by means of small blisters 
over the stomach are often of great service. When the secretion of gastric 
juice is scanty, pepsin or lactopeptine, in quantities of ten grains, fre- 
quently proves itself invaluable as an aid to digestion; or a prescription 
containing : 

R. — Dilute hydrochloric acid 2% drachms 

Pepsin ( soluble) 2 drachms 

Glycerine 1 ounce 

Elix. aromatica 2 ounces 

Water, sufficient quantity for 4 ounces 

Take one drachm of the mixture in water tlaree times a 
day. Best taken through glass tube. 



ULCER OF THE STOMACH. 



CANCER OF THE STOMACH. 



5Y1 



The stomach is one of the most frequent seats of cancer, which is 
especially apt to attack this organ in men advanced in life who have sub- 
jected their digestive apparatus to more or less constant irritation. The 
tendency is very often hereditary. The cardiac end of the stomach is 
generally the seat of epithelial cancer, and the pyloric extremity of hard 
cancer or scirrhus. Its tendency is to extend around the organ, and hence 
it leads to an annular or ring-like constriction. 

Symptoms. — The symptoms are those of gastritis or mere dyspepsia 
at first, but after a few weeks or months, in a majority of instances, a small 
amount of blood is vomited, and serves to indicate pretty clearly the true 
nature of the case. The blood in cancerous hematemesis of this kind 
being effused slowly and in small quantity is altered by the action of the 
gastric juice so as to present a brown color. This tint and the minute 
clots in which it appears have caused the expressive name of coffee ground 
vomit to be applied to it. Although not an infallible sign, it constitutes 
one of the surest early evidences we possess of the existence of cancer of 
the stomach. This disease is distinguished from gastric ulcer, which it 
most resembles, by its occurrence in advanced life instead of in the young ; 
by the presence of a hereditary predisposition; by the character of the 
hematemesis ; by the greater diffusion of the tenderness ; by the constancy 
of the pain ; by the cancerous cachexia, and, as emaciation advances, by the 
increasing tumor, which can be distinctly felt in most cases through the 
thinned walls of the abdomen. The average duration of cancer of the 
stomach is from six months to one year, and it always proves fatal. 

Treatment, — The only treatment which offers any hope of recovery 
is surgical. 

ULCER OF THE STOMACH. 

Causes. — This remarkable disease is attributed to the corroding action 
of gastric juice on the very membrane which has secreted it, in con- 
sequence of the vitality of that membrane becoming impaired by throm- 
bosis of some small artery in the wall of the organ. Disorder of menstrua- 
tion may develop an ulcer, tight lacing or any occupation which necessi- 
tates constant leaning over, as in shoemaking or tailoring. It is more 
common in females than males, and is more frequent in young women 
than those of middle or advanced age. Traumatism or swallowing any 



572 DISEASES OF THE DIGESTIVE SYSTEM. 

corrosive substance may lead to ulceration. Anderson believes that 
alcoholism, syphilis or mental worry may lead to the condition. 

Appearance. — A simple gastric ulcer is round or oval, about one- 
quarter to one-half an inch in diameter, with thin, clean-cut margins as 
if punched out, but deepest in the centre, like a shallow funnel, though 
varying in depth from a mere destruction of the mucous membrane to 
complete perforation of all the coats. It is usually single and most com- 
monly situated at the back of the organ near its lower or pyloric orifice. 
The ulcer may happen to eat into some large blood-vessel, in which case 
serious or fatal hemorrhage is apt to occur. 

Terminations. — The terminations of such an ulcer are the favorable 
ones of its healing up with or without puckering in the wall of the stomach, 
or, on the other hand, of perforation, which may occur with the escape of 
the contents of the stomach into the peritoneal cavity. Such an accident 
is generally followed by peritonitis and almost certain death. 

Symptoms. — The symptoms of gastric ulcer are pain and tenderness 
over the pit of the stomach, this pain coming on shortly after taking food, 
and increasing until the organ is emptied by vomiting. Sometimes the 
distress seems to extend through into the back. The seat o£ tenderness 
coincides with that of pain, and is localized over a comparatively small 
surface. Vomiting of blood occurs in about one-third the cases, and 
though not so frequent as in cancer is much more profuse. It. may be 
either in black clots or fresh blood, and not infrequently blood is passed 
by the bowels. Vomiting of food half an hour or an hour after eating is 
usual, and various dyspeptic symptoms are met with. The pain is often 
described by the patient as of a gnawing character, and is commonly made 
worse by condiments, animal food, saccharine substances and alcohol; 
whilst the pain in neuralgia of the stomach is frequently relieved by these 
articles of diet. 

Medicinal Treatment. — The most successful treatment of gastric ulcer 
is perfect rest in bed and nourishment entirely by nutritive injections, for 
a period of from one to three weeks, or until the subsidence of the pain 
and tenderness indicate the healing of the ulcerated spot. Prussic or 
hydrocyanic acid and bismuth, as directed in gastritis, may be given to 
control vomiting, and morphia hypodermically, guarded if needful by 
atropia, to relieve pain. Stomach should be washed out twice a day. 
Small blisters over the stomach are frequently useful, and the first 
food administered should be lime-water and milk in very small quantities, 
gradually increased as the power of the organ to retain food is found to 



PERITONITIS. 573 

be restored. If vomiting of blood comes on, perfect rest, the quieting of 
the peristaltic motion of the stomach arid whole digestive tube by full 
doses of a grain every two hours of opium, or one-sixth of a grain of 
morphia, and the use of acetate of lead by the stomach in quantities of 
two grains every three hours, tannic acid and gallic acid by enema, and 
five grains of ergotin hypodermically, are to be resorted to. Ice in small 
pieces may be given frequently, and cold cloths applied over the gastric 
region. Perforation is indicated by severe pain and shock. 

Surgical Treatment. — If the patient grows worse in spite of medical 
treatment, if hemorrhage is profuse, if pain is severe, or if the tenderness 
is marked, surgical treatment must be resorted to and should only be done 
by a skilled surgeon. A number of cases of perforation and hemorrhage 
have been saved by a surgical operation. 

PERITONITIS. 

Character. — This dangerous malady is an inflammation of the perito- 
neum or serous sac covering the intestines, liver, spleen, and so forth, and 
reflected upon the inner surface of the wall of the abdomen. It is prob- 
ably more liable to become quickly and violently inflamed than any other 
structure of the body. It may be either general or local. Local perito- 
nitis may occur whenever any of the organs of the abdominal cavities be- 
come the seat of inflammation. 

Causes. — 1. Exposure to wet and cold. 

2. Traumatism. , r 

3. It may result from the perforation of an ulcer occurring in 
stomach, intestines or liver. 

4. Inflammation of the uterus following confinement and constitut- 
ing child-bed fever, which we see. 

5. It may be secondary to some morbid disease as tuberculosis, rheu- 
matism or Bright's disease. 

Symptoms. — A chill with moderate fever, rapid pulse, intense ab- 
dominal pain, abdominal rigidity, painful respiration. The patient lies 
with thighs flexed, features are pinched, vomiting persistent and bowels 
are usually constipated. 

Treatment — Absolute rest is essential. Eestrict the diet. Give fre- 
quent doses of opium, one grain, or morphine, one-quarter grain. Hot or 
cold applications to the abdomen. In non-perforating cases give saline 



574 DISEASES OF THE DIGESTIVE SYSTEM. 

purge. In perforating cases, which are the most frequent, a surgical 
operation offers the only hope. 

ENTERITIS OR IOTLAMMATION OF THE BOWELS. 

Symptoms. — This disease is not very common, but may arise from 
taking cold, from the abuse of purgatives, from swallowing or inhaling 
irritant poisons, and from peritonitis. Its symptoms are diarrhoea with 
pain, often very severe, increased on pressure and most intense about the 
navel or in the right flank. The frequent discharges temporarily relieve 
the griping pains, which, however, soon return. The pulse is excited, 
generally full and strong and marked fever is present. 

Treatment. — The treatment is by anodyne fomentations or poultices 
to the abdomen, such as the flaxseed poultice with laudanum, and grain 
doses of opium by enema or suppository. Eest in bed must be strictly 
enjoined. 

COLITIS. 

Acute dysentery, bloody flux, an acute inflammation of the mucous 
membrane of the large intestine, generally catarrhal, characterized by 
fever and sometimes followed by ulceration. The causes are summer and 
autumn seasons, sudden changes in the atmosphere, errors in diet, impure 
drinking water, etc. 

Symptoms. — Begins gradually with diarrhoea, loss of appetite, nausea 
and slight fever, which continues for two or three days. When the dysen- 
tery symptoms develop, pain on pressure along the colon, colicky pains 
about the navel, burning in the rectum, and a desire to expel it or tenesmus, 
stools contain mucus and blood, urine scanty and high colored, duration 
about one week, patient emaciated. This may lead on to a chronic con- 
dition. 

Treatment. — Patient should be confined to bed, even in mild cases. 
Discharges should be disinfected with chlorinated lime, diet should be 
bland and unirritating. Milk and lime-water, broths, egg albumen. Be- 
gin treatment with a dose of castor oil, or if fever is high epsom salts, two 
drams, or four drams of rochelle salts, until copious discharge, for the 
pain and tenesmus. Opium in some form, or one-half grain extract opium 
and two grains sugar of lead every two or three hours, or: 



APPENDICITIS. 575 

R. — Dil. sulphuric acid V* ounce 

Spirits camphor i ounce 

Tr. capsicum % ounce 

Spirits chloroform % ounce 

Brandy i % ounces 

One teaspoonful diluted every two or three hours. 



Twenty to thirty grains of subnitrate of bismuth is also valuable 
every two or three hours during convalescence. Cod liver oil, syr. of 
lacto phosphate of lime and ihe following are effective : 

R. — Strych. sulphate Va grain 

Acid muriatic dil 2 ounces 

Tr. gentian co. ad 4 ounces 

Teaspoonful in water before meals. 

APPENDICITIS OR INFLAMMATION OF THE APPENDIX. 

Function of Appendix — Appendicitis is the term applied to inflamma- 
tion of the vermiform appendix. It is almost invariably the primary 
lesion of all those various conditions known as typhlitis or perityphlitis, 
terms which are well relegated to obscurity. The appendix is a small 
tube or diverticulum coming off from the postero-internal part of the 
caecum or beginning of the large bowel, and has no function in man, but in 
herbivora and rodents is a functionally active organ. The position of the 
appendix corresponds about to a point two inches from the anterior spint 
of the pubis on a line down from the spine to the umbilicus. This point 
is known as McBurney's point. 

Causes. — At one time it was supposed that foreign bodies, as seeds, 
pins, etc., were important etiological factors in the production of the 
disease, but Fits' statistics show that only twelve per cent, of cases are 
caused by foreign bodies. Appendicitis is a bacterial disease, usually pro- 
duced by the bacteria which are nominally present in all parts of the 
gastro-intestinal tract, which have a powerful action when the vitality of 
the appendix becomes impaired from any cause, as when the deverticulum 
is bruised, obstructed, or in a state of catarrhal inflammation. 

Where non-traumatic inflammation occurs the swelling of the mucous 
membrane occludes the tissues, obstructing the full communication be- 
tween the appendix and caecum, and the appendix becomes converted into 
a closed sac. Dieulafoy maintains forcibly that appendicitis is always 
caused by the conversion of the appendix into a closed cavity. Partial 



576 DISEASES OF THE DIGESTIVE SYSTEM. 

obstruction may be caused by calculi, which are composed of fecal ma- 
terial mixed with salts of lime or magnesia. These calculi are not formed 
in the colon but in the appendix. Pozzi believes that appendicular colic 
may be caused by bending of the appendix, and holds that pain may 
arise when there is no lesion of the appendix. A foreign body may pro- 
duce immediate perforation, giving rise to a diffuse septic peritonitis. 
Where the lesion of the appendix is occluded it begins to swell and be- 
comes very much congested, the blood supply becomes lessened or cut off 
entirely. The microbes multiply with great rapidity and the wall of the 
appendix may become gangrenous, or it may ulcerate and perforate. In- 
terference with the blood supply of the appendix will predispose to ap- 
pendicitis. 

When the appendix becomes inflamed gradually, the peritoneum 
around it partakes of the process and adhesions are usually formed, thus 
walling off the appendix. In a case of this kind, if perforation should 
occur or the inflammation go to the formation of pus, the adhesion would 
protect the general peritoneal cavity from the poisonous materials. 

Who Are Most Subject — Appendicitis occurs most frequently in 
males, as the blood supply is more abundant. It is rare in infants, but 
occurs most frequently between the ages of sixteen and thirty years. 
Appendicitis that subsides may at any time recur, and the life of the 
patient is under constant menace. It always recurs after a second attack. 

Varieties. — Appendicitis is divided into the catarrhal, obliterative, 
suppurative and gangrenous forms, but as a matter of fact appendicitis 
is always one disease which varies in intensity, and it is useless to divide 
it into a number of symptomatic groups. 

Symptoms. — 1. In what is known as appendicular colic there are 
colicky pains in the right iliac region most marked over McBurney's 
point, but radiating towards the umbilicus, nausea, vomiting and usually 
constipation, but no tenderness in the right iliac fossa or abdominal 
rigidity. 

2. In a genuine case of appendicitis the patient feels listless and out 
of sorts for two or three days before the attack, loss of appetite, furred 
tongue, foul breath and constipation is the rule, but in exceptional cases 
there may be diarrhoea. 

3. The onset is usually with colicky pains which at first may be 
general over the whole abdomen but most intense over McBurney's point. 
Circumscribed tenderness over McBurney's point and across may be felt. 



APPENDICITIS. 



577 



There is moderate fever, and vomiting is usually present with constipa- 
tion, abdominal muscular rigidity. 

4. As the attack progresses the fever becomes more intense, radi- 
ating towards the umbilicus and the tenderness over McBurney's point 
recrosses. The pulse increases and fever rises, vomiting becomes worse, 
respiration more rapid and thoracic in character. The patient lies upon 
the back with right leg drawn up. The urine is scanty and highly colored. 
Any case may become suddenly desperately grave because of perforation 
or gangrene. 

Terminations — Appendicitis may terminate in recovery, in death, or 
in a condition of lowered vitality, renewed attacks being certain to occur. 

Treatment. — 1. In appendicular colic apply a hot water bag over 
McBurney's point, give a saline cathartic and watch patient for fur- 
ther symptoms. 

2. Many surgeons give a cathartic in undoubted cases of appendicitis, 
but the increased peristalsis and tension caused is liable to give rise to 
perforation. 

3. In a genuine case of appendicitis perfect rest, liquid diet, ice bag 
to McBurney's point. Do not use opium in any form as it masks the 
symptoms. If the symptoms are not better in thirty-six hours, operate. 

4. McBurney says, if six hours after the beginning of the attack the 
patient is no worse there is no pressing danger, if in twelve hours symp- 
toms are not intensified they will soon begin to abate, but if in twelve 
hours the symptoms have become worse, operation is necessary. 

5. It is always better to operate in the interval between the attacks 
than during an attack. It is not safe to delay operation in a pus case. It 
must be remembered that the mildness of the symptoms is no assurance 
that even in an hour or two gangrene or perforation will not occur. 

A person of generally good health who suffers for some time with 
vague digestive troubles may find himself a victim. 

Pain occurs in the right side of the abdomen between the ribs and 
the hip. It is accompanied by colicky paroxysms, more or less violent, 
which may or may not be followed by vomiting of food or bile. The 
colic eventually subsides, but a fixed pain continues, sometimes exactly 
limited to the point of the appendix and sometimes spreading more or 
less over the bowels. The muscles of the appendix region become hard. 
Usually there is but little fever. 

Notwithstanding the general opinion of physicians that operation is 
necessary, there are many eminent medical men who are of the opinion 
37 



578 DISEASES OF THE DIGESTIVE SYSTEM. 

that appendicitis is in many cases open to medical treatment capable of 
effecting cure. The following prescription is one of the best which has 
been compounded for this trouble. 

Cascara Compound. 

Cascarin J4 grain 

Aloin 14 grain 

Podyphyllum 1/6 grain 

Ext. Bella Leaves % grain 

Strychnine Sulph 1/60 grain 

Oleresin Ginger % grain 

Take one at night or night and morning. 

All drastic cathartics must be avoided. The prescription just given 
should properly regulate the bowels. It is intended to remove all gases, 
sweeten the stomach and aid digestion. It is claimed on high authority 
that it will prevent appendicitis and surgical operation if it is taken in 
due time. 

Rest is necessary and the intestines should be kept in a quiet condi- 
tion. An ice cap may be applied over the seat of the pain. It is advisable 
that the patient go to bed and assume such position as will — so far as 
possible relax the abdominal muscles. Abdominal movements such as 
may be caused by sneezing, coughing, etc., should be avoided. The diet 
at first should consist only of small quantities of cold or lukewarm milk, 
oatmeal, bouillon, etc. ; avoid meat and starchy foods. It is held by 
some that there is great virtue in the external use of kerosene oil in cases 
of appendicitis. If unfavorable conditions continue, or attacks are fre- 
quent, the appendix should be removed. We recommend consultation with 
physician without delay. 



INTESTINAL OBSTRUCTION. 

This term is applied to the obstruction of any part of the intestinal 
canal. It may be acute or chronic. 

Causes — Obstruction may be caused : 

1. By a band, which, becoming looped or attached to one or more 
organs, forms a noose through which the intestine slips. This manner 
of compression is known as strangulation. 



DYSENTERY. 579 

2. By one portion of gut slipping into another. This is known as 
intussusception or invagination. 

3. By kinking of the gut. 

4. By the narrowing of the lumen, by contraction of scar tissue or 
the encroachment of tumors. 

5. By the pressure of foreign bodies large enough to obstruct the 
lumen. 

Symptoms of Acute Obstruction or Complete Obstruction. — The active 
symptoms are usually preceded by a period of constipation, with a feeling 
of lassitude, furred tongue and foul breath. 

1. Pain comes on abruptly, first colicky, then continuous and intense. 

2. Vomiting quickly supervenes and is, first, of the stomach contents, 
then bilious, and finally fecal. 

3. Abdominal distension occurs if the obstruction is in the lower 
bowel, but may not be present if the obstruction is high up. Constitu- 
tional symptoms are those of shock. Thirst is intense, urine scanty and 
highly colored. 

Symptoms of Chronic or Partial Obstruction — Symptoms appear grad- 
ually with the increase of the narrowing until there is complete obstruc- 
tion, or the symptoms of acute obstruction occur from time to time. 

Treatment. — Purgatives are contra-indicated. Food must be with- 
held and nutrition given only by the rectum. Give opium or morphine for 
the pain in doses of one grain of the former and one-quarter grain of the 
latter. 

Accessory Treatment. — Washing out the stomach twice a day to con- 
trol the vomiting. Distension of the bowel with, gas or water should be 
practiced in doubtful cases and in intussusception. Senn recommends the 
infiltration of hydrogen gas. If these methods fail to relieve the obstruc- 
tion a surgical operation must be done at once. 

DYSENTERY. 

This is a febrile disease, characterized by severe colicky pains, fol- 
lowed by straining, which results in scanty mucous or bloody stools, con- 
taining little or none of the natural fecal matter or excrement. 

Causes. — It is especially prevalent in warm climates, and warm 
weather and bad hygienic surroundings play an important role in its 
production. Indigestion of irritating foods, exposure to cold or wet, cer- 
tain debilitated states, as scurvy, Bright's disease, etc., seem to be pre- 



580 DISEASES OF THE DIGESTIVE SYSTEM. 

disposing causes and may alone produce the simple form. The tropical 
form is due to an animal parasite, the amoeba coli. 

Symptoms. — There is moderate fever, severe colicky pains in the ab- 
domen, prostration, tenesmus or straining, constant desire to defecate with 
small mucus and bloody stools. These symptoms are aggravated during 
the night and early morning, and leave behind them the tormenting sensa- 
tion that there always remains in the bowels something which has yet to 
be discharged. This sensation, which is technically called tenesmus, in- 
creases, and ultimately becomes the most striking feature of the disease. 
When the malady is fully established, the evacuations consist of bloody 
slime, sometimes tinged with bile, and containing shreds of membranous- 
like exudation thrown off from the interior of the bowels. They exhale 
an odor almost peculiar to dysentery, very offensive and yet quite different 
from that of ordinary feces. This complaint may prove fatal in con- 
sequence of the great loss of blood, but it more commonly causes death by 
wearing out the patient. 

Other Symptoms. — When a fatal termination threatens, the symptoms 
assume a typhoid character, with great prostration, dry, brown tongue, 
hiccough and vomiting. In favorable cases improvement begins about 
the end of the first week, but convalescence is usually very protracted, and 
many cases stop half way, as it were, continuing to suffer for months 
or years with the chronic form of the affection. 

Common to Children. — This disease is very common among young 
children, being especially prevalent and fatal among those who are cruelly 
kept in cities during the hot summer months, and it is the usual result of 
starvation or deterioration of food, especially if long continued and ac- 
companied by hardship and privation, being then an extension of the 
diarrhoea which is apt to be first produced. 

Treatment. — A mild laxative is indicated in the beginning as epsom 
salts, three drachms, or castor oil and laudanum might be selected. Bis- 
muth is a valuable remedy. Absolute rest in bed and bland, non-irritating 
liquid diet. The following may be found useful : 

4 R.— 

Bismuth 40 grains 

Creosote 15 drops 

Simple syrup . 2 ounces 

A teaspoon ful every three hours. 

After the more violently acute stage has passed, laudanum injections, 
or opium by suppositories, with such astringents as two grains of acetate 



DIARRIICEA. 581 

of lead, half a grain of nitrate of silver, and of sulphate of copper com- 
bined with small doses a quarter or half a grain of opium by the mouth, 
are generally beneficial, but care must be taken not to check the disease 
too suddenly by the use of these remedies. 

Additional Treatment. — Flushing out the bowels with a saline solu- 
tion may be tried, or starch water containing one grain of opium may be 
found beneficial. Hot fomentations over the abdomen may be used to 
relieve the pain. Injections of warm solutions of quinine, 1-5000 have 
been used in dysentery with advantage. Creolin, a drachm to the pint, 
has given good results. 

Diet. — The diet, as pointed out before, should consist of the blandest 
and most unirritating substances, such as boiled milk with lime-water, beef 
essence, boiled rice, and if the debility is extreme, raw eggs beaten up 
with milk. Stimulants should not be administered unless absolutely neces- 
sary, on account of their locally irritating effect. 

DIARRHOEA. 

Causes. — In many cases this common malady is also rather a con- 
sequence or symptom of some morbid condition than itself a disease. The 
frequent discharge of loose or fluid evacuations from the bowels, without 
griping pain or tenesmus, is sometimes a wise effect of nature to get rid 
of some injurious or indigestible material, which has been imprudently 
swallowed into the stomach and has from there passed into the bowels. 
Diarrhoea may likewise be produced by some violent mental impression, 
or by exposure to taking cold, the bowels instead of the throat being often 
the weak spot of the individual. It also results from privation of food, 
food of poor quality, and many analogous causes. 

Medicinal Treatment — In the treatment of diarrhoea from indigest- 
ible food no attempt should, as a rule, be made at first to check it until 
the offending material, whatever it may be, is cast out of the system. 
In fact, a gentle and soothing laxative, such as a dose of castor-oil with a 
few drops of laudanum to hasten along the conservative action of empty- 
ing out the intestinal canal, is often of great service. 

Stopping Evacuations. — After this is accomplished, however, each ad- 
ditional evacuation is an evil, which should be prevented by the use of 
five grains of bismuth or chalk, with three grains of tannic acid, or in a 
teaspoonful of either syrup of galls, or syrup of krameria, and a quarter 
of a grain of opium, or by opiates combined with carminatives like laven- 



582 DISEASES OF THE DIGESTIVE SYSTEM. 

der, or ginger, and camphor, a good mixture being ten drops of laudanum, 
fifteen of compound spirits of lavender, and &yg of spirits of camphor, 
taken on a lump of sugar every hour or two until relieved. 

Additional Treatment. — If the stomach is unsettled, as is frequently 
the case, the opiate and astringent may be administered with advantage by 
enema or suppository, and in patients who cannot, or think they cannot, 
retain medicines in either the stomach or rectum, hypodermic injections 
of the eighth of a grain of morphia may often be resorted to with the 
happiest effect. 

Diarrhoea Mixture. — A good rule in taking a diarrhoea mixture is to 
use a moderate dose every two hours, provided the loose passages recur 
within that time, but if at the end of two hours there has been no liquid 
or semi-liquid evacuation in the interval, to wait until such a one occurs 
before resorting again to the remedy. In this way the blunder of so over- 
doing the good work of checking the diarrhoea as to inflict upon the system 
its opposite evil of constipation may generally be avoided. The patient 
thus gains from the remedy all the good with as little of the necessary 
evil, which lurks in the bottom of every cup of blessing, as possible, a 
desideratum which should constantly and persistently be kept in view in 
every kind of medical treatment, as well as all other affairs of life. 

Other Remedies. — Among the various other valuable remedies often 
beneficial in this exceedingly common disorder, may be mentioned the 
tincture of kino, catechu and logwood, acetate of lead, sulphate of copper 
and sulphate of zinc, nitrate of silver, spirits of chloroform, tincture of 
capsicum, spirits of camphor, compound spirits of lavender, and so forth. 

Accessory Treatment — In cases s of diarrhoea, where the tongue is 
white and coated, the pulse accelerated, the temperature a little raised, 
and some pain or soreness, increased by pressure, is felt in the abdomen, 
small doses of epsom or Glauber's salts, in conjunction with hyoscyamus 
and opium, and perfect rest in bed with the most rigid attention to diet, 
are necessary, lest the slight irritation of the mucous lining of the ali- 
mentary canal become aggravated into actual inflammation, and moro 
serious disease, such as dysentery, enteritis or obstinate chronic diarrhoea 
result. 

Diet — The diet of a person suffering from diarrhoea must be very 
strictly regulated, and, in fact, nothing but tapioca, sago, boiled rice or 
milk-toast with boiled milk, twice-boiled water, beef-tea and table-tea 
should, as a rule, be put into the stomach. Even after the malady seems 
to be cured, much caution must be exercised about returning to the or- 



CONSTIPATION. 583 

dinary diet. This disease, like most others, indeed, exhibits as it passes 
away a singular analogy to a conflagration, which for days after it has 
apparently been extinguished is ready to break out again, if the remain- 
ing sparks happen to be fanned into a name by the wind or any new fuel 
is supplied. 

CONSTIPATION OR COSTIVENESS. 

Definition. — This diseased condition, the direct opposite of the preced- 
ing one, may be denned as a retention of the fecal matters beyond the 
usual period, so that they are passed with difficulty and in a comparatively 
hardened state. 

Causes — The causes of constipation are almost infinitely various. 
Every form of impaired digestion may originate it ; the existence of piles 
or hemorrhoids, a sedentary life, application to study, amenorrhea and 
uterine disease in females, all are apt to induce it, and almost every acute 
disease is frequently ushered in by constipation. It is more often met 
with among women than men, probably because the female sex fail to 
exercise sufficiently in the open air ; and many articles of food largely con- 
tribute to establish the evil of habitual constipation. 

Treatment of the Acute Form.— If the trouble be occasional and acci- 
dental, any of the milder laxatives, such as a tablespoonful of epsom or 
Glauber's salts, rochelle salts, castor-oil — which is the safest purgative, as 
a rule — ten or fifteen grains of rhubarb, senna, or the various purgative 
mineral waters may be employed. For some patients, injections of warm 
water, or soap and water, answer a very good purpose, and if administered 
with care are perfectly harmless. 

Treatment of the Habitual Form. — Habitual constipation is best 
treated by the regulation of the diet, partaking of fresh or stewed fruits, 
bran bread and vegetables in season, in proportions sufficient to antagonize 
the torpor of the bowels ; at the same time resorting to active exercise in 
the open air, and endeavoring to correct any faulty habit of life, which 
may be the primary cause of the trouble. If the difficulty had its origin 
in hereditary tendency, or other deep-seated modification of the organism, 
laxatives should be resorted to, because, in the writer's opinion, at least, 
the evils of constipation are far greater than those arising from the con- 
stant employment of these medicines. 

Additional Treatment.— It is probable that for most persons saline 
laxatives, such as rochelle salts, or purgative waters during the summer, 
and in cold weather pills of a grain of rhubarb, one-sixth of a grain of 



584 DISEASES OF THE DIGESTIVE SYSTEM. 

podophyllin and a grain of compound extract of colocynth, teaspoonful 
doses of the compound liquorice powder, or nd. extract of cascara sagrada 
daily will be beneficial. This acts as a tonic to the muscular coat of the 
bowels. 

Relieving Constipation — Obstinate constipation — that is, absence of 
evacuation for several days, or a week or two — is a dangerous condition, 
and should never be permitted to occur, since the large and densely-packed 
masses of feces may require the operation of drastic cathartics to dislodge 
them, and- such medicines, in accomplishing their work, sometimes set up 
serious or fatal inflammation. Liberal potations of castor-oil, aided by 
large enemas, may first be tried in such a case ; then senna, in teaspoonful 
doses of the fluid extract ; then quarter or half -grain doses of tartar emetic, 
in conjunction with epsom salts, and if these fail, it may be necessary, 
under skillful advice of a physician, to resort to drastic cathartics, such as 
gamboge, calomel, elaterium and croton oil, provided no organic obstruc- 
tion exists. 

HERNIA OR RUPTURE. 

Definition. — Hernia is the name usually applied to the protrusion of 
some portion of the bowel or any abdominal viscera through the wall of 
the abdomen. 

Varieties. — "We may have umbilical hernia or protrusion of the bowel 
at the navel, a form often seen in children ; and hernia in the groin or in- 
guinal hernia, which is probably a most common variety. It has been 
estimated that about one man in every seven is affected with hernia, but 
in most cases the intestine is kept in its place more or less perfectly by 
some form of truss. When a hernia can be pushed back it is called re- 
ducible. An irreducible hernia cannot be returned into the cavity of the 
abdomen, and is constantly in danger of being inflamed, by some ac- 
cidental blow for instance, and so becoming strangulated. 

Causes. — Hernia is sometimes produced or driven out under some 
treacherous truss, which should protect against such an accident, by very 
slight causes, all of which should be carefully guarded against by those 
who have any hereditary tendency to this disease. It may be forced out 
by a jerk, such as suddenly pulling open a door that sticks, or by a fall, 
by an attempt to lift a heavy weight or to raise a moderate one whilst 
in a constrained position, or any other act which tends to bring a strain 
upon the bowels, making them bear downward. It is also favored in its 
occurrence by overeating, by excessively exhausting exertion, and by 



HERNIA OK RUPTURE. 585 

severe effort at times when the body is enfeebled by disease. It is more 
common on the right than on the left side of the body. 

Symptoms. — The symptoms of strangulated hernia are intense pain, 
not only in the neighborhood of the rupture but over the whole abdomen 
and especially around the navel, obstinate vomiting, and cessation of the 
passages from the bowels. At first there may be one or two evacuations 
of the fecal matters already below the seat of strangulation, but after that 
is cleared out the bowels cease to move, and if the strangulation is unre- 
lieved the vomiting, which persists in spite of all remedies, results in 
bringing up fecal material through the throat. This is a very curious 
phenomenon, and seems to indicate that nature in her stupid zeal to get 
rid of digested materials, on finding that the usual avenue downward is 
blocked, soon reverses the normal peristaltic movement and tries to evac- 
uate the bowels through the mouth. In accordance with this idea the im- 
portance of such stercoraceous vomiting, as it is called, in the diagnosis 
of strangulation of a hernia, or some similar obstruction, is very great. 

Treatment of Strangulated Hernia. — When fecal vomiting occurs, if 
undecided before, not a moment should be lost in sending for the best 
medical skill which can be procured, and which even then may arrive too 
late. In the absence of medical assistance, reduction of an obstinate 
hernia on the point of becoming strangulated, or perhaps already com- 
pressed, may sometimes be accomplished by putting the patient in a warm 
bath, and so relaxing the system as already explained; or a full dose of 
opium or morphia, the former preferably by enema, may perhaps have the 
desired effect ; or lastly, the administration of ether or chloroform, by one 
who is accustomed to giving these anesthetics, by still more fully relaxing 
the system, may happily allow the endangered fold of the intestine to be 
pushed back into its proper place. If the hernia cannot be reduced an 
operation is absolutely necessary and is attended with but very little risk 
in the hands of a skilled surgeon. 

Treatment of Reducible Hernia — In this form of hernia the contents 
of the sac can be reduced into the abdominal cavity. The treatment may 
be palliative or radical. 

Palliative Treatment — Prevent constipation, avoid sudden strains 
and violent exercise and order a truss. The continual employment of a 
truss, especially in young persons, may bring about a cure. The day truss 
should be applied before rising in the morning and be removed after lying 
down at night, when a light truss may be substituted. A truss is always 
uncomfortable at first, but a person soon grows used to it. It should be 



586 DISEASES OF THE DIGESTIVE SYSTEM. 

kept perfectly clean, and it is well to dust borated talc powder upon the 
skin under the pad at least once a day. A truss which does not keep the 
hernia up increases pain and does harm. Too strong a spring tends to 
enlarge the hernial opening and thus aggravates the cause. 

Radical Treatment. — This is operative and the sac is completely closed 
and a new canal formed. These operations show a very small percentage 
of recurrences. 

INTESTINAL WORMS. 

The intestinal canal is often the home of parasites, commonly called 
worms, and in many parts of the country nearly all children between the 
ages of one and seven years, as well as many older persons, are troubled 
with these pests. 

Varieties. — 1. In childhood the usual inhabitant of the bowels is the 
round-worm or ascaris lumbricoides, a creature attaining the size of a 
large earth-worm, which it resembles in appearance, except that it is 
whitish or brownish, and stiffer and harder in its structure. 

2. Children are also often infested with the oxyuris, commonly called 
the thread-worm, pin-worm, or seat-worm. This parasite is, sometimes 
found in great numbers about and just within the fundament. In size 
they are very nearly that of a very small pin or piece of thread about half 
an inch long, but by their number and activity they often contrive to prove 
very troublesome guests to their unwilling host. 

3. The third common parasite which preys upon the human species 
is the taenia solium or tape-worm, of which some account has already been 
given. These parasites are always introduced into the system from out- 
side, either with food or drink, and hence one great reason for the good 
cooking so strenuously urged in a former chapter. They are a great source 
of irritation as long as they remain, and in childhood, by the reflex irri- 
tation their movements in the intestines are capable of exciting, constitute 
one of the common causes of convulsions. Exactly what articles of food 
convey the eggs of the round-worms and the pin-worms into the human 
system has not yet been discovered, but the tape-worm is known to find 
its entrance into our bodies by the eating of raw meat, generally beef 
or pork. 

Symptoms of Round-Worms. — The symptoms are often absent. When 
present there are usually symptoms of dyspepsia, diarrhoea, with mucous 
stools, colicky pains in abdomen, voracious appetite which it is almost 
impossible to satisfy. There is anemia and often reflex nervous phenom- 



COLIC. 



587 



ena such as "night terrors/ 7 grinding of the teeth, itching of the nose and 
anus, twitching of the face and limbs and there may be convulsions. 

Treatment. — The diet should be restricted before the remedy is ad- 
ministered. The most effective remedy is santonin, which is best given 
with calomel, as in the following: 

R. — Santonin 5 grains 

Calomel 5 grains 

Sugar 20 grains 

Divide into ten powders, and take one powder morn- 
ing and evening. 

Fluid extract of spigelia, one to three fluid drachms, often proves 
very effective. 

Symptoms of Pin-Worms. — These chiefly affect the lower colon and 
rectum, and produce severe itching of the anus and adjacent parts. 

Treatment. — Flush out the bowel with water, then inject infusion of 
quassia chips two or three drachms to the pint of water. 

Symptoms of Tape-Worm. — These are frequently absent. There may- 
be dyspeptic symptoms, colicky pains in abdomen, loss of flesh, capricious 
appetite and at times reflex nervous phenomena as vertigo, palpitation, 
"night terrors," convulsions, itching at nose and twitchings of limbs and 
face, especially the latter. 

Treatment — A light diet for a day or two previous to the administra- 
tion of the remedy, so that the worms will be hungry enough to feed 
upon the drugs administered. After an unsubstantial breakfast admin- 
ister one of the following efficient remedies : Pumpkin seeds, two to three 
ounces, oleoresin of aspidium, one to two drachms; pomegranate, one 
drachm. 

Auxiliary Treatment. — Before giving any of these the bowels should 
be thoroughly emptied by a good purge, and about twelve hours after the 
administration of the remedy another purge, preferably castor oil, 
should be given. The treatment is successful only when the head is passed, 
so the stools must be watched carefully. If not successful the first time 
try again in a day or two. 

COLIC. 

Colic is an acute spasmodic affection of the bowels without diarrhoea 
or much fever, but attended with severe cramps of the abdominal muscles. 

Causes. — Its most common causes are indigestible food, reflex irrita- 
tion from the uterine or ovarian disease, and lead poisoning. 



588 DISEASES OF THE DIGESTIVE SYSTEM. 

Symptoms. — The great characteristics of colic are the griping, twisting 
pains, radiating from the navel and relieved by pressure. Care must be 
taken not to mistake these pains for those of strangulated hernia, or the 
converse, which would be a much more serious blunder. 

Treatment. — The treatment is to relax the spasm by opiates, and 
remove the offending material if there is any in the bowels. For the 
former purpose twenty or thirty drops of laudanum by enema or hypo- 
dermics of one-eighth of a grain of morphia, and for the latter a table- 
spoonful of castor oil or a Seidlitz powder answer very well in most 
instances. 

HEMORRHOIDS OR PILES. 

Hemorrhoids or piles are exceedingly commpn and troublesome com- 
plaints, consisting of little tumors which form at the edge or just inside 
the fundament, and give rise to intense suffering, especially when the 
bowels are evacuated. 

Varieties. — There are three varieties: external, internal and mixed. 

Causes. — Their production is favored by constipation, sedentary 
habits, hard seats, and some forms of liver complaint. 

Symptoms. — The inflammatory enlargement is detected and is tender 
and inflamed. Pain on evacuation of bowels. The external variety does 
not bleed. Very often their surface, which in the internal variety is com- 
posed of the distended mucous membrane, exudes blood, in which case 
they are called bleeding piles. When seated outside the margin of the 
fundament they are not so apt to bleed, and receive the name of blind piles. 

Treatment. — They may generally be prevented from developing by 
proper attention to the bowels, non-stimulating diet and rest, and, whilst 
small, an ointment of ten grains of extract of belladonna, thirty grains of 
tannin, and twenty grains of powdered opium in an ounce of simple oint- 
ment, will usually relieve them. 

Auxiliary Treatment. — Injections of cold water into the rectum, bath- 
ing the parts with cold water after each bowel movement, or an ointment of 

Chrysarobin 15 grains 

Iodoform 5 grains 

Extract belladonna 10 grains 

Vaseline 4 drachms 

Apply three times a day. 

Apply this night and morning after carefully cleansing the part. Ex- 
tract of hamamelis is a valuable application for external piles. When the 



FISTULA IN ANO. 589 

acute symptoms subside use lead water and laudanum. If the internal 
piles prolapse and inllame use, in addition to the above, Allinghour's oint- 
ment on the parts. If the piles are protruding and reduction cannot be 
affected put the patient to bed, give a hypodermic of morphine sulphate 
one-fourth grain and apply hot poultices. 

Surgical Treatment. — If hemorrhoids do not yield to the above treat- 
ment surgical operation is necessary, which is accompanied with very 
little danger. It may be done under local anesthesia, but general anes- 
thesia enables an operator to accomplish his task with more thoroughness. 

FISTULA IN ANO. 

Causes — Fistula in ano is a very painful disease, in which a com- 
munication at the side of the fundament is opened through the flesh into 
the rectum, or lower bowel, above the sphincter or muscle which ordinarily 
keeps it closed. It is usually the result of an abscess at the side of the 
intestine. There are several varieties of fistula, in the worst of which the 
fecal matters from the intestines constantly leak out through the hole 
or sinus, and besides causing great irritation and pain, render the sufferer 
disgusting to every one whom he approaches. Most of these different 
forms of fistula can, however, be cured by severe surgical operations. 

Fissure of the Anus. — This is another painful affection, in which a 
slit or crack appears in the side of the fundament, often the result of a 
small ulcer at the edge of the opening. As it must be torn apart every 
time the bowels move it is very difficult to heal. Sometimes fissure of this 
kind can be cured by touching the sore with caustic, and using laudanum 
injections to keep the intestine in a state of comparative rest, but if these 
fail a surgical operation is the only remedy. 

Prolapsus Ani, called also falling of the bowel, is the coming down 
of the rectum, which protrudes outside of the body sometimes to the dis- 
tance of three or four inches. It generally results from constipation, and 
is especially apt to occur in weakly and neglected children. The protrud- 
ing portion of the intestine should be carefully and gently pushed back to 
its place with the fingers covered with a well-oiled silk handkerchief, and 
suitable apparatus obtained from the instrument makers to keep it in 
position. Sometimes an operation is necessary. 



590 DISEASES OF THE DIGESTIVE SYSTEM. 

DISEASES OF THE LIVER 

JAUNDICE. 

Jaundice is rather a symptom of disease than a separate malady. 

Causes. — It may be due to a suppression of the secretion of bile by the 
hepatic cells ; or, again, by an over-activity of these elements, and a super- 
abundant supply of bile in the system; or, thirdly, by obstruction to the 
outflow of bile, and reabsorption of its elements into the blood. 

Symptoms. — It consists of a morbid yellowness of the skin, the white 
of the eye and other parts ; but in bad cases this yellowness may become bo 
intense as to appear olive-green, brown or even black. The urine is also 
of a yellow or saffron color, but the discharges from the bowels are pale 
and devoid of the natural brownish-yellow tint, sometimes having the 
bluish-white of potter y s clay. Troublesome itching of the skin, slow pulse, 
low temperature, debility and a tendency to hemorrhage from the mucous 
membranes are frequent in jaundice. 

Diagnosis. — The most important practical point is to determine 
whether the gall-ducts are obstructed or not. If they are closed, so that 
the stools contain no bile, the jaundice speedily becomes intense and the 
swollen gall-bladder can sometimes be felt below the edge of the ribs. 
When not obstructed, the reverse is the case. Jaundice which comes on 
suddenly is probably due either to a gall-stone or to nervous disturbance. 
Intense jaundice which has developed very gradually probably results 
from pressure outside of the gall-duct, such as would be produced by a 
tumor or cancer. 

Gail-Stones. — Intermittent attacks of jaundice point to gall-stones in 
old people, and to catarrh of the bile-ducts in children. Paroxysmal pain 
preceding jaundice points to gall-stones; following jaundice, to cancer 
of the liver. Jaundice with great enlargement of the liver, if the latter 
is painful and tender on pressure, indicates cancer; if painless, it sug- 
gests the waxy or lardaceous condition of the liver. When jaundice ac- 
companies ascites, it is usually due either to cancer or cirrhosis. The 
danger of life from jaundice, unless it does indicate some fatal disease 
like cancer or cirrhosis, is small ; but in its severer forms it is often very 
obstinate, lasting for weeks or months. 

Treatment. — The treatment consists of small doses of calomel or blue 



LIVER COMPLAINT. 





"*W 



| *W* 



' 







Normal or healthy liver 



Diseased liver 



KIDNEY DISEASE. 





Healthy kidney 



Bright's disease 



ABSCESS OF THE LIVER. 



59i 



pill followed by a saline purge for a few days, avoiding salivation. The 
mercurial medicine may be substituted or aided by five grains of extract 
of taraxacum; podophyllin and leptandrin, in quarter-grain doses, and 
bicarbonate of soda in quantities of ten grains. Later on in the attack, 
five-drop doses of diluted nitro-muriatic acid may be administered with 
advantage, leaving a few days' interval between the last dose of any 
mercurial and the acid remedy. The phosphate of soda is also useful. 

Jaundice of Infancy — It is very common to observe jaundice com- 
mence in the first or second day after birth. Usually of no importance. 
Probably due to diminished pressure in the portal system or to poteut 
ductus arteriosus. Recovery takes place in a few days or weeks. The 
severe forms may depend on septic poisoning with inflammation o£ the 
umbilical vein, congenital inflammation of the liver due to syphilis or 
congenital absence of the hepatic duct. 

CONGESTION OF THE LIVER. 

Causes — Acute congestion of the liver may result from cold, from 
over-eating, or from the abuse of alcohol. 

Symptoms. — Its symptoms are enlargement of the organ with tender- 
ness on pressure, and a feeling of painful tension on the right side just 
above the edge of the ribs, often radiating to the right shoulder, slight 
jaundice, furred tongue, loss of appetite and scanty, high-colored urine 
are present, and the whole group of symptoms constitues the condition 
commonly designated as "being bilious." 

Treatment. — It is generally relieved by a small blue pill, or small 
doses of calomel followed by a saline purgative, and attention to diet for a 
few days. If neglected this form may run on to chronic congestion or lay 
the foundation of inflammation of the liver. 

ABSCESS OF THE LIVER. 

Abscess of the liver is the formation of pus in the substance of the 
organ. There may be one large abscess cavity or many small ones. 
Causes. — 1. It may be due to injury. 

2. The presence in the liver of the amvela culi of dysentery. 

3. Foreign bodies, gall-stones and retained bile. 

4. Septic emboli which may come through the hepatic artery but 
usually through the portal vein from other diseased viscera and produce 
a purulent inflammation of the vein. 



592 . DISEASES OF THE DIGESTIVE SYSTEM. 

Symptoms. — The fever is of the hectic variety, high in the evening 
and low in the morning. Chills are sometimes present; pain is variable 
and may be felt in back of right shoulder. The liver is enlarged, painful 
and tender. Marked jaundice is rare. There may be bulging, and fluctu- 
ation is sometimes detected. 

Treatment. — There is only one treatment, which is surgical. 

Degenerations of the Liver. — Acute atrophy of the liver, waxy liver, 
and fibroid deposit in the liver are various forms of degeneration for 
which little can be done by medical treatment and which are fortunately 
rare. Not so, however, as far as regards infrequency, with cirrhosis of 
the liver, called also drunkard's liver and hob-nail liver, because of its 
origin in the abuse of alcohol and the peculiar contracted form which it 
presents. The process which the liver undergoes is a condensation of the 
substance and destruction of the secreting cells, with thickening of the 
connective tissue. The whole liver gradually contracts, ceases in great 
measure to manufacture bile and, becoming an obstruction to the venous 
circulation, produces ascites or abdominal dropsy, under which the suf- 
ferer generally succumbs. 

LIVER OR HEPATIC COLIC (GALL-STONES). 

Gall-stones are hard concretions which form within the gall-bladder, 
and when they attempt to pass out through the gall-duct often give rise 
to the most excruciating agony which the human being is capable of 
suffering. 

Symptoms. — This pain is called hepatic colic, on account of its grip- 
ing, tearing character, and may generally be distinguished by its coming 
on and passing off suddenly; by its frightful intensity; by being deep- 
seated instead of superficial ; by being accompanied with vomiting and by 
the pulse being rapid and feeble. The onset may be marked by a chill and 
fever. It may last from a few moments to several days, and is often so 
severe that strong men will sometimes writhe and roll around on the 
floor, screaming in their agony. It seldom comes on before middle life, 
and women are much more frequently attacked than men. The pain is 
chiefly in the upper part of the abdomen on the right side. If a gall-stone 
remains in the duct for more than twelve hours, it is usually followed by 
jaundice coming on two or three days later. The affection terminates 
either by the stone slipping back into the gall-bladder or passing out 
through the duct into the bowel, in which latter event it may be found 



DROPSY OF THE ABDOMINAL CAVITY, 593 

in the evacuations during the next week, and should always be searched 
for. The stone usually varies in size from that of a small shot to an inch 
or more in diameter, and in color from yellowish-white to dark-brown. If 
single, it is usually oval or rounded ; but if two or more have been formed, 
the first one is marked by impressions of the others, and thus the prospect 
of future attacks can be estimated. Notwithstanding the alarming suffer- 
ing the danger to life is small, and death rarely eventuates from hepatic 
colic. 

Treatment. — The treatment is by thirty-drop laudanum enemas or 
hypodermic injections of a quarter of a grain of morphia and one-one- 
hundredth of a grain of atropia, with chloroform or ether by inhalation, if 
the pain is unendurable. Hot fomentations, or hot baths, sometimes 
afford partial relief. In order to prevent the recurrence of hepatic colic, 
small doses of carbonate of soda, alkaline mineral waters, or a mixture 
of chloroform and turpentine have been highly recommended. 

Value of X-Ray. — The use of the X-ray was found valuable in the 
diagnosis of gall-stones. 

ASCITES OR DROPSY OF THE ABDOMINAL CAVITY. 

Symptoms. — The prominent symptom of ascites is the distension of 
the abdomen, which sometimes becomes enormously swollen, and by the 
pressure upward of the diaphragm gives rise to distressing dyspnoea. 

Treatment. — When possible endeavor to remove the cause. Purge 
freely with concentrated salines, compound jalap powder twenty to thirty 
grains, elaterium one-eighth grain. Increase the action of the kidneys by 
infusion of digitalis two drachms, citrate of caffeine three to five grains, 
diuretin fifteen to thirty grains. 

Auxiliary Treatment. — If the effusion is large and does not yield to 
the above treatment tapping is indicated, which is a procedure accom- 
panied by very little danger. ]STo anesthetic is required, and it gives 
almost immediate relief to the dyspnoea. Care must be taken not to 
draw off the fluid too rapidly, as this might cause collapse. 
38 



594 DISEASES OF THE DIGESTIVE SYSTEM. 

LIVER COMPLAINT. 

Causes. — A congested state of the liver which may depend on an 
obstruction in the portal and hepatic venous system, in which there is a 
deficiency of tone in the veins which prevents the normal ascent of the 
blood from the lower parts of the body, thereby distending the vessels 
and causing an accumulation of blood. This inability of the blood to 
ascend against gravity is found in a great variety of chronic diseases. 
A very frequent cause of disease of the liver is the indulgence in alcoholic 
stimulants and the eating of too highly seasoned food. 

Symptoms. — 1. Perhaps there is no disease in the whole human frame 
in which symptoms assist less. In some of the more acute forms of the 
disease the symptoms are urgent, but except in a few instances they 
convey little or no information with respect to the nature or progress of 
the disease, and in the more chronic forms irreparable mischief is often 
established before the patient even suspects that there is anything wrong. 
There are, however, certain general symptoms which, when present, en- 
able us to pronounce pretty positively as to the existence of liver disease, 
though they will not assist in determining its nature. These are dropsy, 
indigestion and jaundice. The tongue is generally coated and commonly 
furred. A disagreeable, bitterish taste is felt in the mouth, and eructa- 
tions take place, sometimes bitter, cutting, acrid and even excoriating 
the lining of the throat. The skin may be hot and dry-parched and 
rough, or it may be too relaxed, giving rise to cold, clammy sweats. 

2. There is no excretion, not even excepting the bowel evacuations, 
which is more frequently deranged in diseases of the liver than urine. 
Thus, bile may be detected in the urine when no other irregularity is 
present by the application of muriatic acid. 

3. Not unfrequently a patient has lost the power of assimilation, not 
from any well defined organic lesion of the liver or alimentary canal, 
but rather because of a stagnation of want of proper secretion through the 
ducts of the liver. When these become deficient in secretion the healthy 
action of the liver is arrested and various disorders immediately begin to 
be manifested. The bowels do not move freely ; the bile, instead of getting 
excreted by the intestines, is taken up by the blood. In consequence the 
internal organs suffer and a bilious attack follows. After frequent 
attacks the skin becomes sallow, rough and yellowish, and you are affected 
with headache, constipated bowels, coated tongue, pain in the right 
shoulder and side from the poison left behind in the blood. Here is the 
first seat-origin of pulmonary consumption. 



LIVER COMPLAINT. 595 

4. The so-called biliousness, indigestion, capricious appetite, pain 
after food, eructations, acidity, flatulence, irregularity in the bowels, 
whether as constipation or diarrhoea, point almost always to this disturb- 
ance, and it is a most potent factor in causing and inviting other diseases. 

5. The modern liver is a degenerate organ ; the average digestion far 
below the standard of old, and its function abnormally feeble and slow. 
Gout and uric acid congeries prevail to a remarkable extent, and the 
ailments, directly or indirectly attributable to malnutrition, meet the 
busy practitioner at every turn, The bilious attack of olden time, for 
which mercury was a specific, and that of to-day are alike. The former 
was almost always the invariable penalty of a "surfeit," brought on by 
inordinate indulgence in the pleasures of the table, in an age when the 
"three-bottle man" was a hero of every convivial gathering, and the ap- 
petite on the morning following a "night out" usually unequal to the 
most exacting demands of a bountifully-spread board, without the aid of 
the seductive but dyspepsia-breeding cocktail. The latter-day biliousness, 
on the other hand, comes on insidiously, often without apparent cause, and 
follows the most trifling indiscretion in diet. The digestive organs being 
weak to begin with, a slight excess of intestinal decomposition is easily 
provoked, and the whole system becomes gradually saturated with its 
poisonous products. This condition, therefore, is not amenable to the 
mercury treatment. 

Treatment. — 1. The successful treatment of the modern form of the 
disorder is but just begun when all putrescent elements of ingested food 
have been carried off by purgation. The condition remaining, in which 
there are large amounts of slowly accumulated deposits in the system 
which the unaided efforts of nature are impotent to remove. 

A pill composed of aloin, may-apple and nux vomica, an eighth of a 
grain of each, may be taken at night, or night and morning, until the 
bowels become regular. By their judicious use the digestion will be im- 
proved, also the general health, thereby avoiding those principal sequences 
which attend the constipated condition. 

2. Medicines should be "arms of precision." The physician cannot 
push his remedies to the limit of safety unless he has perfect confidence 
in their purity and accuracy. This combination accomplishes this in a 
threefold manner. The may-apple increases the healthy action and 
secretion in the ducts of the liver. The nux vomica, by its stimulating 
and tonic effect on the stomach, enables it to better assimilate and digest 
the food ; while the aloin completely cleanses the walls of the alimentary 
canal. 



596 DISEASES OF THE DIGESTIVE SYSTEM. 

Through their combined action the system is restored to its normal 
standard. This is the secret of their curative power in the treatment of 
liver disease. This secret is one of immense power. They not only 
stimulate the brain by their action in generating more gray matter, but 
in some mysterious manner vivify the great sympathetic nerve which 
covers the bowels and energizes the eighth pair of nerves which supplies 
the liver. They speedily affect the liver, restore the gland to its pristine 
activity, and the bowels become regular, the complexion clear, the breath 
sweet and the whole body seems rejuvenated, proving that the liver has 
renewed its normal function. 

When the bowels do not move freely the liver becomes congested, 
and the bile, instead of being excreted by the intestines, is taken up by 
the blood. In consequence the internal organs suffer and a bilious 
attack follows. After frequent attacks the skin becomes sallow, rough 
and yellowish, and you are troubled with headache, constipated bowels, 
coated tongue, pains in side, and your whole system feels out of sorts. 
For this condition take three pills on retiring at night. 

For an aggravated attack of biliousness or chronic liver disease take 
one pill three times a day for one week. Take one pill each night at bed- 
time for two weeks, after which take one pill twice a week for about 
three weeks. 

For a slight attack of biliousness, indigestion, and so forth, take two 
pills on retiring and one pill each night afterward until five have been 
taken. 

Auxiliary Treatment. — When suffering from this disease the diet 
should first be considered. Light gruel or toast water anc buttermilk 
or skimmed milk can be taken. Light mutton or chicken broth, after 
removing the greasy portion from the top. Food should not be eaten 
between meals, of any kind. Alcohol or malt liquors, as also tobacco, are 
to be avoided. For the relief of pain in the side over region of liver 
apply a hot hop poultice, or, what is preferable, a hot-water bag should be 
placed over this region and replenished so as to keep up constant heat. 
In severe cases the tension may be relaxed by a mustard plaster or an 
application of spirits of turpentine well rubbed in. This acts as a counter- 
irritant and often gives speedy relief. If the patient continues to vomit, 
a little lime-water and milk — a teaspoonful of lime-water in a cup of milk 
— or a mustard plaster made with the white of egg and applied to pit of 
stomach will frequently give immediate relief. Kegarding diet, it should 
bland and unirritating. 



PART VIII OF BOOK IV 

Treats of the diseases to which the Genito-Urinary 
System is subject. 



Bladder, Inflammation of 



607 Impotency 6: 



Stone in 608 

Bloody Urine 603 

Bright's Disease, Acute 600 

Causes of 600 

Symptoms of 601 

Treatment of 601 

Urine in 601 

Bright's Disease, Chronic 602 

Causes of 602 

Symptoms of 602 

Treatment of 602 

Calculus 608 

Catheter, Use of 610 

Chancre 620 

Treatment of 620 

Chancroid Sore 618 

Colic, Renal or Nephritic 606 

Cystitis 607 

Chronic 608 

Urine in 607 

Congenital Syphilis 620 

Symptoms of 620 

Diseases of the Urinary System 599 

Emissions, Involuntary 626 

Epididymitis 615 

Floating Kidney 605 

Formin Compound, Use of in Gonor- 
rhoea 614 

Gravel 608 

Gonorrhoea 611 

Diet in 613 

Formin Compound in 614 

Sanmetto Treatment 614 

Secondary Treatment 613 

Symptoms of 612 

Third Treatment 613 

Treatment of 612 

Gonorrheal Complications 615 

Hematuria 603 

Hysteria, Suppression of Urine in.. 605 



Inflammation of the Bladder 607 

Involuntary Emissions 626 

Kidneys, Function of 599 

Kidney, Floating or Movable 605 

Movable Kidney < . . 605 

Nephritis, Acute 600 

Nephritis, Chronic 602 

Nephritic Colic 606 

Prostate Gland, Diseases of 611 

Cure of 611 

Causes of 611 

Pus in the Urine 604 

Pyuria 604 

Renal Colic 606 

Salvarsan, Use of in Syphilis 625 

Sanmetto Treatment for Gonor- 
rhoea 614 

Six-O-Six (606) Treatment in Sy- 
philis 625 

Sofe-chancre 618 

Spermatorrhoea 626 

Causes of 627 

Results of 627 

Treatment of 627 

Stone in the Bladder 608 

Stricture of the Urethra 609 

Causes of .609 

Treatment of 609 

Suppression of the Urine 604 

in Hysteria 605 

Treatment of 605 

Swelled Testicle 615 

Syphilis ; .617 

Cause of 617 

Chancroid Sore 618 

Congenital 620 

Constitutional Treatment 620 

Conveyed by Conception 621 

Eruptions 619 



597 



598 



INDEX TO PAET VIII OF BOOK IV. 



Syphilis, Hand and Feet Eruptions. 619 

Hereditary 622 

Mercury Unreliable in 625 

Salvarsan Treatment 625 

Secondary Constitutional Symp- 
toms 618 

606 Treatment 625 

Sofe-chancre 618 

Symptoms 617 

Tertiary Symptoms 619 

Tertiary Treatment 621 

Tonics, Use of 621 

Transmission of 622 

Treatment, Secondary 620 

Vegetable Treatment 625 



Syphilitic, Marriage of 621 

Tertiary Syphilis 619 

Treatment of 621 

Testicle, Swelled 615 

Tonics, Use of, in Syphilis 621 

Uremia 603 

Urethra, Inflammation of 611 

Stricture of 609 

Urine, Bloody 603 

In Cystitis 607 

Pus in 604 

Suppression of 604 

Varicocele 616 

Vegetable Treatment in Syphilis 625 



CURATIVE MEDICINE 



PAET VIII. 
DISEASES OF THE URINARY SYSTEM 

The Urinary Organs. — The important group of organs which makes 
up this system comprises the kidneys, two glandular bodies about four 
inches long, and of the peculiar shape of a kidney-bean, with their outlet 
pipes communicating with the bladder, and its exit tube the urethra, 
opening in both sexes in conjunction with the organs of generation. 

Office of the Kidneys — The office of the kidneys in the animal 
economy is to secrete the urine which passes from each gland down its 
separate ureter into the bladder, where it may be stored to the amount of 
half a pint or a pint, and from which it ought, at suitable intervals of from 
four to six hours, to be evacuated. The ingredients of the urine being 
waste material, poisonous to the organism if retained in the blood, it will 
readily be understood why the suppression of the renal secretion, in 
certain morbid conditions, or its retention in consequence of any obstruc- 
tion to its outflow, in the narrow ureters or urethra, may give rise to some 
of the most horribly painful and fatal diseases which mankind is ever 
called upon to endure. 

Function of the Kidneys — The function of the kidneys is purely an 
eliminative one, and a full understanding of its performance could only 
be gained by a study of the intricate structure of the organs, too complex 
to be considered here. It is sufficient for the present purpose to state, 
that the blood entering each kidney by its large renal artery is purified 
by having removed from it the elements of a poisonous substance, urea, 
with uric or lithic acid, phosphoric acid, and sulphuric acid, variously 
combined with potash, soda, lime, magnesia, and probably other refuse 
matters in smaller amounts. These solid ingredients of the urine are dis- 
solved in the forty or fifty ounces of water which is also during health 

(599) 



GOO DISEASES OE THE UKIXARY SYSTEM. 

taken out of the blood by the kidneys, and in this way the urine is manu- 
factured. The purified blood, after giving up these deleterious matters in 
the renal organs, is returned to the general circulation by the renal veins. 

Passage of Urine. — In perfect health a man of average size would 
pass in the forty-eight ounces of urine, which he should daily evacuate 
from his bladder, an ounce and one-third of urea, nearly an ounce of 
chlorides, sulphates and phosphates, and from eight to twelve grains of 
uric acid. If, for any reason, the amount of water filtered out of the 
blood is less than this, there is danger that some solid constituents of the 
urine may crystallize within the urine or bladder, and being, perhaps, 
washed into the ureters in the one case, or into the urethra in the other, 
block up these outlets and give rise to the horrible agony of nephritic 
colic, gravel or stone in the bladder; or, again, even slight inflammation 
in these small tubes may result in a contraction or stricture, which hinders 
the passage of the urine, and also causes great suffering to the unfortunate 
patient. 

Guide to Kidney Disease. — The chief guide to diseases of the kidneys 
is, necessarily, therefore, a chemical and microscopical examination of the 
urine, with the sediments which fall from it, in each individual case, and 
this should never be neglected in any but the most temporary and in- 
significant derangements of the urinary apparatus. 

ACUTE NEPHRITIS OR ACUTE BRIGHT'S DISEASE. 

Nature of the Disease. — Acute Bright's disease, called also acute 
nephritis, is a malady in which the kidney becomes greatly enlarged and 
vascular, with its minute convoluted tubes, in which the urine is primarily 
manufactured, plugged up with epithelial cells. These epithelial cells in 
the form of casts of the renal tubules are voided in the urine together 
with albumen, and sometimes with blood. The obstruction to the outflow 
of the urine and the interference with the function of the kidney give rise 
to the most serious general symptoms. 

Causes — Acute Bright's disease is a rather common complication of 
scarlet fever, and is one of the dangers most to be dreaded in that malady. 
It also occurs in cholera, yellow fever, scarlet fever, erysipelas and diph- 
theria, and may be produced by alcoholic intemperance, or by exposure 
to cold and wet, particularly by sitting on a wet or cold object, such as a 
stone step. Certain poisons which are eliminated through the kidneys, as 



ACUTE BRIGII'f's DISEASE. 601 

cantharides and turpentine. Pregnancy is also a potent factor in the 
cause of the disease. 

Symptoms — The symptoms are, first, in many cases, chilliness, fol- 
lowed by fever, some pain in the loins and across the lower part of the 
spine, scanty high-colored and albuminous urine, and in a day or two 
dropsy, or watery effusion under the skin, beginning beneath the lower 
eyelids or in the organs of generation, but soon becoming general over 
the whole body. Uremic coma may develop at any time. 

The TTrine. — Scanty always, and at times entirely suppressed. Smoky 
in appearance, high specific gravity, rich in albumen and throws down 
a heavy sediment, which, when examined microscopically, will be found 
to contain hyaline, blood and epithelial casts, and free blood and epithe- 
lium. 

Treatment — The treatment, which is successful in a majority of the 
cases, consists in keeping the patient in bed in a room with a warm, moist 
and equable temperature, purging gently with those laxatives which 
cause watery discharges from the bowels, such as small doses of five 
grains of jalap and thirty grains of cream of tartar, promoting free 
perspiration by the use of sweat baths, which are given by placing the 
patient in a tub of water at the temperature of 106 degrees Fahrenheit 
for twenty minutes. Give a thorough rub and place in bed between 
blankets with hot water bottles, or hot cans around, but not touching the 
patient. A blanket should be interposed between the skin and the hot 
cans. Allow free perspiration for an hour to an hour and a half. Sweat- 
ing may be aided by giving from one-twelfth grain to one-eighth grain of 
pilocarpine. Guard against collapse by giving strychnine sulph., one- 
twentieth grain. Dry cups followed by hot fomentations over loins. In 
bad cases, with robust patients, cut-cups or leeches may be used in place of 
the dry cups, and acetate or citrate of potash in twenty-grain doses, with 
ten drops of tincture of digitalis or squills, and half a teaspoonful of 
sweet spirits of nitre are often given with benefit. Citrate of caffeine 
in one to two grain doses may be tried. Infusion of digitalis in one 
drachm doses is especially beneficial in children. Diuretin in from ten to 
twenty grains three times a day for adults, and two to five grains for 
children will often give good results. Basebands mixture, two drachms 
thrice daily. Niemeyer recommends a pill if oedema is present, composed 
of blue mass, powdered digitalis, powdered squill, each of one grain. 
Take one of these thrice daily. The following combination may prove 
efficient in troublesome dropsy : 



602 DISEASES OE THE URINARY SYSTEM. 

Spartine sulph 4 grains 

Caffeine citrate 20 grains 

Lithia benzoate 40 grains 

Divide into ten powders, and take one every three hours. 



CHRONIC BRIGHT'S DISEASE OR CHRONIC NEPHRITIS. 

Causes. — It may follow the acute, or may be chronic from the be- 
ginning. Males are most frequently attacked. Adult life, frequent ex- 
posure to wet and cold, alcoholism and congestion from heart disease and 
syphilis are the chief predisposing causes. 

Symptoms. — The symptoms of well-denned chronic Bright's disease 
are albuminous urine, containing renal epithelial cells and tube-casts, more 
or less dropsical effusion, especially noticeable about the face and ankles, 
anemia, shortness of breath, a peculiar dryness of the skin, dyspepsia, 
headache and giddiness, together with a tendency to dimness of sight and 
inflammation of the retina of the eye, uremia or blood-poisoning from the 
retention of the urea, which ought to be removed by the kidneys in 
the circulating fluid, secondary inflammations, such as pneumonia and 
pericarditis and hypertrophy of the heart. Its presence can only be posi- 
tively ascertained by thorough microscopical examination of the urine, and 
such examinations repeated from time to time are the best guides as to the 
necessary treatment. The variety is essentially chronic, running a course 
of months or years, with a tendency to temporary improvement under 
treatment, on the one hand, and to subacute exacerbations in consequence 
of unhygienic imprudences on the other. It almost always proves fatal 
in the end, however, by uremia with or without convulsions, by secondary 
inflammations, or perhaps by general debility. It is estimated that uremia 
causes death in about one-third the cases. 

Treatment. — The treatment for chronic albuminuria is in the main 
hygienic. Residence in a warm and equable climate. A quiet life with- 
out mental worry, with gentle but not excessive exercise, is recommended. 
In addition the bowels should be kept regular, skin active by daily tepid 
bath with friction. Abundant pure water or some pleasant mineral water 
should be drunk. The underclothing should be wool or silk, and the diet 
non-nitrogenous, and in severe cases absolute diet of skimmed milk will 
prove beneficial, unless dropsy or symptoms of uremia require active 
remedies. 

Further Treatment. — Should the former be very troublesome, and 
diuretics, as suggested when speaking of the acute form, fail to act, as 



BLOODY URINE. 603 

frequently happens, recourse must be had to the hydrogogue cathartics, 
such as a quarter of a grain of elaterium, already spoken of, with hot-air 
or vapor baths to promote elimination by the skin, as a partial substitute 
for the inefficient work of the crippled kidneys. If marked symptoms 
of uremia appear, such as headache, drowsiness, involuntary muscular 
twitchings, sudden and violent vomiting and diarrhoea, recourse to the 
active cathartics should be had at once, without any preliminary trial of a 
diuretic, and if uremic convulsions or coma come on, full doses of elate- 
rium or a drop of croton oil will probably be required immediately to avert 
death. During the convulsion chloroform may be given by inhalation 
to restrain the violence, and perhaps shorten the paroxysm. 

Many cases of uremia are benefited and life prolonged by blood 
letting of from six to twelve ounces, depending upon the pulse, and fol- 
lowed by an injection of saline solution from one to two pints beneath the 
breasts, or in subcutaneous structures of the axilla, strength of solution 
about one teaspoonful of salt to a pint of distilled water, to be injected 
at about the temperature of 100 degrees Fahrenheit. Care must be taken 
to thoroughly 'cleanse the skin at the point at which the needle is to be 
inserted. Early in the case Bascham's mixture does good. 

HEMATURIA OR BLOODY URINE. 

This is more a symptom of other diseases than a disease in itself. 
Causes. — Stevens gives as the causes thus: 

1. Vicarious menstruation. 

2. Traumatism applied to any part of the genito-urinary tract. 

3. General blood dyscrasia as in specific fevers, purpura, malaria, 
scurvy, etc. 

4. Congestion of the kidney from chronic heart, lung or liver disease. 

5. Acute inflammation of any part of the genito-urinary tract. 

6. Stone in any part of the genito-urinary tract. 

7. Varicose veins in neck of bladder. 

8. It may occur without obvious cause. 

9. Parasites in genito-urinary tract. 
10. Tumors and tubercle of the kidney. 

The presence of blood may be suspected from the red, smoky or 
brownish color of the urine, and positively determined by a microscopical 
examination. If the blood is clotted it generally comes from the bladder, 
and if coagulated in long round strings, like earth-worms, it may have been 



604 DISEASES OF THF URINARY SYSTEM. 

effused in the urethra, from a rupture or ulcer in that membranous tube. 
Treatment. — The most important thing is to discover the cause and 
treat that. If this cannot be done tincture of chloride of iron, which is 
especially useful in debilitated patients in 'twenty-drop doses every three 
hours, gallic acid in quantities of five grains, and ergot, or two grains of 
acetate of lead and half a grain of opium every four hours. The effect 
of the general remedies may be aided by the injection of a weak solution 
of alum in cold water, thrown into the bladder by means of a catheter if 
the case is urgent. Where a large mass of coagulated blood is formed in 
the bladder it may sometimes be gotten rid of by the injection of a solu- 
tion of pepsin, which, if the ingenious plan succeeds, dissolves the clot of 
blood. 

PYURIA OR PUS IN THE URINE. 

Causes. — 1. Suppurative inflammation of the kidney. 

2. Calculus (stone) or tuberculosis of kidney. 

3. Cystitis or suppurative inflammation of the bladder. 

4. Urethritis. Inflammation of urethra. 

Symptoms — Urine is alkaline and has a cloudy sediment. 1 There is 
usually frequent and urgent desire to urinate, especially if the pus is 
from the bladder or posterior urethra. 

Diagnosis. — Diagnosis can only positively be made from microscopical 
examination. If from abscess of kidney flow of pus is intermittent. If 
from calculus or tuberculosis of kidney the flow is constant, as it is in 
cystitis or urethritis. 

Treatment. — The treatment consists in removing the cause. 

SUPPRESSION OF THE URINE. 

Description. — This is an affection in which the work of the kidneys 
in secreting the urine is very defective or altogether abolished. There 
may be some pain in the back or irritability of the bladder, the patient 
becomes anxious and restless, then dull and drowsy, and finally after an 
interval of from three to eight days usually dies comatose. In other in- 
stances there is nausea and vomiting, hiccough, and the whole body ex- 
hales a urinous odor. Where the suppression is less complete, and depends 
upon some obstruction to its outflow in the ureters, bladder, or urethra, 
the mind remains clear for a long time, perhaps, and the unfortunate 
patient is fully conscious of the intense local suffering and general dis- 



TLOATIXG OR MOVABLE TTT^XEY. 



605 



tress produced. The time during which the urine may be suppressed and 
yet the patient recover varies considerably. 

Hysteria. — In hysteria, cases where no urine has been passed for ten 
days are reported, but such instances are not free from suspicion of pos- 
sible deception on the part of the patient. Children when teething will 
sometimes for days together void only a few drops of urine at once, and 
that at several hours' interval. The urine passed at such times is ex- 
tremely high colored, stains the linen, and is passed with great pain, the 
child crying bitterly, as it scalds the sensitive surface over which it flows. 
This disease probably arises, at least in some instances, from over-con- 
gestion of the kidney. 

Treatment. — The treatment recommended is to .place the patient in a 
warm bath, and give a saline diuretic, such as a teaspoonful of cream of 
tartar, or twenty grains of acetate of potash dissolved in half a pint of 
water, combined with a moderate laxative. The sweet spirits of nitre, in 
half teaspoonful doses, is also frequently useful. Digitalis leaves made 
into a poultice, or the tincture of digitalis added to a flaxseed poultice, 
have often proved beneficial, and the digitalis may also be used internally 
with advantage in the form of a teaspoonful of infusion every four hours, 
or Dover's powder, ten grains for an adult. 

FLOATING OR MOVABLE KIDNEY. 

The mobility of the kidney depends upon the relaxation of the sur- 
rounding structures. 

Causes. — Females are most usually affected, probably due to the dif- 
ference in dress between them and the males. Middle life. Any disease 
producing rapid marked emaciation predisposes to it. A congenital relaxa- 
tion of surrounding tissues. Muscular exertion. Eepeated pregnancies. 

Diagnosis is made by feeling kidney in abnormal position. 

Symptoms — There is a dragging sensation in back Kidney may be- 
come swollen and painful to the touch. There is a sense of uneasiness 
and attacks of neuralgic pains. Emotional disturbances are often excited 
by this condition. 

Treatment. — Use abdominal binder or pad. Regulate diet, Avoid 
exertion. If the condition persists the only treatment is surgical. 



606 DISEASES OF THE URINARY SYSTEM. 



EENAL OR NEPHRITIC COLIC. 



Causes. — Since the ureters commence inside the kidneys as funnel- 
shaped tubes, it is obvious that any solid substance capable of entering 
the upper part and yet a little too large to pass the lower portion, will 
&tick fast, and can only progress as the pressure of the constantly secreted 
urine behind it drives it along with sufficient force to dilate the pipe and 
allow it to move onward. This process of dilatation is horribly painful, 
and with that of passing a gall-stone, and of certain forms of neuralgia, 
makes up the worst physical suffering of humanity since the Spanish 
Inquisition was abolished. The little stones which cause such agony in 
this way are generally composed of uric acid, or less commonly of oxalate 
of lime, deposited from the urine inside the kidneys, and washed down 
from the seat of their formation by the outflow of that fluid. It is not 
positively determined whether they crystallize out of the urine because 
they are produced in too large quantity in the system, or because a de- 
ficient amount of water to hold them in solution is filtered out of the 
blood; but in either case, increasing the bulk of the renal secretion by 
drinking a larger quantity of water daily, is a most rational- method for 
diminishing the tendency to their production. 

Symptoms. — The first symptom of an attack of renal or nephritic 
colic is usually pain in the region of the loin on the affected side. This 
rapidly increases in severity until it becomes excruciating, and radiates 
downward toward the groin, the testicle on that side being drawn up, a 
symptom constituting in males — who are chiefly the subjects of this 
malady — an important diagnostic sign. With the pain, nausea and vomit- 
ing are apt to occur, and the body is covered with a cold sweat. 

Treatment — The treatment of nephritic colic is to relieve the pain, if 
only moderately severe, by hypodermic injections of morphia and atropia, 
or laudanum enemas, as advised in the article upon gall-stones; but if 
the suffering is intense, by the inhalation of ether or chloroform. In 
order to mitigate the pain sufficiently by these anesthetics, it is not usually 
needful to administer them to complete unconsciousness. A few whiffs 
will lull the distress so as to make it endurable for the time, and as this 
blessed influence passes off, it can be renewed by a repetition of the in- 
halation. Persons whose hearts and lungs are healthy, can thus be kept 
in comparative comfort with comparative safety, for several hours, or 
until the passage of the stone out of the lower end of the ureter into the 
bladder renders the anesthetic no longer necessary. 



INFLAMMATION OF THE BLADDER. 607 

Passage of Stone — It is probable that both morphia and ether tend, 
besides, to hasten the exit of the stone by relaxing the spasm, which no 
doubt is caused by the irritation of the angular corners of the cruel little 
calculus as it makes its way through the slender and sensitive tube of the 
ureter. After the passage of a stone of this kind into the bladder, it 
usually is voided with the urine, in the course of the next day or two, 
and in order to make sure that the enemy has been completely gotten rid 
of, it is best to carefully examine all the urine which comes away in the 
next few days after an attack. The character of the stone, when found, 
will afford some information as to the best mode of treatment to be 
adopted for the purpose of avoiding the formation of others of like 
structure. 

Prophylactic Treatment.— Those who are subject to attacks of nephritic 
colic should live a quiet life, avoiding exertion as far as possible. The 
diet should be regulated as in gout. Diuretics should be taken and water 
in large quantities. 

Sir William Roberts recommends what is known as the solvent treat- 
ment. Citrate of potash in doses of half to one drachm every three hours. 
Osier has not found this satisfactory. Piperazine in doses of five grains 
three times a day may prove useful as a solvent. 

CYSTITIS OR INFLAMMATION OF THE BLADDER. 

Symptoms of Acute Cystitis — There is great frequency and urgent 
desire to urinate. The passage of very little urine at each act, accom- 
panied by great pain above the pubis, and in the perineum radiating to 
the end of the penis and in the loins and sacral region. 

The Urine. — The urine, at first clear, loses its transparency, becomes 
full of thick mucus and contains blood and pus. A rectal examination is 
very painful. 

Treatment. — In treatment of cystitis remove the cause if possible. 
Put patient to bed, apply hot applications to perineum, give suppositories 
containing opium, one grain, and belladonna, one-sixth of a grain. Hips 
should be elevated and bowels opened by salines and glycerine enemas. 
An exclusive milk diet is often beneficial. 

For the pain give a powder containing — 

Extract hyoscyamus 4 grains 

Extract cannabis indica 4 grains 

Sugar 20 grains 

Divide into ten powders, and take one every three hours. 



608 DISEASES OF THE URINARY SYSTEM. 

Or five-grain doses of formin in. half glass of water three or four 
times a day. 

Suppositories of ichthyol, one grain, are often beneficial. All alco- 
holic stimulants must be avoided. 

Symptoms of Chronic Cystitis — In this condition there is frequent 
urination, but it is not so marked as in the acute form. The urine is am- 
moniacal, fetid and filled with tenacious mucus and pus ; not infrequently 
blood. Constitutional symptoms rarely appear. Tuberculosis is a fre- 
quent cause of cystitis, and by careful straining and examination the 
bacillus tuberculosis can be found. This form is accompanied by pyuria 
(passage of urine) and pain. 

Treatment. — 1. If possible, the cause must be removed. Water is 
drunk in large quantities. Salol and boric acid, five grains each, every 
four hours, is very good. 

2. Urotropin, five grains six times a day, catheterize twice a day, 
and irrigation of the bladder with solution of silver nitrate, one grain to 
a pint of water, or solution of permanganate of potassium (1-20,000). 
The bladder is washed out by attaching a glass nozzle to the catheter at 
one end, and to a funnel with rubber tube at the other. The funnel is 
raised to four or six feet above the patient, and bladder filled, and then 
fluid allowed to flow out. This is repeated several times until it returns 
clear. 

CALCULUS, GRAVEL OR STONE IN THE BLADDER. 

This is an extremely painful and annoying disease caused by stone 
or stony deposit in the bladder. When the system is healthy the ingredi- 
ents forming gravel or stone are carried off without difficulty by the secre- 
tion of the kidneys. But when there is excess of uric or any other acid 
these particles sometimes unite and gradually grow and many find deposit 
in the kidneys or bladder. 

It is supposed by some authorities to be in part due to the lime and 
magnesium contained in the hard water used for drinking in certain 
districts. It is more common in men than in women. 

Symptoms. — Small gravel stones may pass off with the urine, some- 
times with great pain, others remain to grow into stone. When the gravel 
or stone is too large to pass through the urethra the patient is subject to 
terrific spasms of pain, in groin, kidney, testicles, thigh and abdomen, 
but generally pointing to the direction which the stone seeks an exit; 
nausea and vomiting sometimes set in, and the pulse becomes weak and 
complexion pale. The patient is rendered uneasy by frequent desires to 



STRICTURE OF THE URETHRA. 609 

pass urine. The now of urine is often suddenly stopped and then resumed 
upon change of position. This is due to the stone obstructing the passage 
of urine at the neck of the bladder. 

Treatment. — The medical treatment is only palliative, and similar 
to that recommended in cystitis and solvent in nephritic colic. The sur- 
gical operation of opening the bladder and taking out the stone, called 
lithotomy, and of lithotrity or crushing the stone, if of suitable size and 
texture, within the bladder, by means of a very ingenious instrument, 
afford, when successful, as they are in a large proportion of cases, a 
complete cure. 

In acute forms warm baths, suppositories of a grain of opium and 
one-sixth of a grain of belladonna, flaxseed tea and the use of salty pur- 
gatives are recommended. 

In chronic gravel, teas or fluid extracts of buchu are often used, and 
in stubborn cases five-drop doses of diluted nitromuriatic acid, or saliciu 
in five-grain doses, thrice daily, may be given. 

Belief may sometimes be obtained from a mixture of two teaspoon- 
fuls of powdered borax and Hve of cream of tartar, dissolved in a pint 
of water, the doses being two or three dessertspoonfuls four times a day. 

To relieve intense pain the following enema may be used : 

Thin-boiled Starch 2 ounces 

Laudanum 30 drops 

This injection must be retained in the bowels as long as posible. If 
pain is very severe, put in forty drops of laudanum. In place of this 
injection thirty drops of laudanum may be given internally every six 
hours, but the warm enema is better. Hot compresses over the abdomen 
and back are also useful. 

STRICTURE OF THE URETHRA. 

Causes — Usually the attention is attracted by the circumstance that 
the desire to urinate becomes more frequent, and the force of the stream 
diminishes, so that the renal secretion dribbles away in drops, or runs 
off in a very fine stream not larger than a knitting-needle. There is 
more or less pain in passing water, and a good deal of straining is required 
to accomplish the operation, which begins to be dreaded from day to day, 
and even from hour to hour. 

Treatment. — The treatment of stricture is purely surgical, as, being a 
meckanical obstruction, medicines can accomplish nothing for its relief. 
39 



610 DISEASES OE THE URINARY SYSTEM. 

The usual method is by gradual dilatation, using first a small steel rod 
bent at the suitable curve and highly polished. This is to be warmed and 
thoroughly oiled, and then carefully passed into the bladder through the 
urethra, scarcely any force being employed. The great danger is that 
some of the inflamed and softened tissues in the neighborhood of the 
obstruction may give way, and what is called a false passage being formed, 
the condition of the patient is rendered far worse than before. 

Using the Steel Rod. — The largest size that can be used successfully 
having been introduced, it is allowed to remain a few aninutes and then 
an instrument of a little greater diameter is employed, and so on until 
the urethra, not without considerable suffering, is stretched to the original 
magnitude. In most instances, however, this dilating process must be 
kept up for months, the patient himself learning how to use the proper 
instrument, and introducing it at longer and longer intervals for a year or 
two until completely cured Various other methods for relieving the 
obstruction of stricture have been devised, such as external incision, 
cauterization, and so forth. 

Emergency Treatment — Iu the emergency of an attack of retention of 
urine, in a man who is the subject of stricture, coming on whilst far from 
medical assistance, the first thing to do is to get into a warm bath, since 
this will often procure sufficient relaxation of the spasm, which always 
makes up part of the narrowing of an irritated stricture, to allow a little 
urine to dribble away, perhaps whilst bathing, and so relieve the distress 
of the patient. If this fails a laudanum and belladonna injection or sup- 
pository, or a full dose of twenty drops of laudanum, will frequently have 
the desired relaxing effect, or ten grains of Dover's powder. 

Self -Use of the Catheter. — Care should be taken to drink as little fluid 
as possible, so as to diminish the amount of the renal secretion to a 
minimum, until the avenue for its escape is again partially unclosed. If 
a catheter can be procured, the patient should try to pass it himself, choos- 
ing the time when he is still partly under the influence of the opium, which 
dulls the excessive sensibility of the urethra. 

Substitute for Catheter. — In the absence of a catheter it has been most 
ingeniously suggested by Dr. Levis, of Philadelphia, to use a piece of 
bell-wire, doubled and bent to the right curve, along the sides of which, 
if safely introduced, enough urine might flow to relieve the over-distended 
bladder. 



GOXORRHEA. 



611 



DISEASES OF THE PROSTRATE GLAND. 

Causes and Cure. — Among the diseases of the prostrate gland the most 
important are chronic enlargement and calculus. This gland is situated 
just in front of the neck of the bladder, and encircles its outlet, the 
urethra. Hence its enlargement is apt to interfere with the outflow of 
the urine from the bladder as soon as it increases beyond a certain point. 
The difficulty thus caused in passing water is especially apt to affect elderly 
men, and would be very serious had not surgical science supplied a 
peculiarly formed instrument, called the prostatic catheter, by which the 
impediment can usually be overcome temporarily. 

Inflammation of Urethra. — The urethra, which constitutes the final 
channel through which the renal secretion flows in making its exit from 
the body, is likewise subject to inflammation, and to obstruction from 
calculus, and, most important, to narrowing in consequence of inflam- 
matory action. This contraction of the canal is called, as most people are 
aware, stricture of the urethra, and notwithstanding the numerous tales 
of accident producing this trouble, which are poured into the credulous 
ears of physicians, its true cause is, at least nine times out of ten, gonor- 
rhea, which will therefore be considered in this connection. When a 
stricture is present a bougie should be used 

GONORRHEA. 

Character. — Gonorrhea, or, as it is vulgarly called, the clap is a 
specific inflammation of the urethra, the result of contagion and very sel- 
dom innocently acquired In the female it affects chiefly the vagina, and 
frequently extends to the uterus and ovaries. 

Gonorrhoea is one of the most contagious diseases. It is caused by the 
germ called gonococcus, discovered by Professor Neisser. It spreads 
through illicit intercourse. 

This disease is scarcely less dangerous, and is more prevalent than 
syphilis. It attacks all ages and spreads unchecked from one individual 
to another. It is a disease born of immorality and filth, and is a menace 
to the eyes of every child born of a woman suffering from the disease, or 
any person using or handling clothing, towels, etc., upon which the dis- 
charges from the penis (male) and vagina (female) have collected. 

The danger of gonorrhoea and the main reason it spreads is due to the 
fact that the average sufferer thinks it a trifling disease, also that he de- 



612 DISEASES OF THE URINARY SYSTEM. 

lays treatment because he is ashamed or frightened to tell his father or 
mother or even the family doctor — the man he should go to at once. Thus 
treatment is delayed while the sufferer becomes worse, uses secretly the 
patent medicines advertised, the family towel, puts his wash in the family 
laundry, eats and works along side of you and me, sleeps in hotels, the 
berths of sleepers, ocean liners, etc., where innocent children and others 
may come in contact with the germs of this filthy disease. 

It is a mistake for a sufferer from gonorrhoea not to consult his own 
physician for treatment, who will protect him (much as he doesn't want 
to), instead of going to a physician of doubtful reputation, for there is no 
disease from which the quack reaps such a harvest as gonorrhoea, and every 
one poses as a specialist in its treatment. 

The dangers from gonorrhoea in the female are far worse than in 
the male, as it leads to complications in the womb, ovaries, etc., and causes 
peritonitis and is responsible for many deaths from blood poisoning 
following child birth. But innocent married women who suffer from 
gonorrhoea are the ones to be pitied and suffer the most, for they are 
ignorant of their condition, and if maimed wonder why they are ill with 
a filthy discharge and often must undergo painful operations/ They fail 
to receive proper and early treatment for modesty holds them back and 
they blame the trouble on some other cause. 

Symptoms — The first symptom in the male is a slight uneasy sensation 
or tickling at the mouth of the urethra, which is generally felt between 
the second and seventh day after exposure to infection. On examination 
the organ is found slightly reddened, and the natural discharge of mucus 
a little increased, and more viscid than usual. These signs of irritation 
soon pass into those of inflammation, in which the redness, heat, pain and 
swelling, characterizing that process, are all experienced in an exaggerated 
form The discharge becomes thick, yellow or greenish, and the pain on 
passing water, which must be done frequently, is very severe. Erections 
are frequent and painful. The penis is bent downward. These erections 
are called chordee. Sweling and inflammation of the glands in the groins, 
commonly called a bubo, is common, but the irritation seldom goes so far 
as to result in suppuration and abscess. Orchitis or inflammation of the 
testicle is more frequently observed. The disease is apt to last under the 
best treatment for a period of from four to six weeks, and if neglected or 
badly managed may be months before it is cured. 

Treatment — The most important part of the treatment is rest in bed, 
but as this can seldom be secured the inflamed parts should be supported 



GONORRHEA. 613 

by a suitable suspensory bandage. At first the treatment must be that 
of inflammation elsewhere, that is by saline purgatives, such as a table- 
spoonful of epsom salts, low diet, and half teaspoonful doses of sweet 
spirits of nitre or ten grains of Dover's powder to promote perspiration. 
Wrapping the affected parts in cloths soaked in a mixture of four ounces 
of lead-water and two grains of acetate of morphia, and covered with oiled- 
silk is useful, and the injection of dilute solutions of the same medicines, 
made by mixing an ounce of this liquid with three ounces of water may be 
cautiously tried, or a one per cent, solution of protargal. In the first few 
days irrigation with a one to ^.Ye thousand solution of permanganate of 
potassium. The scalding on voiding urine may be mitigated by drinking 
freely of flaxseed tea containing two drachms of acetate or bicarbonate of 
potash to the pint, and a belladonna and opium suppository at night, 
repeated in two hours if needful, will generally prevent much trouble 
from chordee. Internally globules copa-kava, one four times a day, are 
effective in acute or chronic conditions. 

Diet. — The diet should be rice, bread with very little butter, milk, 
and, if necessary to keep up the strength, soft-boiled eggs. Meat, alcoholic 
and malt liquors, acids and condiments, are particularly objectionable. 

Secondary Treatment — After the first violence of the inflammation 
begins to subside the injections, such as silver nitrate, one grain to six 
ounces of water, or copper sulphate, one-half grain to the ounce, or acetate 
of lead and sulphate of zinc, each three grains to one ounce of water, may 
be made stronger gradually, allowing them to be of sufficient activity to 
produce a little smarting, lasting not longer than iive minutes, each time 
they are used. They should be employed directly after each passage of 
urine, provided that does not occur oftener than once in two hours. At 
this period the administration of balsam of copaiba is usually commenced, 
and a good article of oil of sandalwood appears to be even more efficient 
in checking the remaining discharge, two capsules of either remedy being 
taken four times daily. 

Third Treatment. — In the course of another week injections of acetate 
of zinc, sulphate of copper or nitrate of silver, one or two grains to the 
ounce of water, may come into service with benefit, but great care must 
still be exercised in regard to errors in diet, a single glass of malt liquor 
being frequently sufficient to bring on a relapse. If neglected or badly 
treated the malady may run into the chronic form, which is called gleet, 
and often proves exceedingly rebellious to treatment. Five-grain doses of 
salol, ten drops each of tincture of chloride of iron with tincture af can- 



614 DISEASES OF THE URINARY SYSTEM. 

tharides thrice daily often, however, succeed in bringing about a favorable 
change, and the introduction of a bougie smeared with belladonna oint- 
ment three times a week is apt to contribute to the cure. 

Formin Comp. — There are few who cannot recall the day of balsam 
copaiba and zinc injections. What a change in the treatment of disease 
— the antiseptic or germicidal treatment of the modern day ! In the treat- 
ment of any disease of the genito-urinary tract the urine should be ren- 
dered sterile. Experiments made with formin comp. prove conclusively 
its value as a genito-urinary germicide, and the brilliant results obtained 
from its use place it foremost among the remedies of the genito-urinary 
specialist. In gonorrhea, acute and chronic, it serves to restrict the area 
of infection and prevent reinfection. Obstinate cases that have resisted 
other treatments should be placed on formin comp. in five-grain doses 
every three or four hours. It will clear up the urine without perverting 
its chemical reaction. The trouble with agents which make the urine 
alkaline is that they are incompatible with the gastric juice and must be 
given in doses large enough to more than neutralize the acid of the 
stomach. Formin comp. preserves the acidity of the gastric juice and pro- 
duces an antiseptic irrigating fluid of the urine without interfering with 
the digestion or irritating the kidneys. 

The Sanmetto Treatment. — We have also another agent possessing 
wonderful specific influence over the urinary organs when there is irri- 
tation or inflammation. It is called sanmetto, and is a combination of 
sandalwood and saw palmetto. It acts as a great vitalizer, increasing the 
strength of the reproductive organs, hastening their action, promoting 
their secreting power and increasing their size. The usual dose is a 
teaspoonful four times a day. 

It is generally recognized by the profession that there is no disease 
which is so common and presents as many dangers to the human race at 
large as gonorrhea. The great danger lies in the fact that medical men 
are apt to be careless about the treatment. No man can pronounce his 
patient well and be sure that his urethra is free from the specific micro- 
organism unless he is able to make a thorough bacteriological examina- 
tion of the patient's urine and of any discharge which may issue from his 
genito-urinary organs. The great source of general infection is the man 
who is told that he is "over his dose" because his discharge is apparently 
checked and he is able to urinate without using bad language at every 
dribble of urine. He is sent away with a host of virulent micro-organisms 
lying extant in his urethra. 



EPIDYDIMITIS. 



615 



Track of Gonorrhea — The urethral inflammation commences at the 
meatus and travels slowly backward. There is no ulceration. The dis- 
ease tends to limit itself and to become localized at the bulb, where the 
disease runs its course. Instead of getting well we have gleet, in which 
there is a certain amount of sticky fluid, often only a drop at the meatus 
in the morning continues to be secreted after gonorrhea, from altered 
patches of the urethra, or coming from the stretched and congested mem- 
brance behind a stricture. Gleet, then, is a symptom of two structural 
lesions, and signifies that there are patches of congestion in the canal, 
covered or not by granulations, or that stricture exists, and that the dis- 
charge comes from behind it. When an individual with a gleet is found 
to be gouty it is particularly advisable to enforce strict urethral hygiene. 

Gonorrheal Complications. — Of the complications of gonorrhea we 
may have inflammatory phymosis, chordee, retention of urine and hemor- 
rhage. The idea of aborting gonorrhea by the internal use of balsams 
has been abandoned. By abortive treatment is now understood the injec- 
tion of any irritating soluble substance into the urethra for the purpose 
of inflaming the canal. Of these substances is nitrate of silver or argyrol, 
of the strength of half a grain to one ounce of water, the injection being 
carefully repeated every two or three hours until a trace of blood is seen 
in the discharges. Then all treatment must cease. The syringe used in 
the abortive treatment should never hold more than two drachms, and 
the fluid injected must be brought well into contact with every portion 
of the first inch and a half of the urethra 

In true gonorrhea the abortive treatment will not avail after the dis- 
ease is more than forty-eight hours old. 



EPIDIDYMITIS OR SWEILED TESTICLE. 

Swelled testicle (epididymitis) frequently accompanies or follows 
gonorrhoea and may appear at any stage of the disease, but it may result 
from several excesses without gonorrhoea, to the introduction of instru- 
ments into the bladder or to a blow upon the testicle. Usually but one 
testicle is inflamed though occasionally both are affected and sometimes 
the sAvelling switches from one to the other. Although a most painful 
affection the disease is seldom dangerous and usually there is a complete 
recovery. 

Symptoms. — There is sometimes a dragging sensation in one of the 



616 DISEASES OF THE URINABY SYSTEM. 

groins, tenderness in the connecting cord and pain in the back a day or 
so before any actual discomfort is felt in the testicles. There is apt to be 
a chill or chilly sensations at the onset of the disease, but the unmistakable 
symptom is the swelling of the testicle and the accompanying severe pain. 
The swelling increases steadily and the pain correspondingly augments, 
sometimes being of an aching character and sometimes neuralgic, occasion- 
ally darting to the hips and back. Nausea and vomiting are frequently 
an accompaniment of the swelling. The influenced testicle may become 
swollen to the size of a man's fist and cause painful tension of the scrotum. 
The duration of the disease varies. The severe symptoms usually subside 
in four or -iive days, but the enlargement and tenderness may continue 
for some weeks. In some cases where there has been considerable inflam- 
matory deposit, the convoluted portion of the seminal canal at the back 
of the scrotum, known as the epididymus, may remain in a hardened state 
for months or years. 

Treatment. — The patient should remain in bed, the scrotum being 
elevated in such manner as to relieve the tension of the cord. This also 
tends to moderate the rush of blood to the testicle. If early in the case 
the scrotum be scarified Avith nitrate of silver in strong solution (40 to 
60 grains to each ounce of distilled water) the pain will be alleviated 
and sometimes completely banished. When pain is unusually severe relief 
may be afforded by a hypodermic injection of morphine under the skin 
at the location of the cord. Half an ounce of muriate of ammonia and 
one ounce of alcohol in a pint of water makes a lotion which applied to 
the testicle with absorbent cotton, often gives gratifying relief. A thick, 
warm linseed-meal poultice also frequently abates pain. Other treatments 
are lead water and laudanum. The testicle should later be supported by 
a proper bandage or suspensory. Severe tension of the scrotum may be 
relieved by pricking the scrotum in such manner as to let out the serum, 
but this should not be attempted by anyone but a competent surgeon. 



VARICOCELE. 

Varicocele is a term used to designate a swollen or knotty condition 
of the spermatic or testicle veins. It occurs in about ten per cent, of 
males. The veins when felt by the fingers impart an impression as of 
a bunch of earth worms inside the scrotum and is generally on the left 
side. Among causes given are constipation, ungratified desire and exces- 



SYPHILIS. 



617 



sive sexual indulgence. In some severe chronic cases there may be a 
washing away of the testicle. 

The treatment is either palliative or radical. The former is simply 
in the use of some means of affording the patient temporary relief, which 
may be accomplished by use of a proper fitting bandage or suspensory, 
frequently bathing the part with cold water. The radical cure is by 
cutting or tying the vessels. Local applications are not of material benefit. 



SYPHILIS. 

Far-reaching Effects. — Directly syphilis is due to immorality of in- 
dividuals and did it affect only the guilty, humanity in general would not 
be so much concerned, but owing to its nature the disease is such that it 
is easily communicated to the innocent. Not only may it descend to off- 
spring unto the fourth and fifth generation, but it may be given to a 
mother or a sister by a kiss or may be conveyed by use of a towel or any 
other article which the diseased has handled. It may be conveyed in so 
many ways that it is almost impossible to give them in detail, and thus it 
is that humanity in general, whether innocent or guilty, are deeply con- 
cerned and should not only be on personal guard but should act unitedly 
to the end of isolating victims as if the case were small-pox and so even- 
tually suppress the disease. 

Cause — It is a disease the result of a specific poison produced solely 
by direct implantation of the contagious material, usually the purulent 
discharge from a venereal sore in a previously diseased person. 

Development. — About a month after it is in any mode implanted in 
the human system it appears to begin a development throughout the whole 
organism, and penetrating to every part of the body, affects especially the 
skin, glands and throat in the form of secondary symptoms, and still later 
the cartilages and bones as tertiary manifestations, until finally, if un- 
checked, it often proves fatal, after intense and prolonged suffering. 

Local Symptoms — The first symptom of this horrible disease is usually 
a primary sore or chancre, which appears as a small pimple or blister upon 
some part of the organs of generation, or point of contact, any time within 
two or three weeks after the infection is received. The great distinction 
between the syphilitic ulcer, or true chancre, and the chancroid, or non- 
syphilitic sore, is that the former has a hardened base, but the most 



618 



DISEASES OF THE URINARY SYSTEM. 



eminent surgeons admit that neither this nor any other criterion is in- 
fallible. The infecting pimple may dry up without ulcerating, but more 
commonly a cup-shaped sore from an eighth to three-eighths of an inch 
in diameter, and with raised edges, is formed, and unless modified by 
treatment lasts for a month or six weeks, when it heals up, leaving a hard- 
ened lump of a dark red coppery or bronze color, which is often several 
months in completely disappearing. The glands in the groins during the 
ulcerating stage of the primary chancre become swollen, hard and slightly 
painful, but seldom suppurate. After some weeks the other lymphatic 
glands partake of this enlargement, and gradually those in the armpit, in 
the neck and behind the ear give evidence of the general infection. 

The Chancroid Sore. — The chancroid, sofe-chancre or non-syphilitic 
sore, generally develops in a few days from the date of infection, first as a 
minute vesicle, then a pustule, and later as an ulcer, round or oval in shape, 
with clean-cut edges, and without any hardening of the base. The floor 
of the ulcer is generally covered with a thick yellowish matter, which is 
virulent and contagious in the highest degree. The glands in the groins 
are often not swollen, but if affected are much more apt to suppurate, con- 
stituting a bubo, the discharge from which is also intensely contagious. 
It is therefore far more troublesome than the primary syphilitic sore, and 
yet infinitely to be preferred to the latter on account of the absence of 
any constitutional infection. 

The following is a diagnosis between chancre and chancroid : 



Chancre. 

i. Appears two to twenty days after ex- 
posure. 

2. Is usually single. 

3. Inflammatory phenomena compara- 

tively slight. 

4. Discharge is serous or bloody and 

readily inoculable. 

5. Margins of preputial orifice are not 

markedly inflamed. 

6. Marked induration. 

7. Buboes are invariably present, and in 

both groins; they rarely sup- 
purate. 



Chancroid. 

1. The interval between exposure and 

appearance is much shorter. 

2. May be multiple. 

3. Inflammatory phenomena, heat, pain, 

redness and swelling very marked. 

4. Discharge, profuse, purulent, very ir- 

ritating and readily inoculable. 

5. Induration, if present, is not marked. 

6. Buboes, if present, are usually on one 

side, and suppurative. 



Constitutional Symptoms; Secondary. — After a true or hard chancre 
has developed, and no matter whether it has healed promptly or is still 
open, there appears in about four weeks, on an average, from the first 
infection the first of the train of general or constitutional symptoms. 
These consist of the tumefaction of the lymphatic glands, followed after a 



SYPHILIS. 619 

few weeks more by fever, headache, rheumatic pains and soreness of the 
throat. About the tenth week after the dearly-bought pleasure its un- 
fortunate purchaser usually finds a crop of eruption appearing upon his 
skin, sometimes slight and easily concealed, but oftener well defined and 
in a tell-tale abundance, which instantly reveals his guilty secret. 

The Eruptions. — This eruption may be of pimples, pustules, or scales, 
the former being the most common and having a new copper-colored red 
or brownish-red tint, which, when well marked, is to the experienced eye 
very characteristic. It is apt to be especially abundant round the sides of 
the nose and angles of the mouth and eyes, the roots of the hair on the 
forehead and back of the neck, the centre of the breast, the inner side of 
the limbs, and around the armpits and groins. 

Hand and Feet Eruptions — An important diagnostic mark of the 
scaly, syphilitic eruption is its appearance on the palms of the hands and 
the soles of the feet. These manifestations are also particularly liable to 
appear as pustules among the hair of the scalp. In some cases the whole 
body is thickly covered. After persisting for periods varying from two 
or three weeks to as many months, these spots usually fade, leaving behind 
them brownish stains which are very persistent, but ultimately may give 
place to pale scars, somewhat like the pitting of small-pox in a very mild 
form. 

Other Appalling Symptoms. — In a minority of instances the patient 
escapes any well defined symptoms, but suffers instead from one of the 
following manifestations of secondary syphilis, which often accompany 
the eruptions also: Alopecia or falling of the hair, which in bad cases 
may include not only that of the head, but also the eyelashes and eye- 
brows; flat whitish sores in the mouth and anus, called mucous patches, 
the discharge from which in the former situation may easily convey, by 
kissing, the whole vile disease to a perfectly innocent person; inflamma- 
tion of the iris injuring or even destroying the sight ; and local diseases of 
the generative organs. 

Tertiary Symptoms — The late or tertiary symptoms of venereal dis- 
ease are disease of the cartilages and small bones of the nose and throat, 
producing the shocking disfigurement of the countenance sometimes seen, 
especially among sailors ; disease of the bones of the skull leading to per- 
sistent and excruciating headache, and sometimes actually perforating the 
cranium; disease of the tibia or large bone of the leg between the knee 
and ankle; disease of the nails which may entirely ulcerate out; disease 
of arteries which, of course, is most apt to prove fatal, and peculiar new 



620 DISEASES OF THE URINARY SYSTEM. 

growths called gummy tumors, which may appear in all parts of the 
system. 

Congenital (Birth) Syphilis. — Congenital syphilis generally shows 
itself between the third and sixth week after birth, by cutaneous eruptions, 
similar to those seen in the secondary period of acquired syphilis, and of 
most frequent occurrence upon the buttocks, abdomen, palms and soles. 

Symptoms — Congestion and subacute inflammation of the mucous 
membrane of the nose, with increased discharge, vulgarly called the 
snuffles, also appear, and the infant has usually a peculiarly shriveled, 
weazened aspect, like that of a prematurely old man. Mucous patches 
from about the baby's mouth may infect the mother or nurse, and kera- 
titis or inflammation of the cornea of the eye is lamentably common. 
Early and active administration of mercury is very important, lest the 
syphilitic cachexia prove fatal. 

Local Treatment of Chancre. — The treatment of the primary sore, or 
chancre, is much disputed. Cauterization with nitric or tr. chloracetic 
acid, or the acid nitrate of mercury, and subsequent dressing with black- 
wash — a mixture of a drachm of calomel, and a pint of limewater — is 
much employed; but the application of iodoform is highly recommended. 
Complete excision of the sore, with its hardened base, in the hope of 
preventing secondary symptoms, has been tried without success, even when 
performed early. If the enlarged glands in the groins give rise to much 
discomfort, they should be painted over with the tincture of iodine or 
twenty per cent, ichthyol ointment. 

Treatment by Caustic. — The prompt destruction of the chancroid 
ulcer by caustic, and the dressing with black-wash or yellow-wash, is ad- 
visable, and hope may be entertained of thus putting an end to the whole 
malady. If the glands in the groins go on to suppuration, however, very 
serious trouble may be anticipated before a cure is effected. 

Constitutional Treatment. — The treatment of the secondary symptoms 
is by the use of mercury, which, although decried by some physicians, is 
considered by our best authorities as the only effectual remedy for syphilis. 
It may be administered by inunction of mercurial ointment, by fumi- 
gation, or in the form of half a grain of calomel, or blue pill, or one-third 
of a grain of the iodide of mercury thrice daily, or protiodide of mercury 
one-fourth grain three times a day. It is also given by hypodermic injec- 
tions of the bichloride, one-third grain, once a week. The injection must 
be made deep into the muscles. Proper precautions must be taken to 
cleanse the needle and syringe before using, also the skin at point at which 



SYPHILIS. 621 

the needle must be inserted. This treatment should be kept up at intervals 
for a year or two after an apparent cure has been effected. To obtain 
its beneficial effects, which are often very marked and satisfactory, it is 
not necessary to induce severe salivation, which, probably, in former times, 
often aggravated the ultimate effects of the syphilitic poison. 

Treatment of Third (Tertiary) Stage. — In the tertiary stage, iodine 
and iodide of potassium, in the form of the compound iodine solution, or 
the iodide occasionally in very large doses of fifteen or twenty grains, 
thrice daily, are the great remedies ; but they may sometimes be associated 
with mercurials to much advantage. In a majority of instances, the 
development of well-marked tertiary symptoms may be prevented by 
judicious treatment in the second stage of the complaint, and even' when 
a slight tendency to disease of the bones and cartilages is displayed, a 
combination of the iodides with mercury will often avert disastrous con- 
sequences, or the sirop Gibert. 

Use of Tonics. — Throughout the whole management of the case the 
administration of tonics, such as iron, quinine and strychnia is very im- 
portant, and strict attention to hygiene by promoting the best general 
health is an almost indispensable condition to securing a favorable result ; 
also frequent hot baths. 

Should Syphilitics Marry? — Professor Alfred Fournier, in a late in- 
structive work on syphilis and marriage, formulates some valuable con- 
clusions in regard to the very difficult problem, from a hygienic point of 
view, whether a syphilitic person ought to marry or not. He asserts that 
a man who enters upon marriage, with syphilitic antecedents, may become 
dangerous : first, to his wife ; second, to his children ; third, to the interests 
of his family. In the first place the wife is apt to be infected directly by 
contact with the pus of secondary lesions ; and Dr. F. says : "I know from 
long experience that it is rare to see a young wife live with a syphilitic 
man, or conversely, without the health of the former being effected by 
the diseased one." It was this which caused a witty French observer to 
say: "The pox is partaken of by a married couple equally, just like the 
daily bread." 

Syphilis Conveyed by Conception. — Secondly, a man may convey 
syphilis to his wife by causing conception, as when a young girl, pure and 
healthy, is married to a man whose venereal disease has not been thor- 
oughly cured. The physician calls a few months later and finds her dis- 
eased with, for example, distinct secondary symptoms, such as cutaneous 
syphilides, mucous patches in the mouth, scabs on the scalp, swelling of 



622 DISEASES OF THE URINARY SYSTEM. 

the glands in the neck, headache, vague pains, lassitude, febrile attacks, 
loss of hair, and so forth — all this without a trace of chancre, and even 
without that faithful companion of a chancre, a bubo, which M. Bicord 
calls so aptly the posthumous witness of a chancre. In these lamentable 
instances, the wife-mother infected without having had any primary symp- 
toms, and whose husband has long been freed from all external indications, 
is diseased, not from that husband, except indirectly, but from her child 
still within her womb. 

Danger to Children — As respects the danger to children: Although 
offspring may be begotten by a syphilitic father who enjoys good health, 
yet the hereditary influence of paternal syphilis is very far from being as 
innocent, minute or negative as has been maintained. 

Development of the Inherited Tendency.— This inherited tendency 
may be developed in the three following modes : Either that, which is an 
exceptional case, by the transmission of syphilis to the foetus; or that, 
which is sufficiently common, by the death of the child; or lastly, by the 
inherent degeneration of the germ, which ultimately reveals itself under a 
great variety of morbid conditions. 

Worst Form of Danger. — But the worst form of danger to the family 
of a syphilitic father is that communicating the disease to the wife, the 
paternal and maternal influences will act upon the same side, and most 
disastrously conspire in unison against the fruit of any pregnancies which 
may result. In such sad cases we can predict that, with a few rare excep- 
tions, either, first, and the child will die before birth ; or, second, it will be 
born with syphilis, and with all the possible and serious consequences of 
infantile syphilis, which in many cases are equivalent to death itself; or 
finally, third, it may be born without syphilis, but with uncertain health, 
with a weak nature and a feeble constitution, which will probably expose 
it to a rapid death ; with menacing morbid tendencies ; with a predisposi- 
tion to certain organic diseases — in a word, to a relatively speedy decay; 
this terrible fate being visited again and again upon successive innocent 
babes. 

Transmission of Syphilis. — At the New Orleans meeting of the Public 
Health Association, Dr. Gihon of the Navy, as chairman of a committee 
on the subject, presented a valuable report, in which he remarked: 
"Every one instinctively shrinks from the touch of the sufferer with small- 
pox, but how few realize that a syphilitic is a leper also to be most scru- 
pulously shunned ? How few mothers are aware of the danger, to them- 
selves and their children, from nurses and housemaids drawn from a part 



SYPHILIS. 623 

of the population in which every fifteenth person is thus diseased \ How 
few parents suspect the peril to their daughter from her accepted lover's 
kiss, since he may be that one in about every five young men among the 
better classes who has a venereal disease, which there is one chance in 
two is syphilis." 

Transmission of Syphilis by Kissing. — These are not mere speculations, 
for Professor Gross reports that he has seen many cases communicated by 
kissing ; and he tells of fifteen women, nine children, and ten men diseased 
by a single midwife, who had a chancre on her finger, contracted in the 
exercise of her profession, and who had thus carried the disease from 
house to house. 

Transmission by Cooks and Nurses. — Dr. J. Marion Sims says:- "I 
have seen a cook and a chambermaid with syphilitic ulcers on their fingers ; 
I have seen nurses infected by the children they had nursed, who were 
born of syphilitic parents, in turn infecting sucking babes, born of healthy 
parents; and I have known a drunken vagabond husband to contract 
syphilis and communicate it to his wife, who in turn gave it unwittingly 
to her four children, simply by using the same towels and washbowl." 

Transmission by Towels. — One of this very committee adds the case 
of an estimable and venerable lady, who lost her eyesight that year, from 
a venereal affection arising from using a towel in her son's room, care- 
lessly left by him upon the rack ; and of another, the wife of a clergyman, 
who the preceding summer sought relief at a Virginia spring for a hor- 
rible affection contracted in domestic contact with her servant. 

Transmission by Pipes and Cigars. — The present Surgeon-General of 
the Navy saw a number of cases of chancre of the lips among the smokers 
of one set of cheroots, of which the wrappers had been moistened by the 
saliva of a Manila cigar girl; and at Beyroot he learned that it was not 
unusual for syphilis to be contracted by using a narghileh that had been 
pressed by the lips of a diseased smoker. How many people would venture 
to eat Smyrna figs if they had seen the top layer of the choicest box pressed 
flat with the saliva-wetted thumb of the packer, who, there was one chance 
in ten, was a syphilitic ? 

Transmission by Exhalation — A certain lady was terribly alarmed 
when told by her husband, a physician, that she had invited to her table a 
young man who, in the course of a physical examination that morning, 
he had found to have his mouth and tongue covered with mucous patches ; 
and that her daughter was dancing in a public ballroom with another 
whose body was repulsive with syphilitic eczema. 



624 DISEASES OF THE URINARY SYSTEM. 

Transmission by Instruments — An editorial in one of our Philadel- 
phia medical journals not long since stated: "It has happened to the 
writer to be recently called to see a man of most respectable surroundings, 
who bore an unmistakable venereal sore upon his lip, and subsequently 
manifested all the features of secondary syphilis. It was said that this 
sore had followed a trifling surgical operation upon the part affected for 
the removal of a slight deformity, during which the instruments or the 
hands of the surgeon had inoculated him with syphilis. 

Ever-Present Dangers. — This energetic committee urged that it should 
be promulgated everywhere throughout the community, that so long as 
syphilitics are allowed to go unrestrained the spotless woman and the 
innocent child share the danger of this horrible contamination with the 
libertine and the courtesan. 

The Various Ways of Transmitting Syphilis — Let it be known by every- 
one, they exclaim, that this fearful pest may be communicated : 

1. By the blankets of the sleeping car, the sheets, towels and napkins 
of the steamship, hotel and restaurant. 

2. By the hired bathing dresses at a seaside resort, and the costumes 
rented for the fancy ball. 

3. By the chipped edges of cups and plates, as seen at any hotel or 
eating house, and by the half-cleansed knives, forks and spoons of the 
same. 

4. By public drinking vessels in a railway car or station, as well as 
the public urinal or water-closet. 

5. By the barber's utensils, the comb and brush in the guest chamber, 
the hatter's measure, or the borrowed hat. 

6. By the surgeon's and dentist's instruments, or the vaccinator's 
lancet. 

7. By the broom or dust-brush handled by a parlor maid, or by the 
spoon or cup touched by the mouth of a cook or nurse. 

8. By whistles and other toys sold to children in the streets by ven- 
dors with poisoned lips or fingers. 

9. By playing or visiting cards which have been used, and especially 
by car tickets and paper money circulating in a city like Philadelphia, 
where 50,000 syphilitics are at large. 

10. By the grasp of a friend's hand or the kiss of a betrothed lover, 
by the son to his mother and sister, the husband to his wife and unborn 
child, and by the latter to its mother 



SYPHILIS. 625* 



SYPHILIS— A VEGETABLE TREATMENT. 

Hematesene. — Under the former methods of treatment there was no 
remedy in the pharmacopoeia which could be relied upon as a specific for 
syphilis, although there were many that had a very beneficial influence in 
aiding the disappearance of the symptoms. It was then, indeed, a question 
whether the disease could ever be effectually cured. 

Mercury Not Relied On. — In former times it was thought that in mer- 
cury we possessed a specific against the disease, and when all sores were 
looked upon as syphilitic, and mercury was administered, a large pro- 
portion of supposed cures were recorded. In our modern times, however, 
the supposed success of the mercurial plan is not recognized. 

The New Specific. — Recent investigation and research have brought 
to light a remedy called hemetesene, which is as much a specific for 
syphilis and blood-poisoning as quinine is for intermittent fever. Mer- 
cury and the iodides produce injurious effects if long continued, and 
should be avoided. Patients who have been treated by the old plan im- 
prove rapidly after taking hemetesene. In some patients an itching is 
produced; in others an eruption on portions of the body or limbs; in a 
few watery blisters in the palms of the hands and soles of the feet which 
require no particular attention except to cleanse them with water, adding 
a few drops of carbolic acid. 

Comparison of Treatments. — This vegetable treatment is a certain anti- 
dote to blood-poison, and increases the number of red corpuscles in poor 
blood, while mercury and the iodides often produce a run-down condition 
of the system if taken for a length of time. 

Effect of This Vegetable Treatment. — The effect of hematesene as a 
constitutional remedy rests, unquestionably, in its power of eliminating 
specific poison from the blood, and in its tonic power, increasing the pro- 
portion of red corpuscles in impoverished blood, thus enabling the system 
to throw off disease. 

ANOTHER TREATMENT FOR SYPHILIS. 

Salvarsan 606 Antisyphilitic Remedy. 

Many observers at the present time are experimenting with this new 
remedy brought before the medical profession by Dr. Ehrlich, of Germany. 
The opinions of the profession at present vary as to whether we have a 
40 



626 DISEASES OF THE URINARY SYSTEM. 

specific for the cure of syphilis. At present it has proven successful in 
quite a number of cases, while some physicians have reported bad effects 
following its use. The following will give a resume of the facts developed 
at this time, and also the mode of treatment. Of course, it should not be 
administered by anyone except a qualified physician. Syphilis is an in- 
fection of the system by spirochceta pallida. This is one of the protozoal 
type of organism, such as malaria, relapsing fever, etc. The pathological 
pecularity of organisms of this type is that they rapidly acquire immunity 
to the antitoxins developed in the body against them, and thus establish a 
more or less permanent residence in the body constituting a chronic affec- 
tion. The protozoa also rapidly develops resistance to small doses of 
chemical poisons introduced into the system against them for curative 
purposes, as malaria is cured by quinine in large doses. 

Mercury and arsenic are two chemical agents found to be especially 
destructive to the germ of syphilis- It having been found difficult to 
introduce enough mercury into the system to destroy the germs, without 
seriously injuring the patient, attention was turned to arsenic. By ex- 
periments Dr. Ehrlich announced to the profession that a combination of 
arsenic with soda would prove effective. This he has named Salvarsan, 
or 606. 

Salvarsan is a light-yellowish powder, containing about thirty-four 
per cent, of arsenic; when dissolved in water forming strongly acid solu- 
tions, on account of this acid reaction, it must be neutralized before use. 
The preparation is administered only with great care by a physician, 
intravenous or by subcutaneous injection. Some observers have secured 
similar results by the use of cocodylic acid, a salt of the allotropic form of 
arsenic, by injections of one or two grains. It also appears that mercury, 
instead of being contra-indicated, at the same time may aid in a cure. 
It is hoped that all that is claimed for it will be fulfilled, and that hu- 
manity will be cured of this so-called great pox. 



SPERMATORRHEA OR INVOLUNTARY EMISSIONS. 

As an appendix to the unsavory subjects discussed in this chapter, a 
few remarks upon spermatorrhoea and its usual cause are appropriate here. 
It would be impossible to estimate, with any approach to accuracy, the vast 
amount of anxiety and mental suffering needlessly endured in our com- 
munity in regard to this disease. It is sad to think of the many men, 



INVOLUNTARY EMISSIONS. 627 

young, middle-aged and those who are still young in age and strength, who 
suffer from one or more of the above conditions, robbing them of all that 
is precious and so important to them. Many men are mere pigmies of 
what they should be. Because of this decline they are backward and sensi- 
tive, unaggressive in their business, easily discouraged, weak and nervous, 
instead of being strong and vigorous. 

The Disease and Results — That the disease called spermatorrhoea ex- 
ists, and in rare cases does result in the utter wreck of mind and body, 
which is painted by these designing quacks in such sombre colors, cannot 
be denied, but that nineteen out of every twenty young men who have be- 
come alarmed by the occasional or even frequent occurrence during sleep 
of what they have learned to control whilst awake, have no real ground 
for their agonizing fears is equally indisputable. 

Causes. — The usual cause of spermatorrhoea, of course, cannot be 
freely discussed in a popular work like this, and yet enough may be ex- 
pressed in veiled language, the meaning of which will be only or chiefly 
comprehended by those who need the lessons inculcated, to accomplish, 
it is hoped, much good. Many young persons of both sexes, after being 
made aware of the danger in which they were becoming involved through 
evil examples, perhaps, of school associates, have earnestly tried to escape 
the thraldom of bad habits or early indiscretions. 

Treatment by Will Power — Some of those who have succeeded, by 
the exercise of a resolution and strength of will, for which they deserve 
great credit, have overcome their enemy, but are yet haunted with the 
fear that they have been irreparably injured in the struggle. This fear 
is entirely unfounded, as time will infallibly prove. 

Treatment by Exercise and Nutrition. — A second and larger class are 
still discouraged by frequently recurring evidence that they are not in a 
natural and healthy condition, and some may even be so disheartened as 
to feel almost hopeless. For such plenty of exercise in the open air, good 
nutritious food, chiefly vegetable, occupation of the mind in some study or 
suitable recreation, and the proper medical treatment, can with a con- 
tinued exercise of the will power during the waking hours speedily ac- 
complish a cure. 

Treatment by Hygiene and Medicine — To a third class, who find them- 
selves still unable to overcome temptation, much aid will be afforded by 
adopting the plan of hygienic and medical treatment hereunder indicated, 
and by diminishing, as the drugs mentioned can do, the force of the im- 
pulse itself, they may so reduce its power that a little additional resolu- 



628 DISEASES OF THE URINARY SYSTEM. 

tion will suffice to achieve a victory. In this struggle they may find some 
support in the grand old maxim, "He that ruleth his own spirit is greater 
than he who taketh a city." Among the best remedies for this condition is 
the pill cann-aven. This should be taken for some time. 



IMPOTENCY IN MALES AND FEMALES. 

Impotence means a lack of ability to properly perform the sexual 
act. It may be partial or complete. 

In females it may be due to faults in the ovaries, absence of perfect 
development, displacements, inflammations or degenerations, faults in the 
oviducts or fallopian tubes, faults in the uterus, faults in external organs, 
etc. Morbid conditions of the vagina should be corrected and morbid 
conditions of the womb overcome. Hot injections and hot baths are of 
great service where inflammation is a cause. 

In males impotency may be due to advanced age, disease of testicles, 
absent or defunct erection, spinal irritation, malformation, non-develop- 
ment of the organs, early abuses, loss of will power, sexual excesses, 
gonorrhoea, gleet, alcoholism, etc. 

In all cases, whether male or female examination should be made by 
a competent physician (avoid quacks) in order to determine the actual 
cause. The general health should be looked after and a tonic treatment 
should be carried out, among the remedies used being damiana, strychnine, 
phosphorus, etc. A good pill is the neuro-tonal or compound damiana. A 
direct and useful remedy is cantharides in ten-drop or fifteen-drop doses 
every three or four hours previous to desired intercourse. Dilute phos- 
phoric acid, phosphate of iron and ergot of rye are also valuable. These 
remedies may be used by either sex and should be continued for some time. 

Apparent impotency in the male is frequently due to lack of confi- 
dence. A newly-married person who finds difficulty in this way should 
not become disheartened. A full understanding of conditions and a 
masterful reassertion of confidence will prove of more avail than medicines. 



PART IX OF BOOK IV 

Treats of the Urine in health and disease and gives 
a series of tests for urine which may be used in the 
home. 



Acidity of Urine, Test for 634 

Alkalinity of Urine, Test for 634 

Gravometer 634 

Hydrometer 634 

Specific Gravity of Urine, Test for... 634 

Table of Urinary Constituents 633 

Tests of Urine 634 

Urine, The 631 

Acid, Test for 634 

Alkaline, Test for 634 

Amount of 631 

Color of 631 



Consistency of 632 

Constituents of 633 

Density of 633 

Examination of 634 

Reaction of 633 

Specific Gravity of 632 

Table of Constituents 633 

Tests for 634 

Test for Specific Gravity 634 

Transparency of 632 

Urinometer 634 



Home Tests for Urine (full page in 

colors) 634 



ILLUSTRATIONS 

The Urinometer 



634 



629 



CURATIVE MEDICINE 



PAKT IX. 
URINE IN HEALTH AND DISEASE. 



As a rule, in chronic diseases one of the first manifestations is a 
change in the urine, sometimes noticeable by appearance, but in other 
cases only discernible by careful examination. We shall first consider 
urine in normal condition and then the effects upon the same when the 
body is diseased. 

Amount. — The normal quantity of urine varies from 2| to 3^ pints 
in the twenty-four hours, the quantity being greater with men than with 
women. It is decreased by free perspiration and increased by chilling of 
the skin. The quantity of fluids taken is of course a factor. Different 
diseases affect the quantity in different ways, causing an increase in 
diabetes, in some nervous" diseases, like hysteria and convulsions, also 
in apoplexy, convalescence from acute and inflammatory diseases and 
in enlargement of the heart. It is decreased by heat, in fevers, shock, 
stoppage due to heart disease, acute congestion of the kidneys, in diseases 
accompanied by purging and vomiting. In all forms of Bright's disease 
(with the exception of chronic diffuse and interstitial kidney trouble) 
and in all diseases before death, the decrease is due to obstruction in the 
bladder or the urethra. 

Color. — The normal color is light amber, which deepens in shade if 
the quantity voided be decreased, and vice versa. The quantity of fluids 
drunk and the extent of perspiration also have effect on color. In disease 
it will be found pale, in diabetes, hysteria, interstitial nephritis and like 
disorders, the specific gravity usually remaining at or near normal with 
the exception of diabetes, where the specific gravity is very high, owing 
to the presence of sugar. It is high-colored in most other diseases and in 
acute fevers and inflammation. Eeddish color indicates the presence of 

631 



632 THE URINE IN HEALTH AND DISEASE. 

abnormal coloring matter, usually blood. A dark brown color may be a 
sign of hemorrhage of the kidney. Urine which turns greenish on stand- 
ing contains bile pigments. In cancer the urine becomes almost black 
on standing, in typhus and cholera, blue. Both diet and drugs have 
effect on color. After taking rhubarb or senna the urine is apt to be 
brownish, santonin produces yellow and methyl causes a bluish color. 

Odor. — There is a peculiar aromatic or urinous odor from normal 
urine, which becomes putrid and ammoniacal on standing. Fresh urine 
which has these latter characteristics indicates bladder trouble; a fecal 
odor indicates a fistule between the urethra and rectum. The odor may 
be changed by vegetables or drugs, turpentine giving the odor of violets, 
asparagus, turnips, cubebs, copaiba, sandalwood, etc., each producing 
their own peculiar odor. In diabetes the urine smells sweet. A par- 
ticularly foul smell, as of sulphur, is given off when there is pus in the 
bladder. 

Consistency. — The normal consistency is that of water, but it becomes 
thick and sometimes stringy on standing, more particularly after it has 
become alkaline. Where there is much sugar or albumin there is a ten- 
dency to frothiness. 

Transparency. — Freshly passed urine in normal state is always clear, 
but after standing a faint cloud of excrete matter floats near the center 
and eventually settles to the bottom. This is increased in cystitis, pros- 
tatitis, urethritis and other catarrhal conditions of the urethral tract. 
It is more pronounced in women than in men. It may be distinguished 
from other cloudy substances by its tendency to float in the center and 
its precipitation by an excess of acetic acid. Bacteria, phosphates, or 
pus cause turbid urine. If due to bacteria, the turbidity is not cleared 
with acetic acid, whereas if due to phosphates, it will be cleared by a few 
drops of acetic acid. Urates cause a deposit to settle quickly, pus pro- 
duces an opaque color which in a few minutes settles to the bottom. 

Specific Gravity. — The normal specific gravity varies from 1.010 to 
1.025. It is low when an increased quantity is passed and high when the 
quantity is diminished. Determination of specific gravity should be made 
by taking a small quantity of the total passed in twenty-four hours, care 
being taken that the vesel is absolutely clean before starting and that it is 
kept covered between the urinations. The specific gravity is increased 
at the beginning of acute fevers, after severe operations, at the commence- 
ment of acute Bright's disease and when the urine contains blood. It is 
exceptionally high in diabetes, sometimes reaching as high as 1.050. It 



EXAMINATION OF URINE. 



633 



is diminished in Bright' s disease (excepting the first stage of acute above 
referred to), in all forms of impaired circulation due to heart disease, in 
hysteria and in chronic interstitial nephritis. 

Reaction. — The normal reaction is slightly acid, excepting after meals, 
when it may be neutral or even alkaline. Acidity is increased by a red- 
meat diet and diminished by obstruction and inflammation of the urinary 
tract. 

Constituents. — The most important organic and inorganic solid con- 
stituents held in solution are: Urea, from 308 to 617 grains daily; uric 
acid, from 6 to 12 grains ; urates of sodium, ammonium, potassium, cal- 
cium and magnesium, from 9 to 14 grains ; phosphates of sodium, etc., 
from 12 to 45 grains, and chlorides of sodium, etc., from 154 to" 247 
grains daily. The following table shows specifically the amount of solid 
matter contained in 1000 grains of urine of different densities. 



Specific 
Gravity. 


Solids. 


Water. 


Specific 
Gravity. 


Solids. 


Water. 


Specific 
Gravity. 


Solids. 


Water. 


Specific 
Gravity. 


Solids. 


Water. 


1001 


2 33 


997,67 


1011 


25.63 


974.37 


1021 


48.93 


951.07 


1031 


72.23 


927.77 


1002 


4.66 


995.34 


1012 


27.96 


972.04 


1022 


51.26 


948.74 


1032 


74.56 


925.44 


1003 


6.99 


993.01 


1013 


30.29 


969.71 


1023 


53.59 


946.41 


1033 


76.89 


923.11 


1004 


9.32 


990.68 


1014 


32.62 


967.38 


1024 


55.92 


944.18 


1034 


79.22 


920.78 


1005 


11.65 


998.35 


1015 


34.95 


965.05 


1025 


58.25 


941.75 


1035 


81.55 


918.45 


1006 


13.98 


986.02 


1016 


37.23 


962.72 


1026 


60.50 


939.42 


1036 


83.88 


916.12 


1007 


16.31 


983.69 


1017 


39.61 


960.39 


1027 


62.91 


937.09 


1037 


86.21 


913.79 


1008 


18.64 


981.36 


1018 


41.94 


658.06 


1028 


65.24 


934.76 


1038 


88.54 


911.46 


1009 


20.97 


979.03 


1019 


44.27 


955.73 


1029 


67.57 


932.43 


1039 


91.87 


909.13 


1010 


23.30 


976.70 


1020 


46.60 


953.40 


1030 


69.99 


930.40 


1040 


93.20 


906.80 



The manner of using the above table is as follows: The density of 
urine passed in twenty-four hours having been ascertained, as hereafter 
explained under the caption "Examination of Urine," a glance at the 
table will show the proportion of solid matter and water in 1000 grains 
of the urine, then taking the weight of the whole quantity of urine passed 
in the twenty-four hours, the solids drained off by the kidneys may be 
determined by the simple rule of proportion. 

Urine passed shortly after drinking excessively is pale and has a 
low specific gravity, varying from 1.003 to 1.009. That passed soon 
after the digestion of a full meal has a specific gravity of from 1.020 to 
1.030. The best specimen of average density and nature of healthy 
urine is obtained in the morning before eating or drinking, and in perfect 
health should range from 1.015 to 1.025. 



634 



THE URINE IN HEALTH AND DISEASE. 



EXAMINATION OF URINE. 



Jtor-^ 



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m 



vV*3 



H 



%L 



The 
Urinometer. 



Different tests of urine are made for the discovery 
of different constituents, but in respect of all tests it 
is first necessary to determine whether the urine is acid 
or alkaline and to ascertain the specific gravity. 

Acidity or Alkalinity. — Dip a piece of blue litmus 
paper in the urine and if on removing the color of the 
paper is changed to red or reddish-brown it will indi- 
cate that the urine is acid. If there be no change in 
the color of the paper then use yellow turmeric or red- 
dened litmus paper. If the color still remains unaltered 
the urine is neutral, that is, it is neither acid nor alka- 
line, but if the yellow turmeric becomes brown, or the 
reddened litmus changes to blue, the urine is alkaline. 

Specific Gravity — For this purpose a urinometer 
should be obtained (see accompanying cut). It is also 
known by the names of hydrometer and gravometer 
and can be obtained at all surgical instrument houses 
and most drug stores. It is graduated in such manner 
as to show the different degrees of specific gravity and 
is utilized in connection with a small glass tube, also 
graduated, into which the urine is poured. When 
placed in still water the urinometer will sink to a cer- 
tain point, and as all solids immersed in fluid displace 
a bulk equal to themselves, it follows that the urino- 
meter will not sink as deep in a fluid which is denser 
than water. The instrument having been immersed in 
the tube of urine and come to rest, the number on the 
graduated scale which stands at the surface of the 
liquid plus 1.000 will represent the specific gravity of 
the urine. For instance, if the number at the surface 
be 7, the specific gravity will be 1.007; if it is 28, it 
will be 1.028. 



2 

5 

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How to Examine the Urine 



Specific Gravity — This should be done with a Urinometer. In health 
it varies from 1.012 to 1.025. In disease from 1.002 to 1.040. Deter- 
mination should be made from 24 hours' urine. 

Reaction. — Xormal urine is slightly acid, and the test can be made 
with Litmus paper. If acid it turns the blue paper red or pink. 

Transparency. — Xormal urine freshly passed is clear, but on standing 
it becomes cloudy and finally there is a precipitate. 

Consistency — Xormal is practically the same as water ; becomes thick 
and stringy on standing. 

Odor. — Xormal urine has an aromatic or urinous odor; on standing 
becomes ammoniacal. 

Albumen. — Test : Boil the urine and add a small quantity of nitric 
acid. If there is a precipitate and it does not dissolve albumen is present. 

Sugar. — Test : Take a teaspoonful of Fehling's or Haines' Solution ; 
boil and add a few drops of urine. If sugar is present there will be a 
reddish precipitate. If no sugar it will remain clear. 

Indican. — Test : To a teaspoonful of hydrochloric acid add one drop 
of nitric and fifteen drops of urine and stir. In HYe to twenty minutes an 
amethyst color denotes normal amount present ; a deep violet shows more 
than the normal amount. 



PART X OF BOOK IV 

Describes the many diseases which are peculiar to 
women, their causes, diagnoses, symptoms and various 
modes of treatment. 



Abdomen, Changes in 689 

Abortion 678, 681 

Criminal . . . , 682 

Dangers of 682 

Divisions of 681 

Evil of .., 678 

Treatment of 678, 684 

Abscess of Breast 675 

Afterbirth, Expelling the 699 

Amenorrhea 640 

Atresia of the Vagina 657 

Baby's First Bath 701 

Putting to Breast 705 

Suckling, The 704 

Bhth of Child . . . . .695 

Presentation of Child 695 

Bladder, Diseases of 673 

Inflammation of 673 

Irritability of 673 

In Pregnancy 694 

Stone in 674 

Bleeding of the Vulva 654 

Bottle, Cleanliness of 706 

Breast, Abscess of 675 

Cancer of 676 

Diseases of 675 

Inflammation of 675 

Milk 704 

Putting Baby to 705 

Tumors of 676 

Bringing up the Infant by Hand. . . .705 

Bulb Syringe 647 

Buttock Presentation in Childbirth. 696 

Cachexia in Cancer of Womb 663 

Cancer of the Breast 676 

Cancer of the Vagina 658 

Cancer of the Womb 662 

Cachexia in 663 

Hemorrhage in 662 

Hemorrhage, Checking of 664 



Injections for 664 

Morphine, Use of 663 

Visceral Disorders 663 

Carbuncle, Urethral '. .' . 657 

Care of the Skin 677 

Cessation of Menses 640 

Change of Life 679 

Child, Attending the 699 

Child-bed Fever 702 

Child-birth 695 

Buttock Presentation . . .^. 696 

Mother's Dress in 696 

Presentation of Child 695 

Should Child Not Cry 700 

Shoulder Presentation 696 

Wrong Presentations 701 

Child Blemishes Produced in Preg- 
nancy 693 

Child, Delivery of 698 

Child, Presentation of at Birth 695 

Child, Weaning the 706 

Cleanliness of Nursing Bottle 706 

Closet, the Outdoor 650 

Coccygodynia 657 

Conception 679, 685 

Conception of Twins 686 

Constipation 648 

Causes of 648 

Diet in 651 

in Pregnancy 694 

Nausea 649 

Poisoning in 649 

Prescriptions for 652 

Treatment of 651 

Contraction of Womb 699 

Contraction of Vagina 656 

Convulsions, Puerperal 703 

Crabs 656 

Cracked Nipples 7° 2 

Criminal Abortions 682 



635 



636 



IOTEX TO PART X OF BOOK IV. 



Cystic Tumors of the Ovary 669 

Cystitis 673 

Delayed Menstruation 641 

Delivery of Child 698 

Dilution of Milk Z 706 

Diseases of the Bladder 673 

and Marriage 678 

of External Genital Organs. .. .653 

of the Female Breast 675 

of the Ovaries 667 

of the Oviducts 667 

of the Uterus 659 

of the Vagina 657 

of the Womb 659 

of Women, List of 639 

Disorders of Menstruation 640 

Displacement of Ovary 669 

of Womb 664 

Douche, The 647 

Douching, Position in 648 

Dressing, Mode of 677 

the Navel 701 

Duration of Labor 695 

Dysmenorrhea 641 

Ectopic Pregnancy 686 

Endometritis 659 

Enlarged Veins in Pregnancy 694 

Exercise in Pregnancy 693 

Excessive Menstruation 643 

Meaning of 643 

Plugging the Vagina in 644 

Removal of Tumors 644 

Treatment 644 

Expelling the Afterbirth 699 

Extra Uterine Pregnancy 707 

Symptoms of 707 

Treatment of 707 

Falling of Womb 666 

Fetid Discharge in Leucorrhea 646 

Fever, Child-bed 702 

Puerperal 702 

Fibrous Tumors of Uterus 660 

Treatment of 660 

Fibrous Tumors of Womb 660 

First Stage in Labor 697 

Flooding in Childbirth 700 

Food During Pregnancy 692 

Proper Kinds of 677 

Fountain Syringe 647 

Genital Organs, External 653 

Diseases Induced by 672 



Gonorrhea 671 

Treatment of 672 

Hematoma of the Vulva 654 

Hyperemesis of Pregnancy 694 

Impregnation, How it Occurs 686 

Infant, Bringing Up by Hand 705 

Management of 704 

Inflammation of the Bladder 673 

of the Breast ■ . 675 

of Oviducts 667 

of the Vagina 658 

of Vulva 653 

of Walls of Womb 660 

Injection, Vaginal 647 

Labor 694 

After-management 701 

Birth Presentation 695* 

Buttock Presentation 696 

Duration of .'.',.. 695 

Duration of Second Stage 695 

First Child ... 695 

First Stage 697 

Length of First Stage 697 

Mother's Dress in ■ 696 

Pains of First Stage 697 

Period of 697 

Premature 695 

Preparations for 696 

Second Stage 697 

Shoulder Presentation 696 

Stages of 696 

Third Stage . ., 698 

Lacerations of the Perineum 670 

Length of First Stage in Labor . . . .697 

Leucorrhea 645 

Fetid Discharge 646 

Injection for 646 

Treatment of 645 

Lining Membrane of Womb 659 

Malignant Tumors of Vagina 658 

Mammary Gland 689, 690 

Mammitis 675 

Management of Infant 704 

Mania, Puerperal 703 

Marriage with Disease 678 

Mastitis 675 

Menopause 679 

Menorrhagia 643 

Menses, Cessation of 640 

Menstrual Period 678 

Menstruation 639 



INDEX TO PAST X OF BOOK IV. 



637 



Beginning of 639 

Delayed 641 

Disorders of 640 

Excessive 643 

Frequency of 640 

Painful 641 

Parent's Duty in 639 

Suppressed 640 

Treatment 641 

When to Avoid Medicines in 641 

Metritis 660 

Metrorrhagia 643 

Midwife, Duty of 698 

Milk-leg ..703 

Milk, Dilution of 706 

Mother's 704 

Testing the 705 

Miscarriage 681 

Morning Sickness 688 

Mother, Attention to, after Child- 
birth 700 

Avoid Excitement 705 

Dress in Childbirth 696 

Milk 704 

Nausea in Constipation 649 

Nausea in Menstruation 642 

Navel, Dressing the 701 

Nipples, Cracked 702 

Sore 702 

Preparation of 697 

Nurse, The Wet 705 

Nursing Bottle, Cleanliness of 706 

Nursing Mothers to Avoid Excite- 
ment 705 

Nursing, Time for 705 

Orgasm, Lack of 687 

Ovaries 667 

Diseases of 667 

Treatment of 668 

Ovaritis 667 

Ovary 690 

Displacement of 669 

Prolapsus 669 

Tumor of 669 

Overwork 677 

Oviducts, The 667 

Diseases of 667 

Inflammation of 667 

Ovule, The 685 

Painful Menstruation 641 

Bearing Down Pains 642 



Meaning of 641 

Nausea 642 

Purgation in 643 

Treatment 642 

Pains in Labor 697 

Parturition 695 

Perineum 670 

Lacerations of the 670 

Period of Labor 697 

Plugging the Vagina 644 

Poisoning in Constipation 649 

Polypus Tumor of Womb 661 

Pregnancy 688 

Care During 692 

Child Blemishes in , . .693 

Condition of Bladder in 694 

Constipation in 694 

Duration of 689 

Ectopic 686 

Enlarged Veins in 694 

Exercise in 693 

Extra Uterine 707 

First Indication of 688 

Food During 692 

Hyperemesis of 694 

Morning Sickness in 688 

Quickening Period 689 

Toothache in 694 

Uterine 688 

Vomiting in 693 

Pregnancy Table 692 

Premature Labor 695 

Preparing the Nipples 697 

Prevention of Flooding in Child- 
birth 700 

Prolapsus of Ovary 669 

of Womb 666 

Pruritus Vulva 654 

Puberty in Women 639 

Puerperal Conditions 702 

Convulsions 703 

Fever 702 

Mania 703 

Pyosalpinx 668 

Quickening Period in Pregnancy. .689 

Removal of Tumors 644 

Salpingitis 667 

Scabies 655 

Second Stage in Labor 697 

Shoulder Presentation in Child- 
birth 696 



638 



INDEX TO PART X OF BOOK IV. 



Skin, Cafe of . ■. -. .677 

Skin Diseases of the Vulva ;.....; .655 
Sore Nipples ■. ■. -. . ■. . . . . ■. \ . » i » » * » » ■-. » » 7°^ 

Spermatozoids •. ■. > •. » 1 •. 4 . -. 686 

Movement of ■. ...686 

Sterility > -. .... .687 

Stone in Bladder ; . . . ; .674 

Suckling the Baby .'. , , -. . •. ■. ; ■. k « . 704 

Suppressed Menstruation : -. ....... .640 

Syringes -. .*»**»»-. -. 647 

feulb v. 647 

Fountain 647 

Table, Pregnancy 692 

Temperature of Douches 648 

Testing the Milk , 70S 

Third Stage in Labor . . * . ( . 1 i'i » . ■. ■. .6g& 

Tight Lacing .,.»,.» 678 

Time for Nursing 705 

Toothache in Pregnancy 694 

Treating the Womb 699 

Tumors, Cystic, of the Ovary 669 

Fibrous, of Uterus 660 

of the Ovary 669 

of the Vagina 658 

of the Vulva 655 

Polypus, of Womb 661 

Removal of 644 

Twins, Conception of 686 

XJlceration of Womb 661 

Menstruation in 661 

Treatment of 661 

Urethral Carbuncle 657 

Uterine Pregnancy 688 

Extra 707 

Uterus 659 

Cancer of 662 

Diseases of 659 

Fibrous Tumors of 660 

Inflammation of 659 

Lining Membrane of 659 

Polypus Tumor of 661 

Ulceration of 661 

Vagina 657 



Atresia of the . . . < .6$? 

Cancer of , s 6gS 

Contraction of ^56 

Diseases of 657 

Inflammation of 658 

Malignant Tumors of 65S 

Plugging the . . ; * > ; 644 

Vaginal Injection 647 

Proper Way to Take 647 

Vaginismus 656 

Vaginitis 658 

Veins, Enlarged in Pregnancy 694 

Visceral Disorders of Womb 663 

Vomiting in Pregnancy > . .693 

Vulva, The 653 

Bleeding of 654 

Inflammation of 653 

Itching of 654 

Skin Diseases of 655 

Tumors of the 655 

Vulvitis 653 

Treatment of 653 

Weaning the Child 706 

Wet Nurse, The 705 

Whites l . 645 

Womb 659 

Backward Displacements 665 

Cancer of 662 

Contracting the 699 

Diseases of 659 

Displacements of 664 

Falling of 666 

Fibrous Tumors of 660 

Forward Displacements of ....664 

Inflammation of 659 

Lining Membrane of 659 

Polypus Tumor of 661 

Prolapsus of 666 

Treating the 699 

Ulceration of 661 

Women, Interesting Facts Concern- 
ing 677 

Wrong Presentations in Childbirth. 701 



ILLUSTRATION 

Ovary and Mammary Gland 691 

Urinary and Generative Organs... 640 



CURATIVE MEDICINE 



«PAET X. 
DISEASES PECULIAR TO WOMEN 



List of Diseases — The diseases peculiar to the female sex comprise 
those of the uterus (womb), ovaries and their appendages, the vagina, 
external generative organs and mammary glands (breasts). 

Divisions of Woman's Life — The life of a woman may be divided 
into five periods. They are infancy, puberty, maturity, the menopause 
and senility. 

Period of Puberty. — Puberty is the period in which the child becomes 
the woman, this is the period when she begins to menstruate. It is the 
time when the breasts begin to assume a rounded form, her general 
contour .becomes shapened, and her generative organs have reached their 
full development. Maturity extends from puberty to the menopause, and 
is the period during which women bear children. 

MENSTRUATION. 

A Mother's Duty. — Menstruation or the monthly flow is characterized 
by a bloody discharge from the womb, and occurs at regular periods, 
usually every twenty-eight to thirty days. It is the duty of every mother 
to explain to her female offspring this condition of affairs, detailing when 
it occurs, how often to expect it, and the use of the napkin during this 
period. Too many mothers, on account of a mock modesty, allow their 
children to pass through the establishment of this function in total ignor- 
ance. Such practice, however, should be condemned. 

Beginning of Menstruation. — I have often seen children run to their 
mother when the first drop of blood appeared, frightened beyond descrip- 
tion. The first flow usually appears between the ages of twelve to four- 

(639) 



640 DISEASES PECULIAR TO WOMEN. 

teen. In the torrid zone it appears two or three years earlier, thus these 
children are capable of child bearing at so early a period. 

Frequency of Menstruation. — Every woman is a law unto herself. As 
before stated, menstruation usually appears every twenty-eight to thirty 
days; some women, however, menstruate every four to six weeks and 
are in perfect health. A napkin should always be worn during the flow; 
surprising as it may seem, many fail to do so. 

DISORDERS OF MENSTRUATION. 

Suppressed Menstruation (Amenorrhea). — This is a term applied to the 
absence of menstruation, between puberty and the menopause. 

Causes. — Pregnancy, and when nursing; anemia (impoverishment of 
the blood (is a very frequent cause; consumption, debilitating diseases, 
non-development of the generative organs; obesity and after the ovaries 
have been removed. 

Symptoms. — Amenorrhea may come on suddenly or be of gradual 
development. The former variety is often the result of some violent 
excitement, fright or mental shock due to the setting in of some fever or 
other acute disease, or to that common and very dangerous cause, espe- 
cially in young girls, imprudent exposure to cold or wet during the 
monthly flow. 

Symptoms in Anemic Persons — If due to anemia the patient has a 
pallor, and the margins of the lips will be pale, she will look "bleached 
out," shortness of breath, palpitation of the heart, swelling of the feet 
and ankles, headache and constipation. 

Symptoms in Consumptives. — If due to consumption, cough and night 
sweats will be present, accompanied by marked emaciation (wasting 
away). When amenorrhea comes on gradually it is apt to indicate some 
serious chronic disease, which should be immediately investigated and 
attended to by a skillful physician. 

Cessation of Menses — When the cessation of the menses is part of 
such a severe malady as consumption or Bright's disease, it often appears 
to be only nature's method of economizing the failing strength of the 
invalid, so that any interference would be likely to prove positively 
hurtful. On the other hand, the natural reappearance of the menses 
after a stoppage in the course of a chronic malady may be welcomed as a 
favorable indication of a tendency toward improvement. 

Symptoms Attending Stopped Menses. — The constitutional disturbance 







Mons Veneris. 
Pubic Bone. 
Clitoris. 
Urethra. 
Bladder. 
Urachus. 
^Ovary. 
Broad Ligament. 



9- 


Womb. 


10. 


Neck of Womb. 


ii. 


Vagina. 


12. 


Rectum. 


13- 


Anus. 


14. 


Rectum covered by Peritoneum 


15- 


Spinal column. 


16. 


Spinal cord. 



The above outline drawing will show the relative position of the Urinary 
and Generative Organs of Women, all contained within and surrounding the 
pelvis. This is shown by dividing the body directly through the centre from 
above downward. The various parts are plainly shown and designated by num- 
bers, so that the position and shape of each organ can be readily seen. 



PAINFUL MENSTRUATION". 641 

from abrupt suppression of the monthly flow is generally very great. 
There is usually severe pain in the region of the womb, similar in char- 
acter to that of colic, and hysterical excitement, or even convulsions, 
and mania, may be the direct effect. 

Treatment. — When due to anemia, iron is the best remedy, given in 
the form of Bland's pill, one four to five times a day. When taking iron 
it is always a good rule to take a dose of epsom salts once a week, in order 
•to counteract the constipating effect of the drug. Other remedies are, a 
teaspoonful of the elixir of quinine, iron and strychnia, three to four times 
a day ; the pill of the same ingredients, one four to five times a day ; per- 
manganate of potash, two grains three times a day; or the bin-oxide of 
manganese, two grains three to four times a day. 

When to Avoid Medicines — The possibility that absence of the 
monthly period may be due to pregnancy should always be borne in mind, 
in which case it would be dangerous and criminal to administer any of 
the usual remedies for restoring the flow. 

Treatment When Due to Cold. — When due to exposure to cold and 
wet resort to hot mustard foot baths or hip baths, mustard plasters to 
the inside of the thighs, calves of the legs and ankles. A hot sitz bath 
is also worthy of trial. This consists of partially filling a "foot tub" with 
hot water ? allowing the patient to sit in it, and covering her with a 
blanket. She should remain in the bath for five to ten minutes. The but- 
tocks and thighs are then thoroughly dried, and she is put to bed. If con- 
stipated the bowels should be regulated. (See Constipation.) Vaginal 
injections of hot water are also to be employed. (See "How to Use the 
Douche.") 

Treatment of Young Girls — The treatment of delayed menstruation 
in young girls who have passed the age of puberty must be on general 
principles adapted to improving the general health, unless there are signs 
of the menstrual blood being retained inside the womb, a dangerous con- 
dition which should always be considered in such instances and relieved 
as early as possible by a surgical operation. 

PAINFUL MENSTRUATION (DYSMENORRHEA). 

Meaning of the Disease. — By this is meant painful menstruation. The 
pain may occur before, during or after the flow. Many varieties have 
been described, such as the obstructive, congestive, mechanical, neuralgic, 
and so forth, but it is very difficult at times to differentiate them. 
41 



642 DISEASES PECULIAR TO WOMEN. 

Causes. — Usually due to the womb being out of its normal position, 
tumors, and inflammatory diseases of the womb and ovaries. 

Symptoms — A woman who enjoys health not only menstruates reg- 
ularly, but does so with perfect freedom from suffering, but unfor- 
tunately there are very few members of the female sex who pass through 
the whole period of their sexual vigor without being called upon to en- 
dure more or less frequently attacks of dysmenorrhea. 

Pain With, the Flow. — Some women experience great pain with each 
flow, from the commencement of puberty, every month, until the change 
of life relieves them. With the majority, however, pain is only the ex- 
ceptional accompaniment. With some women marriage effects a cure, 
whilst in others, especially when there is sterility, it either aggravates or 
originates the dysmenorrhea. Under no circumstance, however, would a 
physician advise a woman suffering with dysmenorrhea to be married in 
the blind hope that it would effect a cure. 

Bearing-Down Pains. — Bearing-down pains, not severe, are often 
present, accompanied by a sensation of weight. The pains as a rule are 
cramp-like, and intermittent, varying in severity. At times the pains are 
followed by the expulsion of blood clots which oftentimes affords relief. 
Severe pains as a rule necessitate the sufferer going to bed, where she may 
have to remain for several hours to a day or two. As a rule constipation 
is present, again diarrhoea may be troublesome. 

Nausea. — Nausea followed by vomiting adds to the severity of the 
attack. Headache is invariably present. The pains may extend from 
the lower part of the abdomen down both legs. Pain in the back is often- 
times quite marked, the sensation being that of the back splitting open. 

Treatment. — The existence of dysmenorrhea depends upon so many 
conditions that the treatment employed in one case will seldom relieve 
the next. During the attack of pain, the patient should take a hot sitz 
bath, and if the suffering is very severe, may have a suppository of half 
a grain of opium combined with a quarter of a grain of belladonna. Un- 
der no consideration should a hypodermic injection of morphine be given, 
without a physician's advice. Again, a sitz bath may be given, followed 
by a turpentine stupe, and ten grains of Dover's powder. Tincture of 
belladonna five drops every three hours may be given; or the following: 
antipyrine five grains every hour until four doses are taken, then every 
three hours until relieved ; acetanilid five grains in the same manner ; 
tincture of gelsemium ten drops every three hours; bromide of soda or 
potassium twenty to thirty grains every three hours ; or as a final resort, 



EXCESSIVE MENSTRUATION. 643 

if the above-named remedies fail to afford relief, morphine, either by the 
mouth or a hypodermic injection, but only on the advice of a physician. 
Hot vaginal injections should also be tried, using at least a gallon of 
water. 

Purgation. — Often when the attack is accompanied by constipation, 
a purgative dose of epsom salts or aloes will be of service. 

Attention to the General Health — Between the attacks attend to the 
general health. Employ the tonics mentioned in the treatment of amen- 
orrhea. Take plenty of out-of-door exercise. Avoid undue excitement, 
straining or heavy lifting, the bicycle and dancing, as the time for the 
flow approaches. 

Prevention of the Pain — An endeavor should be made to prevent the 
pain if possible. The best drug for this purpose is tincture of gelsemium, 
five drops after meals, to begin ten days before the flow is expected. This 
is to be continued until the flow is well established, then cease until within 
ten days of the next period. It will prove advantageous at times to com- 
bine with the gelsemium five drops of the tincture of cannabis indica. 

When Drugs Fail — If drugs fail to afford relief, then it may be nec- 
cessary to dilate and curet (scrape) the womb, an operation which, when 
properly performed, will give excellent results. This operation will only 
keep the patient in bed ten days, and at the end of the second week she 
will be able to resume her routine duties. 

EXCESSIVE MENSTRUATION (Menorrhagia and Metrorrhagia). 

Meaning of the Disease — When the monthly flow persists longer than 
usual or is excessive in amount it is called menorrhagia. When there 
is a bloody discharge from the womb between the monthly periods it is 
termed metrorrhagia. 

Causes. — Both may be due to obstruction of the general circulation 
of the blood, from disease of the heart, lungs and liver. Tumors of the 
womb, inflammatory disease of the womb, ovaries and tubes. The more 
frequent causes are, getting out of bed too soon after confinement, re- 
tained portions of conception, due to improper care during a miscarriage 
(see Miscarriage), polypus tumors of the womb and cancer. 

Symptoms. — Anyone suffering from either of these conditions should 
be examined by a physician in order that he may ascertain the exact 
caues and remove it ; otherwise delay due to home treatment, should the 
cause be a dangerous one, may prove fatal. In a woman otherwise having 



644 DISEASES PECULIAR TO WOMEN. 

a normal flow, she will notice that the flow lasts a day or two longer, or 
may be excessive in amount, requiring a greater number of napkins than 
usual. 

Excessive Flow. — The flow may be so excessive as to require rest in 
bed. When a large amount of blood is lost there will be pallor of the skin, 
dizziness, headache, extreme prostration, specks will appear before the 
eyes, she may feel as though she was falling through the bed. Or again, 
if the condition present is a metrorrhagia, there will be a discharge of 
blood between the periods, which discharge, if it becomes excessive, will 
give rise to the same symptoms just mentioned. 

Treatment. — In the treatment of menorrhagia there are two indica- 
tions to be fulfilled, first to check the present hemorrhage; and, second, 
to remove the cause upon which it depends, and so obviate the certainty 
of its recurrence. To accomplish the first of these desirable objects, which 
should not, however, be attempted in any monthly period, until the usual 
amount of blood has been eliminated from the system, say until the second 
or third day of the flow, try half a teaspoonful of ergot every three hours. 
Rest in bed is, however, an important part of the treatment, without 
which all the good accomplished by skillful medical care may be speedily 
dissipated. Other remedies are, half a teaspoonful of hydrastis cana- 
densis every three hours; half a teaspoonful of witch hazel every three 
hours ; gallic acid, 5 grains every four hours. Stypticin in 5 grain doses. 
A very good prescription for bleedings of this kind is as f ollows : 

R. — Ext. hydrastis fluid (colorless) I ounce 

Ext. ergot fluid % ounce 

Ext. hamamelis fluid I ounce 

Aqua, q. s 3 ounces 

Sig. One teaspoonful every three hours. 

Plugging the Vagina. — If these remedies fail and the case is an 
urgent one, it will be necessary to tampon or plug up the vagina with 
pieces of raw cotton, lamb's wool, or linen cloth, taking care not to employ 
an undue amount of force in introducing these materials. They should 
have a string securely attached to them in order to facilitate their re- 
moval. In no case should such a plug or tampon be allowed to remain 
longer than twenty-four to thirty-six hours, for fear of poisoning the 
system with the putrifying blood entangled in it. When the tampon has 
been removed, if the bleeding is not checked, tampon again. 

Removal of Tumors. — If the bleeding is due to the presence of tumors, 
it will be necessary to have them removed. 



LEUCORRHEA OR WHITES. 645 

Further Treatment. — Frequently medicines and tampons fail to con- 
trol the hemorrhages, especially when there is proud flesh in the womb, 
and when, the muscles of the womb are unable to contract. In such an 
event the only procedure is to dilate and curet the womb, which operation 
will remove the source of the trouble. In some cases of dysmenorrhea 
enlargement and congestion of the ovaries appear to be the important 
factors in the production of the malady. Such attacks are apt to be very 
intractable, unless the disordered conditions of the ovaries are remedied, 
usually by an operation. 

LEUCORRHEA OR WHITES. 

Character of Whites. — This prevalent, troublesome and disagreeable 
condition, vulgarly termed the "whites," consists of a discharge of mucus 
or muco-pus from the womb, neck of the womb and vagina. It is very 
similar to that occurring from the nose during a cold in the head. In fact, 
the condition of the mucous membrane giving rise to leucorrhea is often 
one of catarrhal inflammation. 

Causes — It may be brought on by taking cold ; by local excitement ; 
by inflammation of the neck of the womb, the womb proper or the lining 
membrane of the womb ; oftentimes the trouble is localized in the mucous 
membrane of the vagina; disease of the ovaries and tubes may also be at 
fault. It is frequently due to a "run down" system, yet women in perfect 
health may be affected; in the latter class it is probably nature's method 
of overcoming an excess in the richness of the blood. 

Character of the Discharge. — The character of the discharge varies; 
it may be thick and tenacious, or it may be liquid, when it will run down 
the limbs in a stream and greatly soil the clothing. As ordinarily seen, 
it is not usually accompanied with much pain, but when very profuse, dis- 
tress in the back and a dragging sensation in the lower part of the pelvis, 
often described as a bearing down feeling, are the symptoms most fre- 
quently observed. The discharge is generally more abundant a little 
while before, and for two or three days after the occurrence of the flow. 
In fact, when the leucorrhea is severe, this increase of the flow of whitish 
matter sometimes continues for a couple of weeks after the monthly period 
with increased violence, showing how greatly it depends upon a congestion 
of the parts concerned for its production. 

Treatment. — The treatment of this rather intractable malady, besides 
the necessary attention to the general health, bv the use of tonics and nour- 



646 DISEASES PECULIAR TO WOMEN. 

ishing food, consists of the employment of astringent injections into the 
vagina. For building up the health the following pill will be found of 

service : 

R. — Acidi arseniosi (arsenious acid) I grain 

Ferri reducti (reduced iron) 10 grains 

Quinia sulph. (quinine) 20 grains 

M. Fiat in pil. No. XX. Sig. — One pill after each meal and at bedtime. 

Additional Treatment. — If the leucorrhea is clue to irritation of the 
ovaries, apply a cantharidal plaster over the groin on both sides. The best 
results, however, are attained by the employment of vaginal injections, 
such as a teaspoonf ul of creolin to two quarts of hot water ; twenty grains 
of sulphate of zinc, or ten grains of sulphate of copper in the same quantity 
of water ; thirty grains of alum to the pint ; and a teaspoonf ul of lysol to 
two quarts of water are all worthy of a trial. A very cheap injection is 
made by adding one ounce of powdered oak bark to each pint of water, or 
one ounce each of tannic acid and glycerine to two quarts of water. 

Treatment for Fetid Discharge. — When the discharge is fetid, perman- 
ganate of potassium should be used one-half drachm to one pint of water. 
This solution will stain linen, so be careful to avoid splashing it over the 
douche pan. (See How to Use the Douche.) Another very good drug to 
eradicate the odor of this discharge is bichloride of mercury. The drug- 
gists dispense a tablet containing seven and seven-tenths grains of the 
drug. One of these tablets added to two quarts of water makes a solution 
the strength of which is 1-4000. Such a solution should be used two- or* 
three times a day. All the injections above mentioned can be used night 
and morning, but if the discharge is profuse, three times a day will not be 
too often. 

An Injection for Whites. — A very useful astringent injection for 
leucorrhea, whatever may be its cause, is the tri-septic douche tablet. 

This tablet can be used night and morning and is effective and con- 
venient. 

Local Applications. — When the leucorrhea is caused by catarrhal in- 
flammation of the cavity of the womb, as is frequently the case, injections 
into the vagina are, of course, almost worthless, and local applications 
made by a physician are very important, and should be faithfully perse- 
vered in, sometimes for many months. 



HOW TO USE THE DOUCHE. 647 



HOW TO USE THE DOUCHE OR VAGINAL INJECTION. 

Varieties of Syringes. — Before proceeding further let me describe the 
proper manner of taking a douche. First the varieties of syringes. These 
are numerous, but for practical purposes there are only two which are 
used to any extent. They are the Davidson, or bulb syringe, and the 
Fountain syringe. 

The Bulb Syringe. — The bulb syringe is not to be recommended, be- 
cause it is dirty, a great deal of muscular energy is required to work it, 
hence is tiresome and necessitates too much preparation for its use. It 
is very difficult to employ this syringe while lying down, and this is the 
only position in which a douche should be taken. 

Using the Bulb Syringe — In using this kind of a syringe generally a 
pint of the solution is placed in a basin over which the woman squats, and 
by squeezing the bulb forces the liquid into the vagina as fast as it runs out, 
thereby filling the syringe joints with the vaginal secretions, and returning 
to the vagina as soon as they flow away the impurities which have left it. 
If, however, a woman prefers this kind of a syringe, and insists on sitting 
over a bucket or other receptacle, then the solution should be placed in 
one basin, and that which is forced into the vagina permitted to run into 
the vessel upon which she is sitting. 

Object of Using the Syringe. — The object of using the syringe is to 
bathe the vagina and neck of the womb. By sitting on a vessel the latter 
is prevented, for just as soon as a woman sits down, then the vagina is 
doubled on itself in such a manner as to prevent the solutions reaching the 
womb. 

The Fountain Syringe. — The Fountain syringe is to be advocated, not 
only for this purpose, but for all-round family use. This syringe consists 
of a bag of soft rubber with a long tube and a series of hard rubber 
nozzles. The largest size is intended for the vagina. The "Alpha" is the 
best, because it has a valve at the opening which prevents the solution from 
running out at the top. This is a great advantage because the bag can be 
laid on the floor, a shelf or anywhere without spilling its contents. 

Proper Way to Take Vaginal Injections. — The proper way to take a 
vaginal injection is as follows: First fill the douche bag, which should 
hold at least two or four quarts, with the solution which is to be used. 
Hang it on a nail, which should be driven near the bed. Then place the 
douche pan on the bed. A good douche pan should be large and capable of 



648 DISEASES PECULIAR TO WOMEN. 

holding at least one to two gallons. They are made of tin and agateware. 
Then lie down in bed, placing the douche pan under you in such a position 
that the buttocks rest on the top of the pan, in order that the solution after 
leaving the vagina will run directly into the pan without splashing over. 

Improper Positions in Douching. — This is the correct way to take a 
douche. The other methods of sitting over a basin, or standing over a 
vessel, are to be condemned. This is the only way in which the womb can 
be bathed with the solution used, and not less than one to two quarts 
should be employed when a drug has been added; and when plain hot 
water is used, four to six quarts will not be too many. 

Temperature of Douches. — All vaginal douches should be as hot as the 
patient can stand, and under no circumstances should cold water be used, 
as it is injurious. In exceptional cases hot water increases the pain in- 
stead of relieving it, and is then advantageously replaced by lukewarm 
water. 

What Women Should Avoid. — Under no condition should a woman en- 
deavor to introduce the small nozzh into the womb, or endeavor to force 
a solution of any kind into the womb. This is an exceedingly dangerous 
practice, and many a woman by so doing has sown the seed of pelvic in- 
flammation, which has only been relieved by the removal of both ovaries, 
and in some cases the womb. 

CONSTIPATION. 

Woman a Constipated Animal. — The eminent Dr. Goodell once said: 

"Woman is a constipated animal." While we do not desire to class the 
gentler sex as an animal, still this statement contains a great deal of 
truth, for by far the greater majority of women are constipated. 

Causes. — This troublesome state can be attributed to a number of 
causes, the most frequent of which is leading a sedentary life; omitting 
daily exercise, which tends to excite the secretions of the bowels and liver 
to their proper activity. Another very frequent cause is laziness pure 
and simple, the patient failing to go to stool when informed by nature 
that such should occur. 

A Very Frequent Cause — Modesty is a very frequent cause of con- 
stipation in women, because a woman prefers to suffer rather than to go 
to a closet which may be somewhat publicly situated. Hereditary mus- 
cular weakness, hepatic torpor, lack of secretions in the lower bowels, back- 



CONSTIPATION. 649 

ward displacement of the womb and lacerations of the perineum are fre- 
quent causes of constipation. 

Symptoms. — General weakness, a feeling of languor and mental de- 
pressions are frequent symptoms; nervousness, headache, loss of appe- 
tite and a furred tongue may also occur. Individuals differ in this mat- 
ter, one feels wretched all day without the accustomed evacuation, another 
is comfortable all the week except on the day which, by purge or enema, 
the bowels are relieved. 

More Serious Symptoms.— When persistent the accumulation of the 
feces leads to serious symptoms, such as ulceration of the colon, perfora- 
tion of the bowel, piles and inflammation of the bowels. The bowel con- 
tents may become dry and hard, forming large masses, which can only 
be removed by a physician with a great deal of difficulty. 

Nausea. — In women who have been habitually constipated, attacks 
of diarrhoea with nausea and vomiting should excite suspicion, and lead 
to a thorough examination of the lower bowel. 

Poisoning. — Part of the bowel contents may be absorbed by the sys- 
tem, giving rise to a general poisoning, which will recur at stated periods, 
until the constipation is cured. Costiveness is the recognized cause not 
only of hemorrhoids, of pelvic congestion, of inflammation of the womb 
and of disorders of the digestive apparatus, but also of the fecal poisoning 
just mentioned. For if diseases breed from bad drainage without the 
body, how much more from bad drainage and defective sewerage within 
the body! Feeble mothers beget feeble children — children who are car- 
ried from the womb to the grave, or who peak and pine under the heritage 
of ill health. 

Other Causes. — Such then being the condition of the majority of 
American women, what is the cause? Probably no single cause has had 
so much influence in producing the peculiarly delicate condition for which 
women living in the country and in small towns in America are notorious, 
as the discomfort, inconvenience and frequent repulsiveness, and, I may 
add, indecent exposure, of their closet accommodations. 

Insufficieny of Closet. — In the teeming tenement house of any of our 
large cities there is usually but one closet, and that is invariably a cess- 
pool, wet and foul, reeking with filth, poisoned by noisome stenches, 
periled by lewd couplets or by obscene cuts, indecent from thin parti- 
tions and wide chinks, or from being preoccupied by one of the opposite 
sex. Under such conditions what woman can avoid schooling herself into 
the habit of resisting the evacuation of her bowels % 



650 DISEASES PECULIAR TO WOMEN. 

Inconvenient Privies. — In the small houses of tradesmen and of me* 
chanics the water-closet is rarely to be found, nor are the houses of the 
better classes always supplied with this luxury. The privy is then usually 
placed at the farther end of the yard, and approached by a long and un- 
sheltered path. It is, therefore, almost inaccessible in bad weather or 
on dark nights, and is overlooked by the backbuildings of all the neigh- 
boring houses. 

Risk to Women. — To a delicate woman the exposure to the weather 
is a serious risk; to one who is menstruating it is a constant menace; 
while to the refined woman the exposure to view compels the postpone- 
ment of her physical duties to nightfall, or until driven to them by a sheer 
necessity which knows no law. 

Country Closets — Nor does the condition of the closets in the coun- 
try present a more agreeable contrast. In many parts of the Southern 
and Western States a clump of bushes, the shelter of a rock, the nearest 
grove affords the only accommodations. But take the most thickly set- 
tled States, where is the small farmhouse whose privy invites rather than 
repels an operation of the bowels ? 

Privy a Misnomer. — The very name of privy is a misnomer. How 
seldom is the building hidden by clumps of evergreen, or a screen of 
lattice work. How often is it not an embarrassing distance from the 
house, at the end of a long trail, or, at least, of a long unkept path, which 
frequently runs parallel with a street or with a load. 

The Outlandish Privy. — Where in the country, and for that matter 
in cities also, is not to be found the privy made up of rough boards rudely 
spiked together, with cracks wide enough to spoil all privacy, with a 
door without a bolt, and generally hanging by one hinge, with a crescent- 
shaped hole for a window, and with its sole object of furniture a barrel 
of rasping corncobs ? When is it ever sheltered from the rude blasts of 
winter, or not poisoned by noisome stenches, acrid vapors and unclean 
flies ? After such an unsightly but truthful picture, can we wonder that 
the calls of nature are looked upon as grievous dispensations of Provi- 
dence, as hateful duties which are to be put off as long as possible and 
obeyed as seldom as necessary? 

Repellant Conditions — Imagine now broad daylight, with its busy 
traffic, a rainy or a dark night, the grass wet with dew, or the ground cov- 
ered with snow, or the temperature, perchance, many degrees below zero. 
Under such circumstances what woman can respond to the calls of nature 
without putting herself to great discomfort, to great risk, indeed, if she 



CONSTIPATION. 651 

be menstruating, or without blunting the edge of her womanly sense of 
decorum. 

The Antidote — I have told you the bane ; now what is the antidote % 
Clearly such closets as a civilized Christian people — a people living in the 
twentieth century — are not degraded in using ; closets that are decent, com- 
fortable and accessible; closets that invite rather than repel those in 
which an operation of the bowels is not tantamount to being buffeted by 
Satan for a season. 

Country Earth Closets — In cities, and in towns which are supplied 
with water works and good drains, the use of the water closet ought to 
become universal. In the country, where such a luxury can be attained 
by the rich alone, the earth closet is the only substitute; I cannot too 
strongly urge its adoption. 

Treatment. — Much may be done by systematic habits. Set a cer- 
tain time of the day, and at that time go to the closet and endeavor to 
have an evacuation. Continue with this each day, and permit nothing to 
interfere with this duty at that particular time. The desire to go to stool 
should always be granted ; when there is a desire, go by all means. 

Treatment of Stout Women. — In stout women with flabby abdomens 
the muscles should have the support of a bandage. Exercise is of great 
value; by far the best being horseback riding at least an hour a day, or 
every other day. Massaging the abdominal muscles is also of value. 
Much good can be accomplished by the daily use of the "home gymna- 
sium, " or dumb bells and Indian clubs. 

Diet. — The diet should also be regulated. Very often if a plateful 
of cracked wheat is used at breakfast each morning, and bran bread taken 
in addition, a chronic tendency to constipation can be removed. Milk 
is not to be recommended. Green or canned corn is of great service. 
Fruits also do good. Nothing is so good as a glass of cold water taken on 
arising in the morning just before breakfast; or if the cold cannot be 
borne, then a glass of as hot water as can be swallowed may be substi- 
tuted. It must be remembered that strawberries, raspberries and black- 
berries are constipating rather than purgative. Coffee has a binding 
eifect on some persons ; brandy is distinctly constipating, whereas whiskey 
has no influence one way or the other. 

Treatment by Medicines. — The use of drugs for the relief of consti- 
pation consists in those that unload the bowel, which has become filled, 
and those which will cure the tendency. Let us consider the first variety. 
For this purpose may be mentioned epsom salts, half to one tablespoonful, 



652 DISEASES PECULIAR TO WOMEN. 

preferably taken in the morning on an empty stomach; mercury, in the 
form of calomel, one-fifth of a grain every hour until about ten doses are 
taken, then following with a bottle of citrate of magnesia ; castor oil, half 
to one tablespoonful, or twenty grains of powdered rhubarb at bedtime. 

To Cure Tendency. — Of the second class, half to one teaspoonful of 
the fluid extract of cascara sagrada at bedtime, or a dessertspoonful of 
phosphate of soda in one-quarter of a glass of hot water before breakfast. 
Rhubarb is not to be recommended for constant use, as it is astringent, 
and after the bowels have moved the constipation will be more pronounced 
than before. Mercury is exceedingly harmful if used continuously as a 
purge, and is the cause of much ill health, bad teeth, and digestive troubles. 
Castor oil is notorious for its tendency to ultimate constipation. 

Very Best Drugs. — Of the curative class of drugs none compare to 
cascara sagrada, which should be used in the form of the tasteless fluid 
extract, or cascara cordial. This is the only drug which moves the bowels 
and at the same time tends to make the future movements more easy and 
regular; the dose is ten to twenty drops of the fluid extract every night 
at bedtime, or one to six teaspoonfuls of the cordial. If the fluid extract, 
in the doses above mentioned, fails to act, increase the quantity each night 
until at least a teaspoonful if necessary. 

The following three prescriptions will be of value : 

Aloes 20 grains 

Extract of nux vomica 4 grains 

Extract of physostigma 3 grains 

Extract of belladonna 4 grains 

Make into twenty pills. Take one pill at night or one night 
and morning. 

Or, 

Resin of podophyllum 2 grains 

Extract of nux vomica 4 grains 

Extract of physostigma 3 grains 

Extract of belladonna 4 grains 

Make into twenty pills. Take one at night or night and morning. 
Or, 

Aloin 2 grains 

Extract belladonna 2 grains 

Strychnine % grain 

Extract cascara 16 grains 

Make into 16 pills. One at night. 

Injections. — The employment of enemas, or injections, as a routine 
practice is to be discouraged. In cases where it is necessary to use them 



DISEASES OF THE EXTERNAL GENITAL ORGANS. . 653 

for temporary relief, and to get rid of the gas, a little soap, common salt, 
and a few drops of turpentine may be added to the water. 

DISEASES OF THE EXTERNAL GENITAL ORGANS. 

Vulvitis. — -This is an inflammation of the vulva, the part so often 
referred to by women as their "person" or "privates." It is divided into 
several different varieties, which can only be distinguished by a physician. 

Causes. — One of the most frequent is lack of cleanliness; irritating 
discharges from the vagina and womb, which trickle over the parts ; tight 
fitting drawers, which rub and chafe; injuries, as striking against chair, 
or falling on an object; self abuse; excessive or brutal intercourse; preg- 
nancy ; fevers ; may follow a long and difficult labor ; and is apt to occur 
during an attack of diabetes. 

Symptoms. — General discomfort, sensations of burning which amount 
at times to severe pain; burning pain during urination; the parts are 
usually swollen and very red. In diabetic vulvitis the itching is intense 
and oftentimes is the first symptom of diabetes. Every woman who passes 
large quantities of water and suffers from intense itching of these parts 
should have her urine analyzed to see if it is due to diabetes. Owing to 
the fever and swelling the parts at first are dry, due to the lack of secre- 
tion ; but as this increases the parts become raw and very painful. 

Treatment. — Cleanliness is the first consideration. Warm sitz baths, 
hot vaginal injections of plain water, or water to which has been added 
creolin one-half a teaspoonful to two quarts, borax a teaspoonful to the 
quart, or a dessertspoonful of salt to the quart. Use these several times 
a day. After thoroughly cleansing the parts, they may be dusted with 
talcum powder, starch, or starch and bismuth, equal quantities, bismuth or 
borax. 

Checking the Beginning. — Oftentimes the attack can be checked at the 
beginning by applications of lead-water and laudanum. The best way to 
apply this is to soak a piece of absorbent cotton, about the size of the hand, 
with it, and place it in between the legs. 

Treatment by Injection. — If the irritation is due to worms, a rectal 
injection will usually remove them. If the itching is very severe try hot 
vaginal injections of bichloride of mercury, seven grains to the quart; 
salicylic acid the same strength ; or a solution of hyposulphite of soda, one 
ounce to the pint of water. After the parts have been dried any of the 
following will be found beneficial: benzoated zinc ointment; iodoform 



654 DISEASES PECULIAR TO WOMEN. 

ointment ; solution of carbolic acid, half a teaspoonf ul to a cup of water ; 
nitrate of silver, eight grains to the ounce of distilled water, and painted 
over the parts oftentimes affords the greatest relief. The bowels should 
be kept freely open. 

PRURITUS (ITCHING OF) VULVA. 

Definition. — By pruritus is meant itching; the privates are the one 
part of a woman most frequently affected with this troublesome condition. 
Pruritus is not a disease, but a symptom of other conditions. 

Causes. — It is of frequent occurrence during pregnancy, and very 
often the result of uncleanliness ; is invariably caused by irritating dis- 
charges from the vagina ; may be associated with tumors of the parts, and 
is often present during the course of diabetes. 

Symptoms. — Intense itching, the woman is almost driven to despera- 
tion, and scratches the parts until they bleed. The itching is usually 
aggravated by walking or becoming warm in bed. This condition may be 
so marked as to lead to melancholia. The intense suffering causes loss of 
sleep, exhaustion, and sometimes alarming nervous depression; The more 
the patient is compelled to scratch, the more the parts are irritated. 

Treatment. — Remove the cause if it can be found. In order to re- 
move irritating discharges sitz baths and vaginal douches, as described in 
the treatment of vaginitis, are used. After thorough cleansing of the 
parts they may be dusted with calomel, bismuth, starch or lycopodium 
powder. The calomel is generally preferred. Before applying the powder 
first dry the parts. Great relief is sometimes experienced from a gauze 
compress over the vulva, saturated with a solution of lead-water and 
laudanum, equal parts. This dressing should be frequently changed. 

Auxiliary Treatment. — The intense itching which appears at night 
after retiring can often be prevented by applying to the vulva cloths wrung 
out in hot water. Ointments are useful from their soothing effects and, in 
addition, they protect the parts from the irritating discharges. These are 
iodoform ointment, sulphur ointment and zinc ointment. 

HEMATOMA (BLEEDING) OF THE VULVA. 

This term is applied to any hemorrhage which may occur in the 
tissues of the privates. It usually occurs on one side, rarely on both. 

Causes. — The most frequent are falling on a sharp substance; very 
often while housecleaning a woman will stand on a chair which, should it 



SKH5T DISEASES OF THE VULVA. 655 

slip, may cause her to fall in such a manner as to straddle the back of it ; 
the insane may self-inflict wounds in this spot. Among other causes are 
intercourse, pregnancy, tumors and diseases of the blood-vessels supplying 
the affected parts. 

Symptoms. — The symptoms are practically those of injury to any 
other part of the body. The bleeding may be very profuse, especially if 
there is a cut. If the parts are only bruised the bleeding will be more or 
less extensive, the blood simply pouring out into the tissues, causing a 
swelling of the parts. There will be pain of a sharp or tearing nature, 
which may be accompanied by f aintness. If the swelling is large, it may 
press on the urethra, and cause difficulty in passing water. 

Treatment. — The bleeding may be controlled by the application of ice 
or by using pressure or both. Simply take a clean napkin and hold it 
tightly against the injured parts. After the blood has been in the tissues 
for a few hours a hard blood-clot forms. If this is not absorbed within a 
few days the part should be lanced and the clot turned out. If the swelling 
is small lead-water and laudanum applied to the parts on pieces of gauze 
may cause it to disappear. 

TUMORS OF THE VULVA. 

The vulva, like any other portion of the body, is subject to the occur- 
rence of tumors which may or may not be malignant. If such a tumor 
growth should occur a physician should be consulted, in order that he may 
diagnose its exact nature and institute the proper treatment. Too often 
innocent looking growths have been allowed to go unattended, which, when 
too late, have been found to be cancers. 

SKIN DISEASES OF THE VULVA. 

The skin of the vulva may be affected with various skin diseases, as 
eczema, erythema, acne, herpes, prurigo, scabies, pediculi and erysipelas. 

Causes. — The various diseases are due to irritating discharges from 
the vagina or womb, menopause, vesieo-vagial fistula, indigestion, diabetes, 
and in stout persons during exceedingly hot weather. 

Scabies. — Scabies is due to the parasite acorus scabiei. This parasite 
may spread from some other part of the body. This itch-mite burrows 
into the skin and gives rise to intense itching, which increases when the 
body is warm. It is usually due to uncleanliness and coming in contact 
with uncleanly persons similarly affected. 



656 DISEASES TECULIAK TO WOMEN. 

Crabs. — Pediculi are often found about the external genitals. This 
is also a parasite, commonly called "the crabs." These parasites localize 
themselves in the hair, and can be seen clinging to it. They are generally 
contracted through intercourse with indecent women. Too often husbands 
thus affected bring them home and innocently cause a similar condition 
with their wives. 

Treatment — Hot vaginal injections, as advised for diseases of the 
vagina. Local soothing applications should be made, such as bismuth 
powder, ten per cent, solution of carbolic acid, benzoated zinc oxide oint- 
ment three to four times a day ; powdered zinc oxide three to four times a 
day ; acetanilid and chalk equal quantities, three to four times a day ; car- 
bolized zinc ointment three times a day, and lycopodium powder several 
times daily. If scabs are present wash them off with almond or other 
bland soap, after which apply any of the above ointments. Keep the 
bowels open daily, resorting to the treatment as advised for constipation. 

Accessory Treatment. — If scabies are the cause take a warm bath with 
free use of soap, followed by dusting the parts with sulphur. Sulphur 
ointment has been highly recommended. 

If due to pediculi, the best treatment is to shave the hair and thor- 
oughly rub in a ten per cent, ointment of oleate of mercury three times 
a day, or blue ointment four times a day; bichloride of mercury, five 
grains to a pint of water, bathing the parts several times daily ; or carbolic 
acid solution several times daily. 

VAGINISMUS, OR CONTRACTION OF VAGINA. 

Vaginismus is a painful spasmodic contraction of the vagina which 
more or less prevents intercourse. 

Causes. — Very frequently due to an extremely sensitive condition of 
the remnants of the hymen, which will produce violent contraction of the 
muscles of the vagina. It may also be caused by a fissure of the vagina, 
erosions of the parts, fissures of the anus and an urethral carbuncle. ■ 

Treatment. — If due to a carbuncle it should be taken out, which opera- 
tion will confine the woman to bed for five to seven days. When due to a 
thick hymen it will need the attention of a physician. Among the reme- 
dies which may be tried at home are injections of a teaspoonful of lauda- 
num to a pint of hot water ; an ointment of iodoform ; or fifteen to twenty 
grains of bromide of sodium three to four times a day. 



DTSEASES OF THE VAGINA. 657 

- COCCYCODYNIA. 

It consists of a very painful condition of the muscles at the very tip 
of the spine. Is most common in women who have borne children. 

Causes. — Injuries during childbirth, blows and falls striking the tip 
of the spine, cold or exposure of the buttocks, and uterine or ovarian 
diseases. 

Symptoms. — Severe pains in the region of the tip of the spine, in- 
creased by motion. 

Treatment. — During the acute attacks it may be necessary for a physi- 
cian to administer hypodermic injections of morphine to relieve the pain. 
As a rule an operation will be the only treatment to render a complete 
cure. 

URETHRAL CARBUNCLE. 

This is a small raspberry-like growth which is very sensitive, and to 
be found at the mouth of the urethra. 

Causes. — These are uncertain. No definite cause has as yet been de- 
cided upon. 

Symptoms. — It gives rise to severe itching and pain. During urina- 
tion, as the water runs over it, the pain is more or less excruciating, so 
marked that women will oftentimes withhold from passing their water 
until they are further unable to withstand the calls of nature. 

Treatment. — An operation is imperative, as no other treatment will 
afford relief. 

DISEASES OF THE VAGINA 

ATRESIA OF THE VAGINA. 

Causes. — This means an absence of the vagina, or a closure of it. The 
child may be born this way, in which case it is due to improper develop- 
ment in the womb. Or, as is more frequently the case, it is acquired, due 
to caustic remedies carelessly applied, a long and tedious labor, extensive 
ulcerations, and a hymen which does not have an opening. 

Symptoms. — In children born with this deformity it is often not 
noticed until puberty, when the child should menstruate. In fact, men- 
struation does occur, but owing to the absence of the opening in the hymen 
it is prevented from escaping and accumulates in the womb. Each month 
menstrual pains will recur, but there will be a failure of the blood to 
escape. 

Treatment. — This is purely operative. 
42 



658 DISEASES PECULIAR TO WOMEN. 



VAGINITIS. 

Vaginitis is an inflammation of the vagina. 

Causes. — A rundown system, anemia, systemic conditions producing 
congestion of the pelvis, such as pregnancy and tumors. May he due to 
friction produced by a badly fitting pessary, to irritating discharges from 
the womb, to excessive coition. 

Symptoms. — Feeling of heat in the vagina; pain in the pelvis; at 
times a frequent desire to pass water; itching and burning about the 
entrance to the vagina; backache; loss of appetite and at times nausea; 
leucorrhea. 

Treatment. — When the inflammation is acute keep quiet, not neces- 
sarily in bed. Keep the bowels open, and give a light diet, no meat. If 
there is much pain use a five-grain opium suppository. If the itching is 
severe take frequent warm sitz-baths and vaginal douches of hot water con- 
taining either of the following: Borax one teaspoonful to the pint, sugar 
of lead water one teaspoonful to the pint, or half a teaspoonful of creolin 
to two quarts. These injections should be used several times daily. 

MALIGNANT TUMORS OF THE VAGINA. 

The vagina may be the seat of cancer. It may begin here, or spread 
to this canal from the bladder, rectum or womb. 

Symptoms. — Cancer usually appears from thirty to forty-five years. 
The important symptoms are hemorrhage, which often follows straining at 
stool, or after coition ; a foul discharge, which is very repulsive ; it may be 
thick, but as a rule is watery; pain, this is always present, but not as a 
rule, until after the disease is well developed. 

Treatment. — The disease tissue should be removed, of course, by a 
surgeon. If the disease is well advanced before discovered, as a rule it is 
too late for operation. If such be the case the indications are to maintain 
the strength of the patient, relieve the pain and counteract the foul smell- 
ing discharge. The first may be accomplished by tonics and out-of-door 
exercise. These cases, as a rule, are not bedridden until a short time 
before death. To relieve the pain resort to opium. This is the only drug 
on which we can rely. Begin with a sixth of a grain four to five times a 
day, gradually increasing it as needed during the course of the disease. 
For counteracting the odor of the discharge the best drug to use is perman- 






DISEASES OF THE UTERUS OR WOMB. 659 

ganate of potash, in a vaginal douche, five grains to two quarts of water. 
These douches should be used frequently during the day. 

Auxiliary Treatment — A woman suffering from this disease should 
always wear a napkin, which should be burned as soon as removed from 
her person. Allow plenty of fresh air to circulate in the room. Those who 
handle any cloths which come in contact with these discharges should 
wash their hands at once, using plenty of soap and warm water. 

DISEASES OF THE UTERUS OR WOMB 

INFLAMMATION OF LINING MEMBRANE OF WOMB (ENDOMETRITIS). 

Inflammation of Lining Membrane of Womb. — This is an inflamma- 
tion of the lining membrane of the womb. 

Causes. — Often due to taking cold just before or while menstruating. 
The introduction of unclean instruments into the womb; the introduction 
of knitting needles and other instruments by women in an endeavor to 
produce an abortion. Gonorrhea is oftentimes at the bottom of the 
trouble. Inflammation of the womb often spreads to this membrane, or 
the inflammation may begin in this membrane and spread to the womb. 

Symptoms. — There is a sensation of weight in the pelvis and slight 
pain. The discharge is at first profuse, thin and watery, but later becomes 
thick and tenacious, like the white of an egg. Menstruation may ,or may 
not be painful. 

Treatment. — During the acute attack rest in bed, with an ice bag 
over the lower part of the abdomen, or if this is not comfortable, a hot 
water bag. The bowels should be well moved, preferably by a dose of 
epsom salts. The diet should consist of liquids, cornstarch, gelatine and 
the like. Large quantities of hot water should be used as vaginal injec- 
tions three to four times a day. 

Inflammation of the Womb. — A new and effective remedy for this 
disease consists of a mixture of five ounces of vaseline with three drachms 
of boracic acid. Make this into fifty suppositories and insert one in the 
vagina each night on retiring; or, if found more convenient, take a small 
piece of the mass, about the size of a cherry, and insert as above. This 
treatment serves also to correct irregularity of the menses. Hot water 
injections daily. 



660 DISEASES PECULIAR TO WOMEN. 



INFLAMMATION OF THE WALLS OF WOMB (METRITIS). 

Inflammation of Walls of Womb. — Metritis is an inflammation of the 
muscular walls of the womb. 

Causes. — The most frequent cause is getting out of bed too soon after 
a confinement ; abortions ; exposure to cold during menstruation will give 
rise to it, also sexual excesses and lacerations of the womb. 

Symptoms. — The acute attacks usually begin with a chill, generally 
followed by a fever. Pain is more or less marked, and may extend down 
the legs, and be especially troublesome on the left side of the abdomen 
over the ovary. The monthly flow is apt to be accompanied by a great 
deal of pain. 

Treatment. — The treatment is the same as endometritis. 

FIBROUS TUMORS OF THE UTERUS. 

Symptoms. — They give rise to pain, more or less severe at times, and 
to hemorrhages, which may cause death. The pain is especially severe 
during the menstrual period. The hemorrhages may occur several times 
between the monthly periods, or the monthly period itself may last for a 
week to ten days. 

Treatment. — For the pain, morphine as a rule is the only drug which 
affords relief, one-sixth to one-fourth of a grain every four hours. Tinc- 
ture of gelsemium, ten drops every three hours, may prove of service. 
For the bleeding try a teaspoonful of the fluid extract of hydrastis every 
three hours, or a teaspoonful of the fluid extract of ergot every four hours. 
If drugs fail to control the hemorrhage it may be necessary to pack the 
vagina with gauze, which pressing against the womb usually controls it. 

The following is a very good prescription, which should be tried in 
all cases of bleeding from the womb : 

R. — Extract of hydrastis fluid (colorless) i ounce 

Extract of hamamelis fluid I ounce 

Extract of ergot fluid % ounce 

Peppermint water, to make 3 ounces 

M. Sig. — Teaspoonful every four hours. 

Or, thyroides, one drachm. Make thirty capsules, one three times 
a day. Very often the fibroid can be removed with complete success. 



ULCERATION OF THE WOMB. 661 



POLYPUS TUMOR OF THE WOMB. 



Character. — This disease, which is one of the most common causes 
of excessive hemorrhage from the womb at the monthly periods, is of 
considerable importance. The term polypus is employed to designate 
especially a tumor which is attached to the inner surface of the womb by 
a well defined neck or pedicle. 

Symptoms. — The most important is profuse menstruation. After a 
time, as the tumor grows larger, and becomes more of an irritant, there are 
likewise frequent discharges of blood between the periods, often amount- 
ing to attacks of flooding. There is also a leucorrheal discharge which 
may be tinged with blood. Occasionally there are paroxysms of pain: 

Treatment. — Unless the tumor is removed the case is hopeless. The 
operation simply consists in twisting the polypus off of its pedicle or neck. 
The patient is required to stay in bed ten days to two weeks. 

ULCERATION OF THE WOMB. 

Cause. — In a majority of cases inflammation of the neck of the womb 
is soon followed by ulceration. This appears around the neck of the 
womb, and just within the womb's neck. 

Symptoms. — 1. The inflammations and ulcerations mix and run into 
each other, resulting in raw places, granulations or pimply surfaces, and 
hardened parts. Sometimes the pimply patches become red and hard, the 
whole surface spongy, and bleeding will set in on the slightest touch. 

2. As ulceration progresses it wrecks the mouth of the womb and 
eats deeply into the womb cavity, giving it an unsightly appearance. Pus 
or matter flows freely at times and at other times scantily. It may be 
thick and yellow, or thin and of lighter color. A sensation of heat and 
smarting exists and sometimes severe pain in the right side of the ab- 
domen and in the back part of the head. 

Menstruation — Ulceration generally changes the character of the 
menstruation. Sometimes it becomes profuse and painful, at others 
scanty; and then it may be either frequent or tardy, giving rise to dis- 
tress and pain in the lower part of the bowels and even in the groins and 
thighs. 

Treatment. — 1. A tea made of the white pond lily affords an excel- 
lent remedy. It should be used internally and as an injection; in the 
former case in doses of half a teacupful three times daily. The fluid ex- 



66% DISEASES PECULIAR TO WOMEN". 

tract may be used in place of the tea in ten- or fifteen-drop doses twice 
a day. 

2. Tannic acid, or in place of it a decoction of oak bark, nsed as an 
injection night and morning, gives excellent results. 

3. The application of tannic acid directly to the ulcers has effected 
many cures. 

4. Half a teaspoonful of boracic acid to a pint of water, injected 
when warm, and repeated twice a day, is a highly recommended remedy. 

5. A decoction of golden seal used twice a day as an injection has 
been found to give satisfactory relief. 

Accessory Treatment. — Where injections are depended upon, their 
virtue can be increased by simple injections of warm water between times, 
and as often as every two or three hours. 

CANCER OF THE WOMB. 

Character. — The womb is the one part of a woman's body most fre^ 
quently attacked by cancer. The disease may begin in the neck or the 
body of the womb. When situated in the neck of the womb it looks not 
unlike a cauliflower, hence the term "cauliflower cancer." 

Causes. — It is more frequent among the whites. The lower classes 
are more susceptible than the upper. It is extremely rare that a woman 
who has not borne a child is ever affected with cancer of the womb. In 
unmarried women who have had cancer of this organ the confession of an 
abortion has often been elicited, showing that pregnancy had occurred. 
As a rule a badly-lacerated cervix (neck of the womb) is very prone to 
cancer, the disease invariably starting in such a state of affairs. 

Heredity plays a more or less important role, especially when can- 
cer existed in the mother, or the mother's side of the family. 

Symptoms. — In the very early stages they are absent. As the disease 
progresses the following will appear: 1. Hemorrhages. 2. Uterine dis- 
charges. 3. Pain. 4. Visceral disorders. 5. Cachexia. 

Hemorrhage. — This is usually the first symptom, and is generally du^ 
to ulceration and breaking down of the parts. Unfortunately it is at- 
tributed to the irregularities of the menopause, or to a return of the 
monthly flow after that period. Hence it is the bleeding of cancer is 
very often disregarded until it has progressed beyond the hope of a cure. 
The reappearance of hemorrhage two or three years after the menopause 
is strong proof of cancer and should receive immediate attention. 



CANCER OF THE WOMB. 663 

Examination. — Every woman who has passed the fortieth year, and 
has vaginal bleeding, or leucorrheal discharge mixed with blood, should at 
once consult a physician and insist upon an examination being made. Too 
often women through a mock modesty or for other reasons refuse to have 
an examination, and this stubbornness has cost many a woman her life. 
The symptoms of many of the diseases of the womb and ovaries are sim- 
ilar, and it requires a thorough examination, at times under an anesthetic, 
in order to ascertain the true condition of the pelvic organs. 

Pain — This does not appear early, but late in the disease, as a rule 
too late for an operation. As the disease progresses the pain will spread 
over the entire portion of the lower abdomen, especially so when the 
bladder and rectum become involved; the pain is excruciating and intol- 
erable. This torture is constant and does not ease of its own account. A 
woman suffering from cancer of the womb truly does live a hell upon 
earth. 

Visceral Disorders — These are generally due to the extension of the 
disease, or to the pressure of the womb on the surrounding organs. The 
bladder becomes very irritable, there is a constant desire to pass urine, 
and the patient will strain and strain in an endeavor to squeeze out a few 
drops in order to obtain a little relief. As the ulceration progresses 
fistulse may develop, the openings extending into the womb, the bowels or 
the rectum. Constipation becomes very troublesome. 

Cachexia. — This is a characteristic symptom; and appears several 
weeks after the onset of the disease. It consists of a peculiar yellowish 
discoloration of the skin of the entire body. It is marked by emaciation, 
and the patient may waste away to "skin and bones." 

Treatment. — If seen early and the disease is limited to the womb, 
this organ should be removed at once. If the disease does not return in 
three years then the woman is fairly safe. But if the disease is not limited 
to the womb and has spread into the surrounding structures, and an 
operation be performed, the cancer is very liable, and invariably does, 
return. 

Use of Morphine. — If the woman refuses operation, or should an 
operation be performed and the disease return, there is only one drug that 
will ease the pain, and that is morphine. The patient must practically be 
kept under its influence. In short, she becomes an opium fiend, not 
through choice, but from necessity. This drug may be given, one-quarter 
of a grain three to four times daily, increasing the dose as required; but 
always by the advice of a physician. 



664 DISEASES PECULIAR TO WOMEN. 

Checking the Hemorrhage. — If the hemorrhage becomes troublesome 
it may be necessary to curet the womb in order to control it. Drugs have 
little or no effect on it. Packing the vagina with antiseptic gauze will at 
times prove beneficial. m 

Injections. — The discharge must be attacked with might and main. 
For this purpose resort entirely to vaginal injections, using permanganate 
of potassium, seven grains to two quarts of water, three to four times 
daily ; bichloride of mercury, same strength and as often. These douches 
at times weaken the patient; in that case probably two a day will be 
sufficient, but never less than this. The odor of the room may be very 
disagreeable. In order to counteract this place around the floor in saucers, 
pure carbolic acid, and air the room as often as possible. 

DISPLACEMENTS OF THE WOMB. 

Character. — The womb, like every other organ of the body, is subject 
to deviation from its normal position. The womb is situated in the pelvis 
between the bladder and the rectum. The bladder is attached to the front 
of the neck of the womb while the rectum is very close to,, but not inti- 
mately attached to the back of the womb. 

When the womb becomes displaced the whole organ may turn for- 
wa*rd (anteversion), or backward (retroversion). Or the womb may bend 
on itself. If the top of the womb falls forward then it is called ante- 
flexion, or if it should fall backward then it would be retroflexion. 

The symptoms and causes of the displacements vary more in degree 
than kind. 

FORWARD DISPLACEMENTS. 

Causes. — The most frequent causes are changes in the uterine tissues, 
following an abortion or confinement. Lack of proper muscular support 
plays an important part, also congestions, tumors, lacerations of the pelvic 
floor, tightly fitting clothing, and prolapse of the vagina. 

Symptoms — Dysmenorrhea and sterility are frequently present. Leu- 
corrhea may be troublesome. When the displacement is so great that the 
womb presses on the bladder, this organ will become irritated, causing fre- 
quent irritation, and a more or less constant distress in the lower part of 
the abdomen. This irritation may give rise to inflammation of the bladder. 

Treatment. — If the menstruation is painful use the remedies as de- 
scribed for dysmenorrhea. For the leucorrhea, employ the remedies ad- 
vised for that condition. If inflammation be present local treatments with 



BACKWARD DISPLACEMENTS. 665 

lie hot vaginal douches are to be employed. If a tumor is the cause it 
ihould be removed. The ideal treatment is to replace the organ. 

BACKWARD DISPLACEMENTS. 

These include retroversion and retroflexion. These are the most fre- 
quent varieties, and are more or less easily controlled. 

Causes. — General lack of muscular tone of the uterine muscles, im- 
proper care during confinement, wearing a tight binder too long after 
being confined, tumors, pregnancy, falls, blows, distended bladder and 
lacerations of the perineum. 

Symptoms. — Painful menstruation, as a rule, the first day or two of 
the flow, frequent miscarriages, leucorrhea, constant dull aching pain in 
the small of the back, dragging pains in the lower portion of the abdomen 
and thighs, headache, constipation, the bowel movements are at times 
painful, the bladder may be irritable, and at times the urine may escape 
when the woman laughs heartily. 

Treatment. — 1. First of all the organ must be replaced in its normal 
position. If not fastened down by inflammation a physician can replace 
it; at times an anesthetic may be required. After the organ is replaced 
the physician will introduce a pessary to keep it in its normal position. A 
pessary is a rubber ring of various shapes. This instrument should be 
removed at least once a month, cleansed and replaced. While the pessary 
is in the vagina use a douche of lukewarm water once a day. If the 
pessary feels uncomfortable, or is painful on getting up or sitting down, 
it should be taken out and replaced; if still giving rise to trouble, it is 
in all probability too large, and a smaller one should be tried. 

2. If inflammation exists, this is to be cured by local treatments and 
hot vaginal douches. For the leucorrhea, see description of that con- 
dition. For constipation, see constipation. 

3. If the pessary maintains the uterus in its normal position, and re- 
lieves all the symptoms, then it is optional with the patient whether or not 
she will submit to an operation. If, however, the local treatments, and 
all other remedies fail to afford relief, then it will become necessary to 
open the abdomen, and perform one of the many operations for sewing 
the womb in its proper position. 

4. If the uterus is fastened down by inflammation, local treatments 
will do no good, and an operation will be the only proper treatment. 



66(3 DISEASES PECULIAR TO WOMEN. 



PROLAPSUS (FALLING) OF THE WOMB. 

Prolapsus of the womb is a descent of the organ below its proper 
position in the pelvis, better known as "falling of the womb/ 7 and may 
occur in two different degrees. The term prolapsus is applied to any 
falling downward of the organ, which is not so great that the womb 
passes outside the body; whilst the latter, called procidentia, is that con- 
dition in which the uterus escapes partially or entirely beyond the ex- 
ternal organs of generation. 

Causes. — Falling of the womb is more apt to occur after maturity is 
attained, and appears especially in those who have led laborious lives, 
or who have exercised themselves too much in lifting or carrying heavy 
weights. Hence cooks, laundresses, market-women and nurses, who lift 
and carry large and heavy infants, are especially liable to suffer from 
prolapsus. Women who have borne children are more frequently af- 
fected than those who are sterile, and lingering or instrumental labors, 
or getting up too soon after confinement, particularly predispose to it. 
Among the direct causes may be found congestion, hypertrophy or tumors 
of the uterus. Violent bearing-down efforts in labor, straining in ob- 
stinate constipation and forced respirations, such as occur in coughing, 
lifting heavy weights, and so forth, are also direct causes of falling of 
the uterus. 

Symptoms. — The symptoms of this complaint are sensations of full- 
ness and weight about the pelvis, wearisome backache, and leucorrhea. 
Menstruation is not usually interfered with and obstinate constipation is 
very common. 

As the prolapse increases the bladder will be pulled down, which 
will interfere with its functions; such as frequent desire to void urine, 
the inability to completely empty it each time, resulting in an inflamma- 
tion of its mucous membrane. The rectum will be dragged down in the 
same manner, giving rise to more or less difficulty in the bowel move- 
ments. 

Treatment. — In the first stage, consists in the employment of a pes- 
sary to hold the womb up to its proper level. If the perineum is lacer- 
ated, this must be repaired, otherwise a pessary will drop out. The only 
satisfactory treatment for this condition, especially when the womb hangs 
out, is an operation, which consists in amputating the neck of the womb, 
sewing up the lacerations of the perineum, and opening the abdomen in 
order to stitch the womb where it belongs. Nothing else will afford relief. 



DISEASES OF THE OY ABIES. 667 

This condition too often generates cancer of the womb, and if the women 
so affected would only consent to have this operation done they will be 
free from all the symptoms caused by this displacement, and oftentimes 
will be fortunate enough to prevent a cancerous growth of these parts. 

DISEASES OF THE OVIDUCTS. 

The oviducts are two tubes, one on each side of the womb, and con- 
vey the egg from the ovary into the uterine cavity each month. These 
ducts are subjected to . inflammatory disease, which may terminate in a 
good recovery or develop into an abscess. 

Salpingitis — This is an inflammation of the oviduct. It may effect 
one or both sides. 

Causes. — Usually due to gonorrhea, or poisoning following labor, 
catching cold during the menstrual period, and excessive exercise. A 
cause usually overlooked is disrobing and lying down in a draught after 
a prolonged exercise, when the body is very much overheated. 

Symptoms — This disease may be acute or chronic. During the acute 
stage there will be fever, a great deal of pain on the side of the inflamed 
tube. This pain is increased on walking or standing. The patient while 
lying on her back prefers to have the knees drawn up and the lower part 
of the abdomen is extremely sensitive. 

During the chronic stage there is pain in the affected side, which is 
increased on walking, running up and down stairs, intercourse and sweep- 
ing. Menstruation as a rule is painful, coming on a few days before the 
flow. 

Treatment. — Rest in bed during the acute attacks, and thorough pur- 
gation of the bowels. Copious hot water vaginal douches, at least twice 
a day. Ice bags over the lower portion of the abdomen are highly recom- 
mended. 

DISEASES OF THE OVARIES. 

The ovary may be attacked by inflammation, which may or may not 
form an abscess, tumors, benign and malignant, which may be solid or 
cystic. 

Ovaritis. — By this is meant an inflammation of the ovary. 

Cause. — A frequent cause in young girls is too close confinement in 
school, at work or overstudy. May be due to blood poisoning following a 
miscarriage or confinement, to gonorrhea, inflammation of the womb, 
salpingitis and using a cold instead of a hot vaginal douche, standing in 



668 DISEASES PECULIAR TO WOMEN. 

a draught after being overheated, or while the body is in an overheated 
condition, jumping into a very cold bath. 

Symptoms. — The pain is excruciating, and is situated low down in the 
abdomen, near the groin; this pain oftentimes shoots down the leg of the 
affected side. The pain may extend into the back and hip. The lower part 
of the abdomen is extremely sensitive, and the sufferer will not permit 
anyone to touch it. Even the weight of the bed clothing may give rise to 
so much distress that a prop will be necessary in order to prevent the bed- 
clothing coming in contact with the skin. Fever will be present, the 
height of which will depend on the severity of the attack. Voiding urine, 
and the bowel movements may be accompanied by more or less pain. 
These symptoms occur during an acute attack. 

Treatment — During the acute attack rest in l^ed is imperative. An 
ice bag should be applied over the affected ovary, providing the skin is not 
too sensitive to stand it. If this is not well borne, try a hot water bag, or 
flaxseed poultice. In addition to these, which always tend to ease the 
pain, opium should be given by the mouth or with a hypodermic needle. 
When the pain is so great as to demand opium, of course only a physician 
should prescribe it. 

Accessory Treatment. — At times any of the following drugs may af- 
ford relief. Antipyrine. five grains every three hours; acetanilide four 
grains every three to four hours ; or the two combined, giving two grains 
of each every three hours ; or the tincture of gelsemium ten drops every 
three to four hours, in a teaspoonful of water; for reducing the fever 
tincture of aconite one drop every hour. The following prescription is 
often of value in all varieties of inflammation of the ovary, irrespective of 
the cause: 

R. — Tincture of gelsemium 2 drachms 

Tincture of cannabis indica 2 drachms 

Peppermint water 3 ounces 

One teaspoonful, repeat in two hours, then ever}' three hours. 

When the inflammation becomes chronic, local treatments should be 
persevered in for several weeks ; combined with hot vaginal injections. 
If there be leucorrhea use the remedies advocated under that heading. 

If the local treatments do not afford relief then it will be necessary 
to have an operation, which will consist in removing the ovary if badly 
diseased, or if slightly so then only that portion which is affected. 

Pyosalpinx. — If an acute attack of ovaritis does not get well, or 



TUMORS OF THE OVARY. 669 

develops into a chronic condition, and pus forms, then it is called pyosal- 
pinx, which means pus in the tube or oviduct. 

Symptoms. — They will be those of ovaritis, only more so. Chills may 
also be present, due to the absorption of the poisonous material from the 
pus. 

Treatment. — This consists in the removal of the ovary and tube, as 
no other procedure will effect a cure. Too often women suffering from this 
condition will delay operation until the last possible moment, which delay 
invariably costs their life. 

Displacement of the Ovary — The ovary may drop down from its 
normal position, in so doing it always falls back of the womb. This is 
called prolapsus of the ovary. 

Prolapsus of the Ovary— Causes — Generally due to enlargement of 
the ovary, which may be caused by inflammation or tumors. A sudden 
fall or misstep will at times cause an ovary of normal size to fall down- 
ward, which will invariably become inflamed. 

Symptoms. — Pain located deep down in the pelvis, which may be of a 
dull aching character, or sharp and shooting. The bowel movements are 
frequently painful, due to the distended rectum pressing against the ovary. 
Intercourse is very painful and may be accompanied by nausea. 

Treatment. — Local treatments and the use of the hot vaginal douche 
may afford some relief, but invariably it is necessary to remove the ovary, 
which operation will require a rest in bed of three to four weeks. 

TUMORS OF THE OVARY. 

The tumors of the ovary may be solid or cystic. The former may be 
benign or malignant. The solid tumors are divided into the fibrous, mus- 
cular and cancerous, the latter of which is extremely rare. 

Cystic Tumors of the Ovary — These cysts are divided in the small 
and large. The former attain the size of an egg or the fist, while the 
latter may grow to any size, holding many gallons of liquid. 

Causes. — The immediate cause is very obscure ; usually due to inflam- 
mation of the ovary, sudden amenorrhea, excessive intercourse and blows 
on the abdomen. These tumors may be present at any age, from infancy 
to advanced old age, but are most common during the period of sexual 
activity, between the twentieth and fortieth years. Strange to say they 
are most frequent in the unmarried woman and those who have not borne 
children. 



G70 diseases peculiar TO WOMEN". 

Symptoms — 1. The woman may first notice that one side of the 
abdomen is larger than the other, and later on will be able to feel a lump 
on that side. This may increase rapidly in size, the whole abdomen 
becoming distended, and looking not nnlike pregnancy. Indeed, the 
woman herself may suspect that she is pregnant. Later on, there will be 
a sensation of weight in the pelvis, the bowel movements will be painful 
and the bladder very irritable, due to the pressure of the tumor. Painful 
and profuse menstruation is of frequent occurrence. 

2. As the tumor increases in size there will be pressure symptoms, 
swelling of the legs, due to pressure on the blood-vessels, the privates may 
become swollen, due to the pressure on their blood supply ; when the tumor 
becomes sufficiently large to press on or near the diaphragm there will 
occur shortness of breath. Besides these the face will have a pinched 
expression, characteristic of this kind of tumor ; there will be marked loss 
of weight and general debility. 

3. Pain more or less constant will be present, and at times violent 
in character. This may be due to peritonitis, caused by the irritation of 
the tumor. 

Treatment. — 1. The only cure is, of course, operation. * If the cysts 
are very small, about the size of a pea, they can be removed from the 
ovary, and this organ allowed to remain. But, on the other hand, if they 
are the size of a pigeon's egg or larger, then it will be necessary to re- 
move the ovary with the tumor. 

2. The old method of tapping the cyst and drawing off its contents 
is to be condemned as dangerous. 

3. The operation of ovariotomy, or removal of the ovary, will neces- 
sitate the patient remaining in bed three to four weeks. 

LACERATIONS OF THE PERINEUM. 

Character. — This consists of tears of the anterior and posterior walls 
of the vagina, during childbirth. The laceration may extend through the 
posterior vaginal wall into the perineal body. 

Symptoms — 1. When the anterior or front wall of the vagina becomes 
torn the support of the bladder is usually disturbed, and there will be 
more or less trouble in voiding urine. In addition there will be an in- 
ability to entirely empty the bladder each time, which may result in in- 
flammation of the bladder. 

2. When the posterior or back wall of the vagina is torn the 



GONORRHEA. 



671 



symptoms are more marked. This laceration as a rule extends through 
the muscle which is the main support of the womb from below, by holding 
up the pelvic floor, and in this way supporting the womb. These muscles 
are two in number, one on either sida 

Treatment. — 1. After labor the parts should be thoroughly inspected 
to see if a laceration has occurred. If so it should be sewed up at the time. 
When a physician tells a woman that she is torn — and it is no fault of his 
that such does happen — and desires to insert stitches, she should allow him 
to do so. Too often women will not permit it,, and they regret it only once, 
and that is as long as they live. 

2. If the tears are sewed right after the baby is born they will in- 
variably heal and the parts will be restored to the same condition they 
were in prior to labor. If not the muscles and tissues do not heal togetner, 
and the woman will begin to suffer from all kinds of pelvic symptoms, 
such as forward and backward displacements of the womb, prolapse of this 
organ, prolapse of the bladder and obstinate constipation. 

3. These lacerations are divided into complete and incomplete. The 
first consists of those in which the tear extends through the bowel, the 
latter a tear of any extent near, or down to, but not through the bowel. If 
these lacerations are not repaired at the time, then it will only be a ques- 
tion of time before such an operation will be necessary, so why not permit 
the physician to do as he thinks best at the time these lacerations occur. 

4. If the laceration is complete there will be a loss of control of the 
bowels, and they will move without the knowledge of the woman. If the 
tears are not repaired at the time, it is useless to attempt it less than 
three months after labor, if so a poor result will usually be obtained. 

(JONORRHEA. 

Character. — This is an inflammatory disease commonly called "the 
clap." Greater than any other danger, presented to woman, is sexual in- 
tercourse with a man who has gonorrhea or syphilis ; the former is the 
more destructive. The attack of gonorrhea in the male at the time of 
intercourse may be acute, chronic, or one which had not been thoroughly 
cured. 

A Serious Disease. — While gonorrhea in man in most cases is a trifling 
disorder, although there are exceptions in which it leaves a serious con- 
dition or becomes fatal, are not so very rare; in woman it is one of the 
most serious diseases. 



672 DISEASES PECULIAR TO WOMEN". 

Many an innocent and previously healthy woman, shortly after mar- 
riage to a man who supposed himself to have been cured of gonorrhea 
years before, may get a destructive gonorrheal infection. 

Diseases Induced by Gonorrhea. — When we take into consideration 
that a gonorrheal infection in a woman may cause inflammation of the 
vulva, vagina, urethra, bladder, lining membrane of the womb, the womb 
itself, the tubes and the ovaries; that the inflammation of the tubes and 
ovaries as a rule result in abscesses, nay more, that too often both ovaries 
have to be removed, and oftentimes the womb with it, then you will realize 
the dangers of an attack of this disease in a woman. 

Causes. — They have been mentioned, intercourse with a man who has 
had an attack of gonorrhea, or is still suffering from an old attack which, 
has not been thoroughly cured, and yet his physician has probably dis- 
charged him as "cured." Very frequently you will hear a person say 
that it was contracted from a water closet ; this is impossible, especially 
with a man, but, a woman, under very rare circumstances, may come in 
contact with pus which has escaped from the male on to the seat of the 
closet. I have never heard of such an instance happening; although it 
is possible it is extremely improbable. 

Symptoms. — 1. These consist first, of a burning and itching sensation 
in the "privates," followed in a day or two by a discharge, which in a few 
days generally becomes profuse. The pain in these parts then becomes 
more or less unbearable. Each time the bladder is emptied there is a 
burning, scalding sensation, due to the urine flowing over the inflamed 
parts. 

2. If the inflammation spreads to the urethra and bladder there will 
be all the symptoms of cystitis (which see). If the disease extends to the 
uterus there will be all the symptoms of acute inflammation of the womb, 
which will necessitate the woman going to bed. As the disease spreads to 
the tubes and ovaries the pain in the lower part of the abdomen will 
become intense and the fever increase ; both of which will become intensi- 
fied if abscesses form. 

Treatment — This consists in vaginal injections of permanganate of 
potash, -Q.ve grains to a quart of hot water four times daily ; bichloride of 
mercury, seven and one-half grains to the quart, same as before ; or appli- 
cations to the vagina of nitrate of silver, thirty to forty grains to the 
ounce of water. The latter should be done by a physician. A woman 
who has the symptoms first mentioned may at once suspect she has gonor- 



DISEASES OF THE BLADDER. 673 

rhea, and should consult a physician immediately and place herself under 
his care. 

DISEASES OF THE BLADDER. 

The bladder may be irritable and yet not inflamed, so a special de- 
scription will be made. 

Irritability of the Bladder. — This may arise from purely functional 
causes and is of frequent occurrence in nervous women. Oftentimes 
present in diseases of the womb and vagina, and when the front wall of 
the vagina has been lacerated. Also present in displacements of the 
womb. It may follow abdominal operations and parturition (childbirth). 

Symptoms — Similar to those of cystitis. The urine from an irritable 
bladder is always clear, never contains pus. 

Treatment. — Build up the constitution by the use of tonics. (See 
Anemia.) Regulate the bowels. The following may be tried: 

R. — Atropine sulphate V2 grain 

Distilled water 4 ounces 

Five drops in water after meals. 
If the woman is extremely nervous, fifteen grains of the bromide of potassium 
or sodium every four hours will prove of value. 

Cystitis. — This is an inflammation of the mucous membrane of the 
bladder and may be acute or chronic. 

Causes. — Acute cystitis may be caused by exposure to cold ; gonor- 
rhea; dirty instruments, particularly a catheter; pressure of the child 
during labor ; inflammation of the peritoneum or pelvic organs ; blows 
and falls when the bladder is distended with urine, and the improper use 
of certain drugs. 

Chronic cystitis may be a continuation of the acute form, especially 
by pressure of the uterus during pregnancy, or large tumors. 

Symptoms. — 1. The acute form frequently begins with a chill, fol- 
lowed by fever, which is not very high. There is considerable pain in 
the lower portion of the abdomen, difficult and painful urination, and the 
urine is very cloudy. The desire to urinate at night may be very trouble- 
some, and is apt to become more or less constant. There is a continuous 
feeling of pressure and weight over the bladder. 

2. In the chronic condition the pain is not so severe, but constant 
desire to pass water, especially at night, is very distressing. When there 
is a desire to pass water the patient must go at once, being unable to hold 
43 



674 DISEASES PECULIAR TO WOMEN. 

her water. If she should lift heavy weights or cough the water may 
dribble away. 

Treatment. — 1. All instruments that are introduced into the bladder 
should be thoroughly cleansed and rendered antiseptic. 

The acute form is best treated by rest in bed and an ice bag over the 
bladder. If the latter is not tolerated, then try a hot water bag. A very 
good drink is flaxseed tea. If the pain is severe, one-half grain of opium 
suppository will afford relief, repeating in about three hours if necessary. 
The following prescription will be found very useful: 

R. — Tincture of aconite 4J , I drachm 

Sweet spirits of nitre I ounce 

Liquor potassii citratis 6 ounces 

A dessertspoonful every four hours. 

All alcoholic liquors must be restricted, and the diet should consist of 
milk and broths. 

2. If the disease becomes chronic the patient should be kept on a 
bland diet. Vegetables, such as asparagus and those containing salts, and 
all alcoholic liquors should be prohibited. 

3. If the urine is highly acid it should be rendered neutral by the 
benzoate of sodium; if it is alkaline, it should be rendered less irritating 
by the acetate or citrate of potassium. 

4. Salol, five grains, four times a day is an excellent drug for this 
condition. Mineral waters such as Bethesda, Vichy and Buffalo Lithia 
are to be taken, at least several glassfuls a day. 

5. Great relief is afforded by washing out the bladder, of course this 
can be done only by a physician. ■ __ 

6. If the water constantly dribbles away, it may be cured by stretch- 
ing the neck of the bladder. This will necessitate remaining in bed for 
about a week. 

Stone. — Stone in the bladder of course requires an operation for its 
removal. There is a prevalent idea that a stone in the bladder can be dis- 
solved by medicines and lithia water. This is a false impression and a 
great many quacks take advantage of it, generally to extort money from 
the sufferer. 



DISEASES OE THE FEMALE BREAST. 675 



DISEASES OF THE FEMALE BREAST 

The breast is subject to inflammation, abscesses and tumors. 
MASTITIS OR MAMMITIS, INFLAMMATION OF THE BREAST. 

Causes. — This may be produced by blows on the breast, or to any of 
the usual causes of inflammation. It may occur at any age, and in either 
sex. An acute attack is more often found present in nursing women dur- 
ing the first week or month after delivery. If such happens it is in- 
variably due to cracked nipples. 

Symptoms. — At first only an uneasiness of the breast is noticed, then 
a chill occurs which is usually followed by fever. The gland becomes 
intensely swollen, red and exceedingly painful. The inflammation may 
be so great as to cause an abscess. 

Treatment. — This consists in preventing an abscess from forming. 
To accomplish this wash the nipples thoroughly three to four times a day, 
and stop the baby nursing the affected breast. The breast should be 
emptied of milk, by the cautious use of the breast pump. Cloths saturated 
in a solution of lead water and laudanum should be applied several times 
a day, and over these lay an ice bag, or rub frequently with hot lard. 

ABSCESS OF THE BREAST. 

If the inflammation does not subside an abscess invariably results. 

Treatment. — 1. If it appears that pus is forming hot applications 
should be made, preferably flaxseed poultices, to be renewed as soon as 
they become cooled. 

2. As soon as pus is detected the breast should be incised and the 
cavity drained. 

3. Too often women refuse to allow their physician to lance the 
breast, thinking it will come to a head and be well in a few days. This is 
a great mistake. The breast should be freely opened, in order that the pus 
can easily run out. If necessary an anesthetic should be taken, in order 
that the physician may accomplish thorough work. At times it may be 
necessary to insert a drainage tube ; depending entirely upon the time 
which has elapsed from the formation of the pus until the time it is 
incised. 



676 DISEASES PECULIAR TO WOMEN. 



TUMORS OF THE BREAST. 



These may be benign or malignant. Tumors of the former type can 
be readily removed, and will not give rise to further trouble. On the 
other hand, those of the latter class, which are of a cancerous nature, are 
very apt to return, unless operated on early and thoroughly. 

CANCER OF THE BREAST. 

Character. — Very often a woman will strike her breast against a hard 
object, or may be struck by a fist. This blow may be followed by a lump, 
which in a few days may disappear. 

Again, a woman while dressing may notice a lump in the breast, and 
think nothing further about it, or may try to cure it by rubbing in 
camphorated oil, or other household liniments. 

These lumps frequently are the early stages of cancer, and the longer 
the delay the greater the risk. When a woman discovers a lump in the 
breast she should consult a physician at once in order that he may properly 
treat and watch it. If the lump continues to grow and remains hard then 
he will, or rather should, advise an operation. Under such circumstances 
these lumps are invariably a beginning cancer. 

Treatment. — If the lump is small then it may not be necessary to 
remove the entire muscles, but simply the breast. On the other hand, if 
the lump is large and of long standing, or if the breast is immovable, that 
is, cannot be moved from side to side, then the breast, muscles and all sur- 
rounding tissue will demand removal. Recurrence may follow. Many 
women can be cured of cancer of the breast, providing they will consult a 
good physician early, which is, as soon as a lump is noticed ; and if such 
does not become smaller or disappear in two weeks, submit at once to an 
operation or the application of the X-ray. 

Beware of Quacks. — It is surprising the number of women who will 
scorn the advice of a physician, and place themselves under the care of a 
charlatan or a quack. This class has killed more women than any of the 
most malignant of diseases, and yet the State will sanction their existence. 
Beware of quacks, especially when a cancer exists. These deceivers and 
money extortionists advertise to remove these growths by the "roots." 
Such growths have no roots. And yet how many women will stand the 
torture of the acids which they apply to eat out the tumor, in preference 
to a clean-cut operation, under an anesthetic, which will keep them in bed 



FACTS OF GREAT VALUE TO WOMEN. 677 

only two weeks. While the "eating out the roots' ' process requires a 
torture of several weeks. 



SOME INTERESTING FACTS OF GREAT VALUE TO WOMEN 

Preventing Disease — Education has a great influence in the develop- 
ment of diseases peculiar to women. During early childhood, when the 
pelvic organs are undergoing their development, the child must not be 
confined to the house and at school all day. She should be allowed as 
many hours recreation a day as feasible, in order that she may enjoy 
out-door exercise, and obtain all the fresh air possible, which is of so 
vital importance to her constitution. Too long daily practice at the piano 
or organ is also harmful. 

What to Avoid. — Everything that causes an increase of blood to the 
womb and ovaries should be avoided. In this category belong sexual 
excitement brought on by reading suggestive novels; by looking at ob- 
scene pictures; by masturbation ( self -abuse ) ; sodomy and even normal 
coition if performed too violently. 

Care of the Skin — The care of the skin is of great importance. Baths, 
daily or two or three times a week, should be encouraged. The accumu- 
lation of dirt blocks up the sweat glands, and nature is unable to throAV 
off the impurities through these vessels. The Jewesses from Russian 
Poland are very susceptible to disease, and their appearance conveys to 
one the idea that they never wash their bodies. 

Overwork. — All work and no play is a fruitful cause of ill health. 
Every woman who has the cares of a household should indulge in open- 
air exercise, or daily walks. Golf, horseback riding, walks, gathering 
flowers and the like, are to be highly commended, because they combine 
exercise with open air. 

Proper Food. — There is room for improvement regarding food. 
Many girls have a loathing for food in the morning, and often take noth- 
ing but a cup of coffee, and at times not even that, and go to school, and 
allow their brains to work for hours on an empty stomach. Such a 
practice is to be condemned in the strongest terms. It is not only a 
very bad habit, but it spoils the appetite, tends to cause a sour stomach, 
and impoverishes the blood, which leads to nervous disturbances. The 
same may be said of candy, the immoderate use of which among girls 
and women corresponds to alcoholic beverages and tobacco in men. 

Mode of Dressing. — Some few suggestions regarding the mode of 



(>7£ DISEASES PECUEIAE TO WOMEjNf. 

dressing may be of value. One of the most frequent causes of congestion 
of the pelvis is the "decollete" evening dress and the bell-shaped nether 
garments. High heels, when worn at an early age are apt to change the 
normal inclination of the pelvis, a cause of tedious and difficult labors. 

Tight Lacing — Of much more importance is the use of the corset. 
A loose corset at the best is more or less binding. Tight lacing, of course, 
should be avoided, it displaces the various organs in the abdomen, push- 
ing them in all directions, excepting the normal, and causes a crowding 
down of the pelvic organs, hence a fruitful cause of diseases of women. 

The Menstrual Period. — Neglect during menstruation is one of the 
most fruitful causes of female diseases. Dancing and skating during this 
period should not be permitted. Sexual intercourse at this time, to say 
the least, is a repulsive habit, yet it is not of rai?e occurrence. Such a 
practice is very apt to result in a pyosalpinx (abscess of the oviduct, which 
see). 

Marriage with Disease. — Marriage with existing disease of the pelvic 
organs is a frequent cause of unhappiness for both husband and wife. 
Disease of such organs may prove destructive of all sexual desire or may 
prevent the possibility of conception. But if these should not ensue, there 
still remains the greater and more appalling danger of defective child de- 
velopment in the womb, or of the actual transmission of disease to off- 
spring. Such calamities are all too frequent, and those who would enter 
the marriage estate should feel certain that their pelvic organs are free 
from diseased conditions. 

Evil of Abortions. — Abortions, however brought about, play their part 
in causing inflammatory and nervous wrecks of women. They are the 
source of many serious and, ofttimes, permanent diseases. Causes of abor- 
tion are very numerous. Among those most common are displacement of 
the womb, ulceration of the neck of the womb, too much exercise, heavy 
lifting jar from a slip or fall, strong emetics, powerful purging, etc. 

Treatment of Abortion — If the symptoms are slight, it may be that 
nothing more than a few days' rest will be required, keeping the body as 
much as possible in a horizontal position, taking occasional cooling drinks, 
and at bedtime a pill composed of one graia of camphor and two grains 
of sugar of lead. In addition, a mustard plaster may be applied to the 
lower part of the back to allay any pain that may be experienced. If the 
conditions are severe, and flooding should set in, accompanied with marked 
symptoms of miscarriage, a napkin wetted with cold water, or vinegar and 
water, should be laid upon the external genitals. Rest in bed is important. 



CHANGE OF LIFE (MENOPAUSE). 679 

If the symptoms are not thus allayed, recourse must be had to the plug- 
ging of the vagina with pieces of cloths soaked in a solution of alum or 
tannin ; fill the vagina full and then place a fold of linen in the genital 
fissure and apply a bandage. Remove the plug in from five to ten hours 
and replace if the discharge continues. 

Conception. — Every young couple intending to enter the marriage 
relation should know what a terrible curse they are liable to transmit to 
their future children through ignorance of the vital principles which regu- 
late reproduction. This attended to, it then remains with the mother to 
mold the infant growing within her by being herself at the time what she 
would like her child to be. 

The physical obstacles to conception are chiefly those diseases which 
have been previously described. When it is dependent on the causes which 
produce painful menstruation, or profuse menstruation, or a suppression 
of menstruation, the remedies are the same as are pointed out for those 
complaints. If inflammation of the ovaries be the cause, a cure may be 
effected, provided the inflamed condition be removed. If inflammation or 
ulceration of the neck of the womb be the obstacle, the remedy may be 
found in the treatment recommended for these affections. 



CHANGE OF LIFE (MENOPAUSE). 

This is better known as the "change of life," also called the cli- 
materic. 

Time and Character. — It comes on gradually, extending over a period 
of three to four years; it comprises the times when the monthly flow 
begins to be irregular, gradually diminishes and ceases altogether. As 
a rule in most women it begins about the age of forty-five, but invari- 
ably so between forty-five and fifty years. Those who menstruate early 
continue to menstruate longer than those who begin late, hence have a 
late menopause. Those who suffer from a chronic inflammation of the 
womb or are weakened by severe uterine hemorrhages begin to change 
life sooner than a healthy woman. 

When the menopause comes on gradually the woman is not very 
liable to have severe disturbances, but if it comes on abruptly the dis- 
comforts are very bad, and the general strain of symptoms are marked. 

Dangers of the Period. — This period is a critical point of a woman's 
life. Too often women while passing through this stage pay little atten- 
tion to it, and every bad symptom is attributed to the "change of life." 



680 DISEASES PECULIAR TO WOMEN. 

This is the time of all others that cancer of the womb and breast is 
prone to develop. Every woman with a lump in her breast, which de- 
velops during this period, should consult a physician at once. When 
ever bleeding takes place from the vagina, after the menopause has ended, 
invariably signifies beginning cancer, and the woman should immediately 
submit to an examination. 

Symptoms. — 1. The first symptom of the menopause is irregularity in 
the menstrual flow, as regards the time and quantity. The intervals be- 
tween the menstrual periods will become extended, say every five to six, 
seven or eight weeks. Sometimes, on the contrary, menstruation becomes 
more frequent. The periods last longer, say six to eight days. There 
will be congestion of the head, causing a red face, headache and indistinct 
vision, buzzing in the head and ears, dizziness, the sleep is disturbed by 
dreams, and at the time the flow should occur may have bleeding of the 
nose. 

2. Besides the above, there may be catarrh of the stomach and in- 
testines; congestion of the liver, rendering it torpid; the kidney disturb- 
ances generally appear in the form of a sediment in the urine. Leu- 
corrhea may be very troublesome. An eruption of the skin oi the face 
may occur, and there may be intense itching, burning or smarting sensa- 
tions all over the body. The vulva may be the seat of most distressing 
itching. 

3. A very disagreeable feature of the "change" is the fever and 
sweats; this consists in a rush of blood to the head, the body becomes 
very warm and then breaks out into profuse perspiration. This may 
occur at any time and place. When others think the room very cool, she 
will think it exceedingly warm. 

4. The heart is often affected in the form of palpitations and short- 
ness of breath. The nervous system also shows evidences of a general 
upset. Sometimes the limbs become very trembly. The temper is sub- 
ject to great changes, and the sexual appetite may be greatly increased. 
She may become delirious, or even go insane. 

5. The organs of generation undergo marked changes. The uterus, 
vagina, vulva, ovaries and breast all shrink and became greatly reduced 
in size. 

Treatment. — 1. Although this is a perfectly natural process, which is 
of normal occurrence in every woman's life, conditions will arise demand- 
ing interference. 

Above all keep the bowels open. For the sediment in the urine it is 



ABORTION. 681 

well to drink Vichy or Seltzer water freely during the day ; or to take half 
a teaspoonful of bicarbonate of soda in a tumblerful of water in the course 
of the day. 

2. The congestion of the head and the disturbances of vision are re- 
lieved by hot footbaths, with or without mustard, and of the cold water 
eye douche five minutes three times daily. 

3. Lukewarm general bath taken three times a week will keep the 
skin in good condition, which is of value. 

4. Those women who have a tendency to stoutness should adhere to 
a restricted diet, such as fish, meat, green vegetables, lettuce, salad and 
juicy fruits. Milk and beer are prohibited. 

5. The few women who lose flesh must be well fed, and have choco- 
late and plenty of milk to drink, providing they can digest them. 

6. A sudden suppression of the flow during this period is particularly 
dangerous, hence she should avoid getting the feet wet, wet skin, and 
should not take a cold bath nor wash the privates with cold water. All 
these refer to when the menses are present. 

7. If hemorrhages occur employ the remedies advocated for the 
treatment of menorrhagia and metrorrhagia. 

8. If the bleeding is quite profuse, pack clean pieces of linen tightly 
in the vagina, and allow them to remain until a physician is consulted, 
which should be immediately. This method of packing the vagina will 
control the bleeding until the physician arrives and institutes more radical 
measures. A good uterine tonic such as the pil uter ova often does much 
to relieve the nervous condition and allay pain and distress. 

MISCARRIAGE OR ABORTION. 

Meaning. — Abortion is the expulsion of the product of conception 
from the womb. It is also called miscarriage, by which name it is better 
known. Amongst the laity at large the term miscarriage is generally used 
when this accident happens without any violence on the part of the mother, 
whereas abortion is applied when attempts have been made to bring on 
this condition by the introduction into the womb of instruments. 

Divisions. — Abortion has been divided into spontaneous or natural 
and accidental. A better division is spontaneous and artificial. The latter 
class is divided into therapeutic and criminal ; therapeutic abortion is that 
in which it is done by the physician in the interest of the mother's life 
or health, while criminal abortion is without this or any other justification. 



6S2 DISEASES PECULIAR TO WOMEN. 

It is further divided into complete and incomplete; threatened and in- 
evitable. 

Complete Abortion — By complete is meant that all the product of 
conception, foetus and afterbirth, is expelled ; incomplete, when only a part 
of it comes away, invariably the foetus, the afterbirth or part of it remain- 
ing in the womb ; when the symptoms of an abortion appear, and it can be 
checked, it is spoken of as a threatened abortion; whereas, if it is in- 
evitable, when in spite of all that is done, miscarriage occurs. 

Criminal Abortions. — The greater number of miscarriages occur in 
the first three months of pregnancy. It has been shown by statistics that 
criminal abortion is more frequent from the third to the sixth month than 
in the first two months. The explanation of this fact is due, that up to 
three months the woman hopes that there is simply a delay in the appear- 
ance of the flow, but when this hope fails she is ready to resort to any pro- 
cedure to end a pregnancy which now becomes almost certain ; on the other 
hand, when six months have elapsed the life of the child has become so 
manifest that she shrinks from its destruction. Movements of the foetus 
in the womb make successful appeals to the mother's conscience, if not to 
her love also, for the salvation of the new life which dwells within her 
womb as its sanctuary. 

Dangers of Abortion. — It is surprising the number of criminal abor- 
tions that occur yearly, and which fail to come to notice, unless the victim 
dies, when an expose is made by the coroner. And even then many 
women die with the names of the abortionist and her seducer sealed upon 
her cold lips. Women do not for one instant think of the damage which 
is wrought to their generative organs, when they introduce some instru- 
ment or "what not" into the womb in order "to open it," so that a mis- 
carriage will occur. Inflammations, displacements of the womb, and 
pelvic abscesses, and abscesses of the ovaries too frequently follow these 
foolhardy attempts. How many women have sacrificed their lives in this 
criminal and damnable manner? 

Causes. — 1. The causes of this unfortunate condition are numerous, 
they may be due to disease of the foetus, placenta, womb or the mother. 
Then again the father may be at fault. For instance, men who are con- 
firmed alcoholics, or suffering from consumption or syphilis will invariably 
have a serious effect on their offspring, in that if pregnancy should occur 
the foetus dies within a month or so after conception. Abortion is of 
frequent occurrence in the wives of men who work in lead. 

2, Violent exercise, as running, dancing, jumping, riding on a hard 



ABORTION. 683 

trotting horse or over a rough road; lifting heavy weights, falls, blows, 
tight corsets, surgical operations, especially if on the organs of generation, 
are very prone to cause an abortion. Frequency of intercourse is not an 
unfrequent cause. 

3. Among other causes which may be attributed to the mother, are 
infectious diseases, such as typhoid fever, during which she is very apt to 
abort ; syphilis, this is one of the most frequent causes ; backward dis- 
placement of the womb plays a very important part in this condition ; a 
pregnant woman working in a tobacco factory is very liable to miscarry. 

4. Again, violent sneezing or cough may be the cause. Tumors of 
the womb and malignant disease of this organ are also active factors; 
though as a rule a woman with cancer of the womb rarely becomes preg- 
nant, the same applies to large fibrous tumors, and the smaller when 
located in the cavity of the womb. High altitudes will also produce an 
abortion, and it is asserted that in certain mountainous countries pregnant 
women descend to the valleys to escape the accident. 

5. Medicines play an important role in the causation of this accident, 
such as active cathartics, laxatives and even emetics. The administration 
of quinine has been followed by miscarriage, although oftentimes it has 
been attributed to the disease and not to the medicine. But many of these 
drugs cannot be blamed for the accident, as there usually exists a tendency 
of some kind to a miscarriage. 

6. The foetus may be affected by the same diseases as the mother, 
which, if it should cause the death of the foetus, will produce an abortion. 
Excessive distension of the womb due to plural pregnancy is apt to pro- 
duce premature contractions of the womb, with a resulting miscarriage. 

Symptoms. — 1. There may be premonitory symptoms such as flushing 
of the face, alternate flushes, and of heat and chilliness, pain in the back, 
irritability of the bladder which may extend to the rectum. 

The characteristic symptoms are hemorrhage and pains. These 
pains begin in the lower part of the abdomen and on both sides of the 
same, in the groin or just above it. As the condition progresses these 
pains extend to the back, and later on pass around to the front. The 
pains begin first, to be soon followed by a bloody discharge, or vice versa. 
Some cases have a gush of watery fluid early in the attack, which may be 
slightly discolored with blood ; this discharge does not necessarily indicate 
rupture of the ovus and hence that miscarriage is inevitable, for it may 
occur from inflammatory diseases of the womb. 

2. The flow of blood is very much greater than that which occurs 



684 DISEASES PECUTJAE TO WOMEN. 

in menstruation ; large clots are very apt to be passed, in which, if care- 
fully sought for, the ovum may be found. 

3. After seven or eight weeks of pregnancy the symptoms of abortion 
are quite plain. Prior to that time it may be mistaken for a case of pain- 
ful menstruation. 

4. If the pregnancy has advanced beyond three months the foetus 
as a rule escapes first, soon to be followed by the afterbirth. If the after- 
birth is not expelled the woman is liable to suffer from hemorrhages until 
it is removed. These hemorrhages may be so great as to cause a fatal 
result, providing the woman has not a physician in attendance. 

Treatment. — 1. If a woman is subject to repeated miscarriages she 
should exercise every care to* place herself in the best surroundings during 
each pregnancy. At the regular time each monthly flow is expected she 
should remain in bed for a few days ; this will give the body absolute rest 
and may tide her over to full time. If she has been in the habit of 
aborting at a special time, say the third or fourth month, when that period 
is reached she should go to bed several days before the time expected and 
remain there at least two weeks. 

2. If the abortions are due to syphilis, a course of mercury and iodide 
of potash should be instituted. If due to a backward displacement of the 
womb, this should be corrected by placing the womb in its normal position 
and holding it there with a pessary, or by an operation if necessary. 
Sexual intercourse during pregnancy should be prohibited, as this is a 
very frequent cause of miscarriage. 

3. When a pregnant woman feels pains in the lower part of the 
abdomen, soon followed by the discharge of blood, or sudden discharge 
of blood followed by pain, she has in all probability a threatened mis- 
carriage. She should loosen all her clothing and lie down; her drinks 
should be cold; twenty drops of laudanum with half a teacupful of water 
should be injected into the rectum, or a half grain opium suppository may 
be inserted. If the symptoms are not abated in one hour the injection 
or suppository should be repeated, and again at the end of the second and 
third hours if needed. If the patient is very restless and nervous, twenty 
to thirty grains of chloral may be added to one of the opium injections; 
if such is done do not use warm water, but the yolk of an egg and some 
warm milk, in order to prevent the drug from irritating the bowel. 

4. The opium may be continued from day to day as long as there is 
hope of arresting the abortion. Meantime once in two days the bowels 
should be opened by a warm water injection, or by a mild laxative. 



CONCEPTION. 685 

Should the pain and hemorrhage cease it is better for the patient to re- 
main in bed for three or four days after this cessation ; when she gets up 
she should only gradually resume her usual habits of life, even then as 
an experiment, and be prepared to return to bed at the first recurrence 
of the former symptoms. 

5. Unfortunately in the majority of cases the hemorrhages do not 
cease, or having stopped return, and the abortion is apparently inevitable, 
or the flow may be so great that it will be necessary to complete the 
abortion in order to save the life of the woman. 

6. If the abortion is inevitable stop the bleeding and empty the 
Avomb. Hot water injections may be valuable to accomplish the former. 
If they do not suffice, then the vagina should be tightly packed with 
antiseptic gauze, antiseptic lamb's wool, or pieces of boiled linen or 
muslin. In order to hold the packing in place, a napkin should be tightly 
applied. 

7. When an inevitable abortion is assured the physician may pack the 
vagina with tampons and allows them to remain for eighteen or twenty- 
four hours, and usually when removed the ovum (if it has not been 
previously expelled) and the afterbirth will be found forced out of the 
womb. If the afterbirth does not come away in twenty-four hours the 
woman should be placed under an anesthetic and the womb emptied of 
its contents. If not the discharge in a few days will have a very bad 
odor, and the patient develop blood poisoning. 

Every woman who has a miscarriage should remain in bed at least 
ten days to two weeks after such an occurrence. The women who do not 
properly attend to this accident are the ones who later in after life pay the 
penalty, which either means chronic invalidism, or the removal of one 
or all of her pelvic organs, which may or may not result in death. 

CONCEPTION. 

Character — A woman who has conceived is pregnant; pregnancy be- 
gins with conception and ends with labor, providing an abortion does not 
occur. It is normal when the uterine cavity contains the fecundated 
ovule or ovules; and abnormal, ectopic or extra-uterine, should it or 
they be outside of that cavity. 

The Ovule or Egg. — Each month when menstruation occurs an egg or 
ovule, as it is called, escapes from the ovary. An ovule may come from 
the one ovary or from both, or two or more may come from the one, 



686 DISEASES PECUNIAE TO WOMEN. 

and so forth. Leading from the ovary into the cavity of the womb is a 
tube called the oviduct. When the egg or ovule drops from the ovary, 
it falls into the end of this tube, which by a wave-like motion conveys it 
to the cavity of the womb, where it remains until the next menstrual 
period, when it is carried off with the flow. A new one is then deposited. 
It is estimated that women during their menstrual age pass many thou- 
sands of ovules. 

Twins. — If one ovule passes down and the woman becomes preg- 
nant that month the result will be one baby; if there are two ovules 
and impregnation occurs, the result will be twins, and so on. 

Ectopic Pregnancy. — On account of disease, or from other causes, the 
progress of the ovule or egg may become obstructed, then the egg or 
eggs will become lodged in the tube. Should it or they become impreg- 
nated while lodged in the tube, the pregnancy will be an extra-uterine 
or ectopic pregnancy. 

How Pregnancy Occurs. — How does impregnation occur ? When the 
male has intercourse with the female the semen of the male is deposited 
in the vagina of the female in such a position as to "bathe" the neck 
of the womb. The heat of the parts causes this gelatinous seminal 
discharge to liquefy. The semen is merely a solution to convey the 
spermatozoids. The spermatozoid is composed of a head, of a tail and 
of an intermediate segment, sometimes called the body. The entire 
length of the human spermatozoid is not more than 1-500 to 1-325 of 
an inch. The spermatozoids have an eel-like motion, the tail being the 
motile power. The spermatozoids move along until one of them comes 
in contact with the ovule, the head then enters the latter, and the tail 
drops off. Conception then occurs. Although there are thousands of the 
spermatozoids in each seminal discharge, it only requires one to fecundate 
the ovule. 

Movement of Spermatozoids. — Their rate of movement varies. It has 
been estimated about three inches in three hours. They have been found 
alive in men who have been executed seventy and even seventy-two hours 
after death. In the human female they were found endowed with active 
movements in the neck of the womb seven or eight days after coition. 
In temperate climates boys of twelve years may have discharges simulat- 
ing the seminal fluid, but it is unusual for spermatozoids to be found in 
these discharges before they are fifteen or sixteen years old. One care- 
ful investigator claims that about one-half of men between sixty and eighty 
years of age are capable of fecundation. 



STERILITY. 687 



STERILITY. 



Causes. — 1. When a woman is unable to become pregnant she is said 
to be sterile or barren. At least one marriage out of every eight is child- 
less. It is commonly believed that the fault is always, or nearly always, 
to be found in the wife, but modern investigation has shown that the 
husband is at fault in about one case out of every six. When the male 
is at fault it may be due to impotence, which is an inability to perform 
the sexual act to aspermatism, although he may succeed in getting an 
erection he may be unable to have an ejaculation of semen; or to zoo- 
spermia, the condition in which the ejaculated semen does not contain 
spermatozoids, and, therefore, has no fertilizing power. Or again the 
testicles may be improperly developed. 

2. If the female is at fault it may be due to the absence of the ova. 
In chronic inflammatory diseases of the ovaries the ovule may disap- 
pear, or the end of the oviduct may become closed. If such be the case, 
the egg will drop into the general peritoneal cavity and be absorbed. 
Another cause is incapacity for sexual intercourse, such as absence of 
the female organs of intercourse, inflammatory diseases and tumors of the 
vulva and vagina. If the perineum is badly torn the seminal fluid will 
flow out, a cause of sterility. 

3. A frequent cause is a very small opening in the neck of the 
womb, which is not sufficiently large to permit the spermatozoids to enter, 
and is termed stenosis. This should be dilated and is curable. 

Treatment. — If due to inflammatory disease resort to the remedies 
described for the various inflammations of the generative organs. 

If the end of the oviduct is occluded, and tumors are present, or 
should the perineum be badly torn, or a small opening in the neck of the 
womb be the cause, then an appropriate operation will be the only pro- 
cedure which will tend toward future conception. 

Lack of Orgasm.— A condition for which a physician is frequently 
consulted is lack of the normal feeling of the highest sexual excitement, 
called orgasm. With such the fault is probably due to some imperfec- 
tion in the nervous system. The lack of orgasm may be found in other- 
wise healthy women, and not a barrier to conception. 

In those who have never experienced the orgasm it is often incurable. 
With others the use of tonics, or pill neuro-tonal or comp. damiana will be 
found effective. 



688 DISEASES PECULIAR TO WOMEN. 



UTERINE PREGNANCY. 



Nature's Most Wonderful Miracle. — It lias been well said that every 
pregnant woman should be looked upon as a laboratory in which nature 
is performing that most wonderful of all her miracles, the fashioning 
of a new human being, and that nothing should be allowed in any way 
to disturb or derange this most important operation. Could such an idea 
be constantly kept in mind not only by mothers themselves, but by all 
those who surround or even momentarily approach the female who is 
performing the most sublime duty of her sex, that of continuing the race, 
and every effort made to aid her in accomplishing this great function in 
the most perfect manner possible, what vast improvements might be looked 
for, even in the next generation of mankind. 

First Indication of Pregnancy — The first indication of pregnancy is 
generally the stoppage of the monthly periods, and it is also one of the 
most reliable of the early indications. It should be remembered, how- 
ever, that there is no certain sign of pregnancy, none which has not 
been found to fail, and lead into errors which were profoundly mortify- 
ing, if not worse, up to the time when the heart of the infant can be 
heard to beat through the walls of the mother's abdomen. This beat of 
the child's heart can seldom be positively identified before the fifth month, 
and often not until the sixth. 

Failure of Signs. — In some instances pregnancy may occur and yet 
the monthly flow continue. This is quite common for one or two months, 
and less frequent for four or five. In fact, some mothers assert that the 
first intimation they had of being pregnant was quickening or feeling the 
motion of the child, which generally makes itself evident about four and 
a half months from the date of conception. 

The Morning Sickness. — Morning sickness occurs with most females 
for the first few months of pregnancy, and some females when pregnant 
suffer intensely from it. It usually comes on whilst dressing, not being 
felt on first getting up, and when not very severe often passes off later in 
the day to recur, however, the next morning. It differs from other forms 
of sickness, such as those which are due to disease of the stomach itself, 
in that as soon as the vomiting is over the patient is often perfectly well 
again, and can take food immediately afterward. The sensitiveness of 
the stomach to odors and flavors, and the peculiar ease with which feel- 
ings of nausea are brought on by such impressions is a very significant 



UTERINE PREGNANCY. 089 

sign, and rarely fails, if supported by the other usual symptoms, to indi- 
cate pregnancy when it is well marked. 

Changes in Mammary Gland. — Changes which occur in the mammary 
glands are valuable corroborative signs. They consist in the enlargement 
and puffiness of the nipple, the darkening and increase of size of the 
areola, and occasionally the secretion of milk. These indications show 
themselves during the second and third months. 

Quickening Period. — Quickening is the feeling of the movements of 
the child, which is so constantly noticed by the mother about the end of 
four and a half months, or just half way through the pregnancy, that it 
often helps to fix the time of the approaching confinement. The first 
sensation is described as being like the fluttering of a bird, or the creeping 
of an insect, but after a few weeks it becomes progressively more decided, 
and more perceptibly like the struggles of an infant with human arms and 
legs. The popular idea that up to the time of quickening the child in the 
womb is not alive is, of course, totally erroneous, because if the infant was 
not living from the very day of conception it would not grow and develop. 
It is only felt primarily at this period because before the date of quicken- 
ing its struggles have been too feeble and made too deeply in the cavity 
of the abdomen to be perceptible. 

Changes in Abdomen. — In the early months of pregnancy the abdomen 
is often even flatter than in the unimpregnated female, but after the period 
of quickening enlargement occurs, and in the latter months becomes so 
great as to cause, in many instances, a good deal of distress by mere pres- 
sure, distension and weight. The stretching of the skin necessary to ren- 
der it capable of covering the uterine tumor generally gives rise to nu- 
merous cracks in its surface, which remain as whitish scars through after 
"life. 

Changes in Disposition. — Changes in temper and disposition, longings 
for strange and unsuitable food, drowsiness, toothache, heartburn, palpita- 
tion of the heart, and so forth, are less constant and therefore less reliable 
symptoms of pregnancy, some of which, however, occur in a large propor- 
tion of the cases. 

Duration of Pregnancy. — This average date is usually considered for 
the fruit of the womb two hundred and eighty days, or forty weeks, or a 
week over nine calendar months, from the day of the cessation of the 
menstrual discharge when last seen at the commencement of pregnancy. 
In order to be able to make this calculation accurately it is a good plan 
for every married woman to keep upon a calendar a regular account of the 
44 



690 DISEASES PECULIAR TO WOMEN. 



OVARY AND MAMMARY GLAND 

Figure Xo. i. — The ovary, showing the vesicular bursted and the large grums 

which fills its cavity. 

Figure Xo. 2. — Change in the breast from pregnancy. 

A. Xipple. 

B. Sebaceous tubercles. 

C. Spots in the branded areola. 

D. Marks due to the enlargement of the skin. 

Figure Xo. 3. — Lobes of a mammary gland. 

A. Acinos. 

B. Canaliculi or small canals. 

C. Conduit formed by several small canals. 

Figure X"o. 4. — Mammar}- gland. 

Figure No. 5. — Mammary gland in a woman. 

a. Xipple. 

b. Areola. 

c. c, c, c, c. The gland lobes. 

1. Breast or enlarged part of one of the conduits which carry milk. 

2. Extremities of the conduits which carry milk. 




Figure No. 1. 




Figure No. 3. 





W 

„ -,11,1.1'" ' 
S— IK 



Figure No. 2. 




C 

Figure No. 4. Figure No. 5. 

OVARY AND MAMMARY GLAND 

For an explanation of the illustrations see text on opposite page. 

691 



692 DISEASES PECULIAR TO WOMEN. 

day in each month when she ceases to he unwell, so that if at any time 
before the next period impregnation should occur, she may have at hand 
the precise datum upon which to base her preparations. The date of 
quickening, when that is a prominent symptom, as is the case in most 
pregnancies, ought also to be carefully noted. 

Pregnancy Table. — The table given below is one which will prove 
reasonably accurate : 






Jan. 
Oct. 


1 2 3 4 5 6 7 8 9 10 1 1 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 


Nov. 


Feb. 
Nov. 


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 


Dec. 


Marchl i 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 | 
Dec. ! 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 | Jan. 


April 
Jan. 


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 
678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1234 


Feb. 


May I12345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 
Feb. ! 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1234-567 


March 


June 
Ma rch 


12345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 

8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 123456 | April 


July j 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 | 
April I 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 | May 


Aug. 
May 


12345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1234567 


June 


Sept. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1617 18 19 20 21 22 23 24 25 26 27 28 29 30 | 
June | 8 9 10 1 1 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 | Ju7.v 


Oct. 
July 


12345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 | 

8 9 10 1 1 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4' 5 6 7 | Auf/. 


Nov. 


12345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 I 

8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 | Sept. 


Dec. 
Sept. 


1 2345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 | 

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 | Oct. 



Explanation — Find in the top line the date of the last menstruation 
the figure below will indicate the date when the confinement may be ex- 
pected. If the date of menstruation is April 8, then the date of expected 
confinement will be January 13. 

Care During Pregnancy. — The pregnant woman should ask herself, 
before making even a trivial variation from habits of life, which have been 
proved by experience conducive to her individual health, "can this change 
produce any injurious effect upon the future, mental or physical, of my 
darling baby ?" and unless the answer is unequivocally in the negative, it 
is her duty to refrain from incurring unknown risks by alteration of diet, 
exercise, sleep, clothing, and so forth, which, previous experience has 
taught her, contribute most effectually to the preservation of her perfect 
sanitary condition. 

Food During Pregnancy. — The amount of food taken into the system 
during the early period of pregnancy, as intimated by nature in the broad 
hint of morning sickness, should be rather less and of a more easily 
digested quality than at ordinary times. But in the latter months, when 



PEEGTTAT5TCY. 693 

the infant is rapidly developing and material mnst be supplied for muscles 
and bones in abundance, the quantity of aliment should be largely in- 
creased. It is better, however, to eat more frequently than to run any 
risk of over-loading the stomach at such time. 

Exercise. — The amount of exercise should also be ample, since this is 
vitally important for the proper assimilation of food into the blood, whence 
it is transferred to the foetus in the womb, and contributes, of course, every 
atom of the material composing the little body. Care must be taken, how- 
ever, to avoid violent exercise of any kind for fear of bringing on abortion 
with all its dangers to the mother, and in the earlier months with certain 
destruction to the child. 

Child Blemishes. — As regards the production of blemishes and defor- 
mities in the infant by mental impressions of the mother during preg- 
nancy, there is a large amount of evidence that such an effect is produced, 
although many of the stories of such occurrences are grossly exaggerated 
or totally withou^ foundation. At the same time a calm and equable frame 
of mind is greatly to be desired during the whole period, and anything 
which is likely to operate in the direction of causing mental shock, de- 
pression or excitement should be scrupulously avoided. 

Vomiting. — 1. Among the diseases of pregnancy are excessive vomit- 
ing, which may be treated with tablespoonful doses of lime-water, iced 
carbonic acid water, or iced champagne, ginger, bismuth, hydrocyanic 
acid, and two-grain doses of oxalate of cerium; heartburn, from which 
half a teaspoonful of bicarbonate of soda or ten drops of aromatic spirits 
of ammonia affords relief. 

2. If the nausea is due to a prolapsed or backward displaced womb, 
the condition will be relieved by replacing the womb and inserting a 
lamb's wool tampon. A method which often suffices is to give the mother 
a cup of hot tea and a cracker about an hour before she arises. 

The following prescriptions are advocated: 

Tincture of mix vomica 2 drachms 

Hydrochloric acid % ounce 

Essence of pepsin 3 ounces 

Teaspoonful after each meal and at bed-time. 

Bismuth subnitrate 2 drachms 

Tincture of nux vomica 10 drops 

Make into ten powders. One powder every hour. 

Carbolic acid or creosote 10 drops 

Subnitrate of bismuth 2 drachms 

Make into ten powders. One every two hours. 



694 DISEASES PECULIAR TO WOMEN. 

Excessive Vomiting, Treatment of — The nausea and vomiting may be 
so pronounced as to be uncontrollable and is then called the hyperemesis 
of pregnancy. When this exists nothing will remain on the stomach, and 
the woman rapidly loses flesh and becomes very much exhausted. When 
blood appears in the vomited matter of these cases the termination, as a 
rule, is unfavorable. 

The treatment consists of emptying the womb, in other words, pro- 
ducing an abortion, and is one of the exceedingly few reasons for which a 
physician is justified in producing an abortion. 

Constipation, Treatment of the. — Constipation, which must be meddled 
with very cautiously by the aid of mild saline laxatives, such as a teaspoon- 
ful of rochelle salt, a dessertspoonful of castor oil, or injections of soap 
and water; and piles, the discomfort of which can be palliated only by 
the use of some such ointment as that already recommended, or daily 
doses of cascara. 

Toothache, Treatment of the. — If toothache comes on care must be 
taken that sound teeth are not extracted in the vain hope of relieving it. 
When teeth decay rapidly in pregnancy it seems sometimes to be due to 
the removal of the bony materials for the purpose of building up the skele- 
ton of the foetus, and efforts should be made by supplying the lime salts 
as phosphates or hypophosphites mixed with the food to remedy the diffi- 
culty. Finely powdered bones have been shrewdly recommended. 

Enlarged Veins, Treatment of the — Enlargement of the veins of the 
legs should be treated by bandages or elastic stockings, and dropsy of the 
feet and ankles should lead to an immediate examination of the urine, 
lest some tendency to albuminuria may be threatening. 

Bladder, Treatment of the. — Irritation about the bladder, perhaps with 
incontinence and retention, occasion much inconvenience, but can often be 
relieved by gentle laxatives and diuretics, such as the cream of tartar, or, 
if very troublesome, by a belladonna and opium suppository. The patient 
should, however, be guarded against the possibility of becoming fond of 
the action of anodynes, especially opium or chloral, at this trying time. 

LABOR. 

Definition. — Labor is the end of pregnancy, and may be defined as 
the process by which the foetus and the afterbirth are separated from the 
mother. Nature's design being the continuance of the race, the foetus 
must have reached such development before its expulsion that it is viable ; 



LABOR. 695 

that is, capable of living external to the mother. If, therefore, the product 
of conception be expelled before such capability, the process is not called 
labor, but abortion or miscarriage. 

Premature Labor. — Should labor occur in the seventh or eighth month 
it is called premature, because the foetus has not attained its perfect de- 
velopment ; if labor be delayed beyond nine months it is called postponed, 
if the foetus be alive, but missed if it be dead. 

Parturition, — Parturition is a term very often used instead of labor. 
When parturition occurs, with the efforts of the womb and the woman 
alone, it is called natural ; but if it is necessary to render aid, usually by 
the application of forceps, it is called an artificial or instrumental labor. 
In order that a labor may be natural the foetus must not exceed the normal 
size and the presentation must be normal, also the passageway and the 
muscular forces required to cause the expulsion of the passenger. 

Duration of Labor. — This varies with race, place, climate, manner of 
living, hereditary, physical conformation, whether first or subsequent 
labor, and with the sex, presentation and position of the child. Labor is 
shorter in warm than in cold climates, in savage than in civilized races, in 
women in the country accustomed to plain food, outdoor exercises and 
regular habits, than in those leading opposite lives in the city. In the 
primipara (a woman who is having her first baby) it is longer than in 
the multipara (a woman who has had more than one child) ; it is also 
longer when the face or buttocks come first instead of the head, and with 
male than female children. 

Labor with. First Child — As a rule the primipara is in labor fifteen to 
twenty hours; the multipara six to eight hours. If the primipara is 
thirty-five years old and more, labor may be prolonged for twenty-one to 
twenty-seven hours ; above forty-one years labor is very apt to be thirty- 
three hours. 

Duration of Second Stage — The second stage of labor is generally one- 
third that of the first stage. The majority of labors begin between 9 and 
12 P. M., and end between 9 P. M. and 9 A. M. 

Birth Presentation. — The presentation of the child varies. By far the 
p'eater majority of the children are born head first. The child may 
present by the head, buttocks (when it is called a breech), face and either 
shoulder. The vertex or head may demand forceps application at time*, 
especially if at the expiration of any hour during the second stage it fails 
to progress. Should the face present, the physician will endeavor to 
push it up and change it to a vertex, otherwise it will be necessary to apply 



696 DISEASES PECULIAR TO WOMEN. 

foiceps. Such a child will have a blackened face, which discoloration at 
the end of a week or ten days will disappear. 

Buttock Presentation. — If the buttocks present, more or less difficulty 
will occur, and it may be necessary to apply force to the after-coming Head. 

Shoulder Presentation — A shoulder presentation will require an 
entire change of the position of the child, as this is an impossible labor. 
As a rule both feet are brought down first, the head being born last. 

» Preparations for Labor. — The lying-in chamber should be large enough 
for suitable ventilation, and yet not so large as to be with difficulty 
heated. Every precaution to secure for the invalid a full supply of un- 
polluted air should be instituted, and conveniences for affording hot water 
at short notice are of importance. The bed should be a hair or spring 
mattress, which ought to be covered with some waterproof material; 
over this a thick, old spread, newspapers or comfortable, to absorb the 
blood and other discharges, should be laid, and this again covered with 
a sheet. The remaining bed-covering must be arranged according to the 
season of the year. In this room should be collected all the clothing which 
will be needed for the comfort of the mother and expected infant, and 
besides the articles of every-day use there should be provided a strong 
sheet, which can be tied around the post at the foot of the bed, for the 
patient to pull upon during her pains, a firm cushion for her to press her 
feet against if she so desires, an abundant supply of towels, plenty of soap 
and warm water, a pound or so. of lard free from salt, a few yards of 
flannel, a soft, warm shawl or small blanket to receive the baby in before 
it is washed, sharp-edged but blunt-pointed scissors to cut the cord or 
navel string, eight yards of coarse sewing cotton doubled eight times and 
knotted at the two ends for tying the cord, a binder of strong new muslin 
about a yard and a half in length and half a yard wide, or larger if 
needful, and a paper of large, strong safety pins for fastening the same 
around the invalid's abdomen after she is delivered. 

The Mother's Dress — The dress of the patient should be the usual 
chemise and night-dress rolled up around her waist, so as to keep them 
from being soiled, and a sheet folded in four and pinned around her 
limbs as a skirt, fastening it at the right side so that it can easily be un- 
pinned and slipped down out of the way when the labor is completed. 

Stages of Labor. — Labor, parturition or confinement, is divided into 
three stages. The first consists in the dilation of the mouth of the womb, 
sufficiently large to permit the foetus to escape. The second constitutes 



LABOR. 697 

the birth of the child. The third is the expulsion of the placenta or after- 
birth. 

First Stage of Labor. — During the first stage of labor the patient may 
walk around the room, sit up in a chair or lie upon a lounge, as is most 
agreeable to her, but when the mouth of the uterus is dilated to the size of 
a silver half-dollar she should take her position upon her left side, with 
her hips near the edge of the bed, and about a foot lower down than she is 
accustomed to lying. In this posture the medical attendant can best aid 
her in her trial until toward the end of the process, when some advantage 
is often gained by placing the patient upon her back. 

Preparing the Nipples — Preparation of the nipples should be made 
by washing them with strong green tea, or solution of a drachm of tannin 
in two ounces of cologne water, twice daily for three weeks before con- 
finement, in order to harden the skin and render it less liable to crack and 
become sore whilst nursing. 

Period of Actual Labor. — The period of actual labor is generally 
ushered in with slight griping pains in the abdomen, and more or less 
aching in the back, which come on at first, perhaps, at intervals of half 
an hour, lasting for a minute at a time ; then at intervals of ten or fifteen 
minutes, and so on until they grow severe and the space of respite between 
them dwindles to five, four or even three minutes. 

Pains and Length of First Stage. — In the first stage of labor the pains 
have a cutting or tearing character, and are commonly felt in the stomach, 
or lower part of the abdomen, and also in the back. They are accompanied 
by a frequent desire to pass water, produced by the pressure of the child's 
head upon the urinary bladder as it descends, and often by a disposition 
to evacuate the bowels, from a similar cause. Pressure of the head like- 
wise frequently produces severe cramps in the legs, which may be partly 
relieved by friction, but often disappears as the labor progresses. The 
duration of this stage varies greatly, but in a labor of twelve hours' dura- 
tion, the usual proportion would probably be ten hours in the first stage, 
an hour and three-quarters in the second stage, and fifteen minutes in 
the third. 

Pains of Second Labor. — In the second stage of labor the character of 
the pains and the expulsive efforts which accompany them is changed. 
They now become what are commonly called bearing-down pains, in which 
the patient almost instinctively endeavors to aid the contractions of the 
uterus in its efforts to empty itself, by straining as if at stool; and, indeed, 
should she seem reluctant to yield to this disposition, she ought to be in- 



698 DISEASES PECULIAR TO WOMEN. 

structed to bear down exactly as if her bowels were being moved whilst 
constipated. The cries emitted are generally more like prolonged grunts, 
and can be readily recognized at a considerable distance by one who is 
familiar with their peculiarities. After a continuance of these pains for 
one, two or more hours the child's head, if that comes first, as happens in 
probably nineteen out of every twenty cases, begins to press upon the 
external parts or vulva, and finally, with an unusually forcible pain, often 
with a piercing cry from the mother, her baby's head emerges into the 
world. As a rule, the next pain expels the shoulders and hips, the rest 
of the body offering little resistance to the expulsive efforts of the womb 
after the head is born. 

Third Stage of Labor — The third stage, consisting in the delivery of 
the placenta, is usually attended with one or two slight pains, by which 
the afterbirth is forced out of the womb into the vagina, whence it must 
usually be removed by the medical attendant. 

Although in the majority of cases any intelligent person could suc- 
cessfully manage a case of labor, there are numerous accidents, malposi- 
tions and complications, which may occur without any warning in any 
particular case, so that if skilled medical assistance can possibly be pro- 
cured it should by all means be sent for. The man or woman who neg- 
lects this runs a terrible risk of being the murderer of the mother or of 
the child, perhaps of both. 

Duty of Midwife — But if no qualified physician is procurable, the 
acting midwife should from time to time, say every ten minutes dur- 
ing the second stage of labor, anoint the vulva or external parts of gen- 
eration of the patient freely with lard, at the same time examining very 
gently, with the finger, what progress is being made in the descent of the 
head, supposing, as is usually the case, that forms the presenting part, as 
this too frequently causes puerperal sepsis, which see. 

The Delivery. — The moment the head is born the finger should be 
repassed in around the infant's neck, so as to find out whether the navel- 
string is wound around it, as not unfrequently happens. If such is the 
case, the cord should be pulled down a little, and the mother urged to 
bear down for the child's sake, as rapidly as possible, and complete the 
birth; when the cord must be immediately loosened and slipped over 
the baby's head to save it from strangulation. At the same moment the 
head of the child comes into the world the midwife's other hand should 
be placed upon the lower portion of the mother's abdomen, and the uterus 
pressed upon gently. 



LABOE. 699 

Treating the Womb. — As the body of the child is horn the uterus 
should contract to the size of a ball, apparently about five inches in 
diameter, and if this does not take place, the womb should be firmly 
grasped through the walls of the abdomen, in the hand, and so stimulated 
to due contraction. This is very important, because, if it does not occur 
promptly the patient may bleed to death in a very few minutes. 

Attending the Child — As soon as the womb is found to be properly 
contracted into this hard ball, attention should be turned to the child. 
If it cries at once, the cord may be immediately tied an inch and a half 
from its attachment to the infant, with the sewing-cotton already pro- 
vided, and then cut half an inch above this again, that is, half an inch 
further away from the child, squarely off. The baby is then to be lifted 
up, with both hands clasped around its body, for it is very slippery, and 
received by an attendant in the flannel or old blanket, which has also been 
prepared. The attendant ought either to hold it until the labor is com- 
pleted, or to place it on its left side, in some safe situation, preferably in 
its cradle or crib, not in an armchair, where it may be crushed to death 
by being sat upon. 

Expelling the Afterbirth. — During this time the midwife should 
keep her hand upon the patient's abdomen, gently pressing and knead- 
ing the womb occasionally, in order to promote the recurrence of a con- 
traction, strong enough to expel the placenta. As long as the afterbirth 
remains the woman is not safe from dangerous or fatal flooding ; but 
whilst the uterus continues firmly contracted, and feels like a hard ball 
under the fingers of the midwife, there is but little danger. After five 
or ten minutes, if slight pains come on, the mother should bear down a 
little, and the cord be gently pulled upon, when, in many instances, the 
placenta comes away. As it reaches the vulva, the patient should be 
told to cease her efforts, and the midwife should twist the afterbirth round 
and round on itself, eighteen or twenty times, gradually withdrawing it 
at the same moment. This is to wind the membranes, or bag which held 
the water into a string, if possible, inside the vagina, and perhaps the 
uterus, so that they may all come away with the placenta in safety. The 
mass, when removed, should be laid away for subsequent careful examina- 
tion, in order to determine whether any part has been left in the mother, 
as the effects of such an accident are much to be dreaded. 

Contracting the Womb. — The attention of the midwife should, how- 
ever, immediately return to the mother, and her hand at once applied 
again over the abdomen, when the womb ought to be felt as a ball of some 



TOO DISEASES PECULIAR TO WOMEN. 

three and a half inches in diameter, or about the size of the new-born 
baby's head, and even harder than before. If not so felt, firm pressure 
and friction over the abdomen must be made to induce it to contract. 
Should it not do so within a minute or two the midwife must introduce 
her hand up the vagina into the cavity of the womb, under strictly anti- 
septic precautions, and pulling out the clots of blood she will probably 
find there, strive again to excite the womb to its proper contraction. 

To Prevent Flooding. — Should these efforts prove unavailing, not a 
moment is to be lost, for the next five minutes will perhaps cost the 
patient her life by flooding. Let, therefore, a piece of ice, a sponge 
dipped in vinegar, or a peeled and gashed lemon, be carried up with one 
hand and rubbed around inside of the womb, whilst the other hand of the 
midwife, by firm pressure and friction over the patient's abdomen, con- 
tributes to stimulate that uterine contraction in which lies the mother's 
only safety. Or a teaspoonful of ergot, repeated in fifteen to twenty 
minutes. As soon as this is accomplished, as it probably will be by these 
remedies, a tight bandage should be pinned around the patient's body, 
with two or three folded napkins beneath it, pressing upon the part of the 
abdomen over the womb, to prevent relaxation, which happily- seldom oc- 
curs when thus treated. 

Making the Mother Comfortable — After being securely bandaged, the 
patient may be lifted up a little, out of the wettest part of the bed, if it 
can be done without any effort on her part; but for fear of flooding, the 
more quiet the parturient is kept for the first two hours after labor, or 
until the blood has had time to clot firmly in the large, open-mouthed veins 
of the uterine cavity, the less is her danger. When the patient is made as 
comfortable as possible, a clean napkin, loosely folded, is to be placed be- 
tween the thighs, but not pressed up tightly against the vulva, lest it act as 
a plug and prevent the detection of flooding, should that come on. 

Should the Child Not Cry. — In case the child does not cry when first 
born, its mouth should be carefully cleared of mucus and other obstruc- 
tion, and a little cold water sprinkled upon its breast. Should this fail in 
rousing a gasping effort at breathing, the baby, still attached to the cord, 
if that is pulsating, should be put into a basin of very warm water, and 
after a minute or two, when the surface of its body is well heated, the 
dash of cold water over its face and breast again tried. If still unsuccess- 
ful, the baby should be wrapped up in hot flannels, and artificial respira- 
tion, by blowing into the mouth whilst the nostrils are held, and then 
forcing the air out by compressing the chest, attempted as a forlorn hope. 



LABOR. 701 

The writer has found the results of dry heat, applied by cautious roast- 
ing before a fire, promising enough to warrant further employment in 
otherwise hopeless cases. 

Baby's First Bath. — If, on the contrary, the child cries lustily, and 
the mother is doing as well as can be expected, the cord should be again 
examined to verify the fact of its being securely ligated, and the baby 
given its first bath. The infant should be rubbed all over with lard, to 
soften the vernix caseosa or cheesy matter with which it is more or less 
covered, then well washed with white castile soap and milk-warm water 
and thoroughly dried. 

Dressing the Navel — The cord is dressed by being drawn through a 
hole cut in the middle of a piece of soft old linen, folded once; and 
trimmed to four inches square, and after being wrapped in this is laid 
upward on the baby's stomach, and bound in place by a belly-band of 
silver flannel, fitted snugly but not too tight, and secured by safety pins 
or a few stitches, or the cord can be dressed in absorbent cotton and freely 
covered with boric acid. 

Of the Wrong Presentations. — The management of labor when the 
back of the head does not come down first, and especially when the but- 
tocks, feet, or arms present, is so apt to be difficult and dangerous that a 
physician ought always to be summoned, even from a great distance and at 
the utmost inconvenience, should any signs of a "cross-birth," as it is popu- 
larly called, be detected, or should unusual delay in delivery render ob- 
struction probable. It will sometimes be a comfort to a woman in labor 
who is anxiously awaiting the physician's arrival to be reminded that if 
the birth comes before the doctor it will be because everything is all right, 
whilst, on the contrary, if there be anything wrong, the physician will 
usually have ample time to reach her before his services are actually 
needed. 

After-Management of labor. — The management after labor should be 
such as will best avoid any excitement, either mental or physical, liable 
to light up inflammatory action in the womb, which has just been the sub- 
ject to such momentous change. The patient, in ordinary cases, ought to 
remain in bed until the twelfth or the fourteenth day, partaking of semi- 
solid food until the third day, when the bowels should be moved. For 
this purpose she may be given a bottle of the citrate of magnesia in two 
doses, one-half hour apart, salts or an enema. After the bowels have been 
thoroughly moved, solid food should be given. She should not receive 
company for at least three days, but devote all her energies to the task 



702 DISEASES PECULIAR TO WOMEN. 

of recovering as speedily as possible, both on her own account and for the 
sake of the frail, new life so utterly dependent upon her care. 

PUERPERAL CONDITIONS. 

Character — The puerperium, or the puerperal stage, is the two weeks 
following the birth of the child. It begins immediately upon the expul- 
sion of the placenta. 

Among the conditions of the puerperal state may be mentioned after- 
pains, which, though seldom troublesome subsequent to first deliveries, 
may in others cause more suffering than the labor itself. 

After-Pains. — They can, however, be greatly relieved by the use of 
ergot just as delivery is accomplished, and of one-half grain opium sup- 
positories, or forty-drop laudanum injections, or a Dover's powder, in 
two or three hours if they persist. 

Sore Nipples. — Soreness of the nipples and cracked nipples are very 
apt to come on in patients with tender skins from the constant irritation 
of the baby's gums in nursing, and are unfortunately very difficult to 
heal, because the same irritation which originated the trouble in the 
first place is continually kept up. 

Treatment of Nipples — Vaseline, zinc ointment, laudanum and ni- 
trate of silver sometimes succeed in curing the sore, but the most success- 
ful plan is to use a wooden shield with a rubber nipple if the baby can be 
persuaded to consent to the innovation. Women who suffer in succeed- 
ing pregnancies from this condition may do much to prevent its recur- 
rence. About three months prior to the expected date of confinement, rub 
the nipples night and morning with cocoa butter and expose them several 
hours daily in the sunlight. Before and after nursing the nipples of the 
mother and the mouth of the baby should be washed with a solution of 
a teaspoonful of boric or boracic acid in a tumblerful of water. The 
nipples should be thoroughly dried. 

Danger of Cracked Nipples — The great danger of cracked nipples 
is. that it may lead to abscess of the mammary glands (the so-called 
gathered breasts). 

CHILD-BED FEVER OR PUERPERAL FEVER. 

Character. — Puerperal fever is a very dangerous disease, which is 
invariably due to a lack of antiseptics. All cloth or napkins that come 
in contact with the vulva of the woman which have not been boiled, the 






CHILD-BED FEVER. 



703 



hands of those attending to her unless thoroughly washed, all instruments 
used unless rendered aseptic will carry dirt of some kind, giving rise to 
this condition, which, practically speaking, is blood poisoning. 

It generally comes on or about the third to the fourth day after 
delivery with a violent chill, great thirst and extreme prostration. 

Symptoms — The uterine discharge, or lochia, which should persist 
for ten days to two weeks, becomes very foul, the odor of which is 
nauseating, or it quickly dries up. 

The fever may run very high, and diarrhoea with obstinate vomiting 
may set in. The mind soon grows clouded, if the attack be a severe one, 
muttering delirium makes its appearance, and the patient often dies on 
the third to the seventh day of the attack in a condition similar to that 
observed in typhus fever. 

Treatment. — A large majority of the cases prove fatal, but full doses 
of twenty to thirty grains of quinine, with one-thirtieth grain of strych- 
nine sulphate every two to three hours, succeeds in saving a small propor- 
tion of the cases. If an abscess forms, be it in the pelvis or elsewhere, 
it should be incised and drained. Cold sponge baths every two or three 
hours will reduce the fever, and an ice bag to the head will oftentimes 
prevent brain complications. Injections of bichloride of mercury should 
be used once or twice a day. 

Puerperal Mania. — This is a form of insanity liable to come on a 
week or ten days after confinement, in which there is frequently a singu- 
lar aversion to the child, and perhaps to the husband also. A tendency 
to suicide is also prominent, and patients thus affected should be watched 
with the most unremitting care. Under perfect rest, nourishing diet, 
moderate stimulation and sedatives persons generally recover. 

Puerperal Convulsions. — These may come on before or during labor, 
as well as in the month following delivery. They are generally due to 
accumulation of urea in the blood, the consequence of temporary Bright's 
disease, resulting probably from the pressure of the uterus containing 
the foetus upon the kidneys. The treatment has already been pointed out 
under the head of uremia. 

Milk-Leg. — This is an inflammation of the lymphatics of the limb, 
coming on especially toward the end of the second week after labor and 
deriving its name from the milk-white appearance usually presented by 
the skin of the affected part. As the febrile state of the system is apt to 
cause drying up of the milk, it was formerly supposed that in some 
mysterious way the lacteal fluid was transferred to the leg. At first i: 



70-4: DISEASES PECULIAR TO WOMEN. 

may be quite painful, but after the integument becomes accustomed to 
distension, the sensations are rather those of weight and discomfort than 
of positive suffering. The treatment is by laudanum or turpentine fo- 
mentation at first, and later with stimulating and anodyne liniments ? 
which hasten a little the naturally tardy convalescence. The ordinary 
duration of the affection is from a month to six weeks. 

MANAGEMENT OF THE INFANT. 

Suckling the Baby. — After a baby has received its first bath, and 
been for the first time introduced to the mysteries and miseries of clothes, 
it should be put to the breast for the purpose of extracting whatever 
nourishment nature has there provided for it, and also as the commence- 
ment of its education in the art of nursing, a business upon which its 
life for some months will depend. Curiously enough whilst some chil- 
dren take hold of the breast as if by instinct, others must be taught to 
nurse, and show for this vital operation all the perverse unwillingness 
of Shakespeare's schoolboy, notwithstanding it is the one thing in the 
world they have to do. 

Mother's Milk the Best. — Every mother ought, if possible, to suckle 
her own infant, not only for her own sake but for that of the child. 
Statistics show that babies nursed by their mothers, amid the unfavor- 
able surroundings of prison life, thrive better than those who are brought 
up by hand in healthy country districts outside, and no woman in good 
health, who can furnish the nourishment, should be spared the reproach 
of risking the life and health of her offspring if she refuses to perform 
her maternal duties in this regard. A mother undertaking the suck- 
ling of her infant should, moreover, do so with a mind fully alive to 
its importance, and with a firm determination that no pleasures of society 
or of fashion shall interfere with its conscientious performance, or else 
she had better not attempt it at all. 

Amount of Breast Milk. — The amount of milk contained in the breast, 
especially with the first child, is very small for two or three days, but in 
some forty-eight hours the rush of milk, as it is called by nurses, com- 
mences, and is often attended with some fever, and marked pain and 
soreness in the breasts. The remedy for this disturbance in the mother's 
system is, however, very simple and conveniently at hand, and as the 
child, which, if healthy and vigorous, generally has a good appetite, draws 
out the milk which nature has provided for its special benefit, all these 



MANAGEMENT OF THE INFANT. 705 

uneasy sensations soon subside. If the coming in of the milk is unusually 
delayed, it may be necessary to give the baby a little cow's milk, well 
diluted and sweetened with sugar of milk; but this is seldom required. 

Mothers to Avoid Excitement. — During the time a mother is nursing 
her infant every care should be used to avoid any violent mental excite- 
ment or shock, which is exceedingly apt to influence the secretion of the 
mammary glands to a certain extent, just as it does that of the lachrymal 
gland, and render the lacteal fluid temporarily unwholesome or poison- 
ous to the infant; or it may completely suppress the secretion of milk, 
with very serious consequences to both the parent and her offspring. 

The Wet Nurse. — If, for any reason, the mother is unwilling or un- 
able to suckle her infant, the next best chance for the baby's life is- to 
procure a good wet nurse. When such an alternative is adopted, great 
care should be exercised in selecting the foster-mother, and the physician's 
advice ought always to be obtained upon this important subject. 

Bringing Up by Hand. — Should the mother fail to nurse her child, 
and no good wet nurse is procurable, the child must be brought up by 
hand, a species of manipulation which contributes, it is probable, more 
than anything else to swell the lists of infant mortality in most large 
cities, as well as to some extent in country districts. Although goat's 
milk is used occasionally in this country as an infant's food, practically 
the choice is narrowed down in most cases to cow's milk, and the great 
object should be to secure this from healthy animals, pure and free from 
all admixture, as pointed out in an earlier chapter upon milk as an 
article of diet, and in a perfectly fresh condition. 

. Testing the Milk. — All milk used for the feeding of young infants, 
especially in the summer, should be carefully tested, and particularly in 
regard to its acidity, with litmus paper. If found to be acid it ought 
to be at once rejected, and a sample of pure, sweet milk obtained. 

Putting Baby to the Breast. — A new-born infant is not hungry, con- 
sequently it need not be put to the breast for three or four hours or 
more. This will also give the mother a chance to obtain a little needed 
rest. For the first twenty-four to thirty-six hours the baby should be 
put to the breast every four to six hours. ~ The subsequent twenty-four 
hours about every three to four hours. About the third day or so, when 
the milk is well established, the baby should be nursed every two to three 
hours. 

Time for Nursing — Under no consideration nurse the baby between 

11 P. M. and 5 to 6 A. M. If mothers would only institute this from 
45 J 



706 DISEASES PECULIAR TO WOMEN. 

the time of birth, both she and the baby will obtain a good night's 
sleep. Should the baby awaken, change its position, and give it a little 
water to drink, and invariably it will go off to sleep. Another bad 
practice is to give the baby the breast every time it cries, in order to 
quiet it. It should be conquered from the beginning, so do so. 

Weaning the Child — The time for weaning, generally about the age 
of nine months, should be determined partly by the growth of the teeth, 
presuming, of course, that the mother's health is not suffering in the 
meanwhile. When the first lower middle incisor teeth appear, which 
usually happens about the sixth or seventh month, the mother may begin 
to diminish the number of times for suckling more rapidly, at the same 
time replacing the breast milk, of which the infant is deprived, by cow's 
milk thickened with oatmeal, barley or wheet flour, and so forth. After 
the child has four teeth it should be weaned, although if the infant is 
feeble or the season unfavorable, the period of nursing may be extended 
a few months longer. 

Dilution of Milk. — If the new-born baby is not nursed and fresh 
cow's milk is employed, it should at first be diluted with half its bulk of 
pure, tepid water, sweetened with a teaspoonf ul of sugar of' milk to one- 
quarter of a pint of milk, and a few grains of salt. Condensed milk will 
not require sweetening, but should be freely diluted so as to resemble 
human milk in color. For the first month of a child's life it may be mixed 
in the proportion of one part of the condensed milk to ten or twelve of 
warm water. 

Cleanliness of Nursing Bottle. — The most rigorous cleanliness of the 
nursing bottle and nipples must be insisted on, and under no consideration 
should the long rubber flexible tube apparatus be employed. It is an 
exceedingly dirty arrangement, as it cannot be properly cleaned. Simply 
use a very plain bottle, keeping the nipples in a soda solution. 

Foods Other than Milk. — When a child does not seem to thrive well 
upon pure or diluted cow's milk, it has often been advised to resort 
speedily to mixtures of milk with meat broths, raw eggs, and so forth. 
Bretonneau reported, as early as 1818, that when children under his 
care who were suffering with tabes mesenterica, were fed with milk and 
meat broth, they rapidly improved, and other authorities recommend this 
mixture as the next best thing to woman's milk, or the malted milk can 
be tried. 



EXTRA UTERINE PREGNANCY. 70' 



EXTRA UTERINE PREGNANCY. 



This constitutes a pregnancy occurring in the oviduct and not in the 
cavity of the womb. 

Symptoms. — 1. The woman will have all the symptoms of pregnancy. 
A pregnancy of this kind invariably follows a long period of sterility. The 
woman who has previously menstruated regularly will miss a period and 
consult a physician. If he examines her to ascertain the cause of the stop- 
page of the flow, and this variety of pregnancy is present, he will find the 
uterus very slightly enlarged and a mass to one side of it. 

2. About four to eight weeks, as the foetus continues to grow, the dis- 
tended tube may rupture, or the contents may be expelled through the end 
of the tube (tubal abortion). 

3. If the tubal abortion or rupture occurs, the woman will first notice 
a sudden, sharp, severe pain in the abdomen. This will be followed by 
fainting spells which may or may not end in death, due to the loss of 
blood. 

Treatment. — If the condition is recognized prior to rupture, the wo- 
man should submit to an operation at once, before rupture takes place, 
which accident invariably terminates in death. 

If the woman is not seen by a physician until rupture does occur she 
should be operated on at once, in order that the bleeding vessels may be 
tied. In a few rare cases nature checks the bleeding, which will be fol- 
lowed by a second rupture, usually with fatal results. 



PART XI OF BOOK IV 

Treats of the diseases of the skin, hair and nails, 



Barber's Itch 724 

Causes 724 

Precautions in m . 725 

Treatment of 725 

Brown Patches in Scald Head 727 

Boils ..0 715 

Bunions 719 

Carbuncles 716 

Corns 719 

Diseases of the Skin 711 

Eczema 713 

Treatment of 713 

Erythema 711 

Flesh-worms 720 

Freckles 720 

Herpes 714 

Impetigo 715 

Itch 727 

Disinfection for 729 

Symptoms of 727 

Treatment for 728 

Itching 720 

Lice 729 

Treatment for 729 

Lichen 717 

Moist Tetter 713 

Nettle Rash 713 

Pemphigus 714 

Pimples 716 

Prurigo Symptoms 717 



Pityriasis 718 

Precautions in Barber's Itch 725 

Prickly Heat 717 

Pruritus 720 

Psoriasis 717 

Pustular Eruption 715 

Redness of the Skin 711 

Ring-worm of the Body 724 

Ring-worm of the Head 723 

Scabies 727 

Scald Head 726 

Brown Patches in 727 

Scalp Disease .718 

Treatment of 718 

Seborrhea 720 

Shingles 714 

Skin Diseases 711 

Classes of 711 

Due to Vegetable Parasites 722 

Skin Glands, Diseases of 720 

Flesh-worms 720 

Seborrhea 720 

Skin Redness 711 

Strophulus 716 

Tetter 717 

Treatment of 718 

Urticaria 713 

Warts ■. 719 



ILLUSTRATIONS 



Burrow of Itch Insect 729 

Eczema, Scaly Form 714 

Eczema, Simple Eruption 714 

Itch Insect 728 



Ring-worm on the Hair, Effect of . . . .^23 

Sebaceous Gland, Magnified 721 

Scald Head 726 

The Skin 712 



709 



CURATIVE MEDICINE 



PART XI. 
SKIN DISEASES 



This class of affections embraces diseases of the skin, hair and nails, 
and therefore includes maladies which occasion much distress and deform- 
ity, but are seldom dangerous to life. 

Classes of Skin Diseases. — Skin diseases are easily recognized, but 
there is sometimes difficulty in distinguishing between the different forms. 
They divide themselves thus : 

1. Those of an eruptive (erythematous) character. 

2. The catarrhal, in which the conditions resemble those belonging 
to inflammation of the mucous membrane. 

3. The vesicular, which is composed of small blisters. 

4. The pustular, made up of pustules or small boils, containing pus 
or matter. 

5. The papular, in which pimples appear, containing neither water 
nor pus. 

6. The scaly eruptions in which the affected parts are covered with 
dry, whitish layers of epithelial cells. 

7. Skin diseases caused by animal or vegetable parasites, of which the 
itch is a remarkable illustration. 

SKIN REDNESS (Erythema). 

Symptoms. — Erythema is the name applied to the redness due to a 
superficial inflammation of the skin. It is the mildest form of skin dis- 
ease, and is apt to affect fat people in hot weather. Infants are liable to 
be affected with it behind the joints. 

Treatment.— See Nettle Eash. 

(711) 




a. Epidermis or cuticle. 

b. Dermis or true skin. 

c. Nerve prolongations. 



THE SKIN 



712 



d. Blood-vessels. 

e. Oil cells. 
/. Glands. 



ECZEMA. 713 



NETTLE RASH (Urticaria). 

Symptoms — This is an eruptive affection which sometimes comes out 
quite suddenly, and is attended with a most troublesome itching. It is 
characterized by the formation of '"wheals" or rounded patched of elevated 
skin, whiter than the surrounding parts, which are slightly reddened at the 
margins. 

Causes.— It may arise from the bites or stings of insects; from the 
eating of certain fish, especially shellfish; or from reflex irritation, and 
other causes. 

Treatment. — It is greatly aggravated by scratching, and, like simple 
erythema, is relieved by dusting with finely-powdered oxide of zinc and 
starch, with lycopodium, or even with rye flour. Lotions of lead water, 
benzoic acid and borax are also sometimes useful. Locally carbolic acid, 
two drachms; glycerine, two drachms; water, one pint. Small doses of 
calomel, followed by a saline. 

MOIST TETTER OR ECZEMA. 

Symptoms. — Eczema, sometimes called moist tetter, is a catarrhal in- 
flammation of the skin usually attended with a breach of surface. It pre- 
sents at first irritable, raw, red patches, with occasional little blisters which 
soon break and a fluid is discharged, which in drying forms crusts or scabs. 
Later on the patches become dry, scaly, and often cracked. This is a 
form of skin disease which is often seen in young infants, in whom it 
sometimes receives the name of milk-crust. The pain, burning and itch- 
ing of eczema are intense, and yet it is only aggravated by scratching. 
It is especially apt to appear about the flexures of the joints, as, for ex- 
ample, in the hollows of the elbows and knees. 

Treatment. — Many formulas have been recommended and used for 
this prevalent condition. Stimulation of the skin is of great importance, 
and various drugs have been used for that purpose, such as resorcin, tar, 
camphor, etc. The following have been recommended by various spe- 
cialists on the disease : 



R. — Camphor I drachm 

Oleate zinc 2 drachms 

Powd. starch I ounce 

Use freely as a dusting powder. 



714 SKIN DISEASES. 

R. — Acid boric 2 drachms 

Acid carbolic V2 drachm 

Giycerine V2 drachm 

Water ." 1 pint 

Apply twice a day. 

Resorcin Vz drachm 

Bismuth snbnitrate 2 drachms 

Glycerine 2 drachms 

Lime water 4 ounces 

Apply two or three times daily. 

Some cases do better with an ointment, when the following may be 

applied : 

R. — Ichthyol 1 drachm 

Pulv. Camphor % drachm 

Zinc ointment 1 ounce 

SHINGLES OK HERPES. 

Symptoms. — Herpes, which is a good type of the vesicular affection of 
the skin, is characterized by little blisters which come out in small groups, 
and when appearing about the mouth and nose constitute the cold-sores 
with which almost everyone is familiar. 

Shingles Proper. — A severe form called herpes zoster, or the "shin- 
gles, " comes on with smarting and burning pain in a belt half way around 
the body of large patches of the eruption. It is distressing and tedious, 
often lasting a month or six weeks, but rarely dangerous. The popular 
idea that it will prove fatal if it goes all around the body is without 
foundation. 

Treatment. — The only treatment is to apply anodynes and soothing 
lotions, such as the morphia and lead water recommended in erysipelas, 
and administer opiates to relieve the pain, or pil acetanilide comp. 

PEMPHIGUS. 

Character. — Pemphigus is another vesicular eruption, characterized 
by the formation of large blisters, from half an inch to two inches in 
diameter, resting on slightly reddened surfaces, and mostly attended with 
severe itching. These blisters sometimes appear on the fingers, but com- 
monly attack the lower limbs. They should be punctured at once and boric 
acid applied. They generally indicate a more or less impoverished state 
of the system, in which iron, quinine, strychnine and good nutritious food 
are called for. 




.2 

N 



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^3P 



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i 




E. J. S. 



SCALD HEAD (Favus). 



BOILS. 715 

Remedy. — Arsenic is also very useful, and locally soothing ointments 
or absorbent powders may be employed. 

IMPETIGO (Pustular Eruption). 

Character. — Impetigo is the most common of the pustular eruptions, 
and is characterized by the formation of separate pustules, somewhat like 
those of small-pox. They may attack any part of the body, but are most apt 
to appear upon the face and limbs. This disease, like eczema, which 
in many respects it resembles, seems as if it were an aggravated form of 
impetigo, and is especially frequent among children, although adults are 
not exempt. Impetigo is always associated with general debility, defective 
nutrition, or hygienic neglect. 

Remedies. — The treatment is by good food, tonics, with cod-liver oil, 
and strict attention to cleanliness. Soothing applications, such as Gou- 
lard's cerate, should be made first to the pustules, but later on a very mild 
mercurial ointment is more effectual. Mild antiseptics or boric acid can 
also be used. 

BOILS. 

Causes. — Boils, those common and exceedingly troublesome inflictions 
upon mankind, are classed under the head of pustules. With all the ad- 
vances we have made in late years in pathology, the cause of boils still 
remains undiscovered. Sometimes they seem to be due to high living, and 
in other cases poor diet appears to determine the advent of a troublesome 
series of these parts. One boil is very apt to precede a crop of fifteen or 
twenty, although there is no certainty that this will be the result. 

Treatment. — 1. The best way of managing a boil is to poultice it with 
flaxseed or bread and milk, containing laudanum to ease the pain. If the 
boil is small, the poultice may be spread upon a piece of oiled silk, which 
prevents it from becoming dry, and held in place by a bandage, or by a 
square piece of linen upon each corner of which has been daubed a little 
spot of adhesive plaster, the stick of plaster being melted in the flame of 
a candle for the purpose. This holds a dressing of any kind on a broad, 
flat surface of the body, as, for instance, the skin of the back, very satis- 
factorily. 

2. When the boil softens in the centre, and the fluctuation of matter 
can be detected, or its yellowish color can be seen under the skin, some 
twenty-four hours of suffering may be saved by having it lanced, and the 
pain of the cut may be abolished by freezing the surface with ether spray, 



716 SKIN DISEASES. 

or by stroking it with a little bag containing a mixture of ice and salt. In 
certain cases it is important to lance a boil early, so as to prevent the bur- 
rowing of the pus toward some important structure ; but ordinarily, if the 
sufferer dreads the knife, there is no actual necessity for using it, and the 
boil may safely be left to break of its own accord, under the poultice,, one, 
two or three days later than the time when it is ripe for lancing. 

3. Lancing the little pimple, with which a boil first commences, 
exactly through the middle, which can be done almost painlessly under 
the ether spray, will nearly always cut short this troublesome affection. 
Ten or twelve grains of quinine daily, so as to produce slight cinchonism 
for a week, occasionally breaks up a course of boils, but is by no means an 
infallible remedy. 

CARBTJNCLES. 

Character. — Carbuncles chiefly differ from boils in the larger area in- 
volved in the inflammation, from which a core of dead connective tissue, 
called a "slough," several inches in diameter, may come away. Car- 
buncles are apt to come on the nape of the neck, and on the back, but may 
appear on any part of the body. A large carbuncle will sometimes keep 
a patient in bed for a month or six weeks, and the pain and exhausting 
discharge wears out the strength so much that it may cause death; if a 
second of large size appears, after the first begins to heal, as it is not very 
unusual, it quite frequently proves fatal. 

Treatment — Poultices of flaxseed meal, bread and milk, powdered 
slippery elm bark, or of yeast ; anodynes to relieve pain ; and twelve grains 
of quinine daily, with tincture of iron to support the strength, constitute 
the appropriate treatment. Early and free incisions into the inflamed 
tissue, made after freezing the part, are of great service. After opening 
apply equal parts of carbolic acid and glycerine. 

PIMPLES. 

The papules or pimples are solid elevations of the skin, containing 
neither water like the vesicles, nor pus like the pustules. They are three 
in number, including strophulus, the red gum or tooth-rash peculiar to 
infants, lichen or prickly heat and prurigo. 

Strophulus. — This consists of an eruption of innumerable small, red- 
dish pimples, which occur for the most part on the face, neck and arms of 
young children. The irritation and general disturbance is slight. The 
eruption is usually caused by digestive derangement of some kind, as, for 



PSORIASIS. 7 17 

instance, that of cutting a tooth, and passes away with the cessation of its 
cause. 

Treatment. — The only treatment necessary is some mild, saline laxa- 
tive, and a lotion of very weak solution of carbonate of soda, five or ten 
grains to the ounce, with a teaspoonful of glycerine, to allay the itching if 
that appears to be very troublesome. 

Prickly Heat or Lichen. — This is very common in hot weather, in the 
simple form of reddish pimples, which itch a great deal but usually sub- 
side on the approach of the cooler season. It sometimes takes on a severe 
form, and may even become chronic. 

Treatment. — In mild cases tepid baths, plain and easily digested food, 
an occasional saline laxative, with a tablespoonful of infusion of gentian, 
and five grains of bicarbonate of potash or soda internally, three times 
daily, will effect a cure. To relieve the itching, solutions of borax, vine- 
gar or carbolic acid may be used with advantage. In aggravated cases 
the more powerful tonics, with tablespoonful doses of cod-liver oil and one- 
sixteenth of a grain of arsenic three times a day must be resorted to. 

Prurigo Symptoms. — This is characterized by an eruption of pale, 
slightly elevated pimples, most situated on the trunk of the body, and 
attended with very intense irritation, especially at night, so that the marks 
made by the patient's nails in scratching can almost always be seen, and 
aid in recognizing the malady. It is frequently the result of the presence 
of the vermin with which so many dirty people are infested. 

Bemedies. — Cleanliness, by the aid of strong alkaline baths, and the 
use of an ointment of carbolic acid, or if white precipitate, with the 
administration of tonics and good food will generally effect a cure. Some- 
times, however, the disease, unless it is carefully treated early, proves very 
obstinate, being kept up in great measure by the constant scratching, 
which it is very difficult for the patient to abstain from. 

PSORIASIS (Tetter). 

Character. — Psoriasis is the most important scaly eruption ; in certain 
of its varieties it probably constituted one form of the leprosy of the 
Bible. It is characterized by the appearance, at first, of oval or rounded 
patches of slight irritation, then upon these an eruption of scales, which 
grow dense and white toward the centre. Afterward the spot expands 
from its outer edge, where the skin is often reddened and slightly raised 
above the level of the surrounding surface. This is the skin disease to 



718 SKm DISEASES. 

which the name of "dry tetter*' is commonly applied. In the worst or in- 
veterate form, the whole body may be covered with these white scales, ex- 
cept the face, the palms of the hands and the soles of the feet. Even these 
do not always escape. The incrustation of scales in this variety of 
psoriasis is thick and dense. When it has lasted for some time, the skin 
chaps and breaks, after which there is severe soreness with exudation of 
fluid from the broken surface, intense irritation and itching, with great 
general and physical exhaustion, lasting for many weeks, or perhaps 
months. In rare cases it may even prove fatal. In the milder form, it is 
especially apt to appear very symmetrically upon the knees and elbows, 
and is most common between the fifteenth and twenty-fifth year of life. 
It is prone to recur in a patient who has once manifested it, but is not 
contagious. Often it is hereditary, and may be associated with a gouty 
or rheumatic taint in the system. 

Treatment. — The treatment consists of careful attention to diet, avoid- 
ance of alcoholic stimulants, and the administration of arsenic in the form 
of Fowler's solution, five drops thrice daily. Externally soothing lotions 
or ointments are required in the first stage, and mild mercurial or tar 
ointments are of service after it has become chronic. 

R. — Ol cade i drachm 

Lanoline I ounce 

Apply twice daily. 

R. — Tar ointment I drachm 

Petrolatum i ounce 

Apply twice daily. 

R. — Chrysarobin 15 grains 

Lanoline 1 ounce 

Apply to each spot twice daily. 

PITYRIASIS (Scalp Disease). 

Character. — Pityriasis is a squamous disease especially apt to affect 
the scalp when it appears in the milder form, giving rise to the shedding 
of an immense number of bran-like scales, resembling an exuberant crop of 
dandruff. 

Treatment. — The condition of the health in general should be looked 
after. Iron and arsenic are given, also calcium sulphide locally for the 
scalp. 



719 

R. — Tr green soap 4 ounces 

Alcohol 2 ounces 

Dilute and use as a shampoo, if crust or scales. After removal apply 

R. — Sulphur precip 1 drachm 

Salicylic acid . 10 grains 

Petrolatum 1 ounce 

Or, 

R. — Tr Cantharide 3 drachms 

Tr capsicum 3 drachms 

Castor oil 2 drachms 

Bay rum . . .* 3 ounces 

WARTS, CORNS AND BUNIONS. 

Hypertrophies of the skin are all unusual diseases, except warts and 
corns, which are common enough to make up for all the rest. The com- 
ing and going of warts on the hands is as much a mystery now as in former 
ages, when the most ridiculous remedies were gravely prescribed. 

Wart Remedy.- — Warts can be destroyed by caustics, of which nitric 
acid is the most severe and effectual, and chromic acid perhaps the least 
painful. When arising from the poison of syphilis, they are sometimes 
extremely sore and troublesome, so much so as to require removal by sur- 
gical operation. 

Causes and Treatment of Corns. — Corns are similar to warts in their 
structure, except that they have a much thicker layer of epidermis over 
their surface. They are almost always produced by the pressure of tight 
shoes, and may be avoided by caution in this respect. They can usually be 
prevented from giving much trouble by carefully trimming out the centre 
of the corn at short intervals, or by wearing one of the various forms of 
perforated corn-plasters in common use. In cutting corn, the incision 
should never go through the epidermis, so as to cause bleeding, since dan- 
gerous inflammation has thereby been set up. 

R. — Salicylic acid % drachm 

Ex. Cannabis Ind 10 grains 

Collodion 4 drachms 

Apply daily for 3 or 4 days when the callous can be removed. 

Bunion Treatments. — A bunion is generally made up of a corn on the 
side of the great toe, and an irritated synovial sac or bursa beneath it. 
It is also the result of wearing too tight a shoe, especially such as are too 
narrow at the point. When inflamed, it should be soothed with lead water 
and laudanum ; a loose shoe, or one with a piece cut out of the side, being 
worn. After the reduction of the inflammation, benefit may be obtained 



720 SKIN DISEASES. 

by painting with tincture of iodine. A bunion should never be neglected, 
as it is liable to suppurate, leaving a troublesome indolent sore, which may 
for years cripple the patient, even if permanent lameness does not result. 

PRURITUS (Itching). 

Character. — Pruritus is a very common disease of the skin, which is 
characterized by itching without any eruption or other apparent change in 
the appearance of the part affected. Children and elderly people are par- 
ticularly apt to suffer thus, and the localities involved are generally those 
about the orifices of the body. 

Causes. — Sometimes, like prurigo, it may be traced to the irritation 
caused by vermin, usually the pediculus corporis or body-louse, which may 
be gotten rid of by attention to cleanliness and the application of weak 
mercurial ointment, a tincture of larkspur, or various other home rem- 
edies. When not thus produced, the cause must be sought in some de- 
terioration of the general health. 

Treatment — As local applications, lotions of borax, half an ounce to 
the pint, or of carbolic acid, one or two teaspoonfuls to the pint, and oint- 
ments of zinc camphor, belladonna or morphia are useful. 

FRECKLES. 

Freckles consist of a deposit of oxide of iron from the blood, just 
beneath the epidermis or in its lower layers. They may often be dissi- 
pated by painting with tincture of iodine or frequent application of per- 
oxide of hydrogen. 

DISEASES OF SKIN GLANDS. 

Seborrhea. — In seborrhea there is an excessive production of secre- 
tion, made up of oily matter and cast-off epithelial cells, which accumu- 
lates upon the surface in the form of thin, yellowish scales. It is especially 
common on the skin of young infants. 

Treatment. — The layers of scales may be removed by the use of white 
castile soap and warm water, and if there is no inflammation of the skin, 
a mild carbolic or white precipitate ointment may be used to prevent 
their return. 

Flesh-worms. — Acne, commonly called pimples or flesh-worms, com- 
ing, as it does, upon the face just at the time when young people of both 
sexes begin to feel most anxious about their personal beauty, gives rise 



DISEASES OF SKIN GLANDS. 



Y21 



to a far greater amount ofunhappiness than many of the serious mala- 
dies to which flesh is heir. It is an inflammation of the sebaceous glands 
of the skin upon the face and back, and elsewhere, which comes on in 
successive crops, and gives rise to the spotted and pimply countenances 
w T hich are often so unsightly or even repulsive. » 

Description. — These sebaceous glands, one of which is well delineated 
in the accompanying wood-cut, are generally situated ; as there indicated, 

by the side of a hair, and if in- 
flamed, caused by the pressure 
they exert when distended, an in- 
flammation of the surrounding 
derm constituting the pimple of 
acne. In the figure is exhibited 
a hair in its follicle, highly mag- 
nified. At 7 and 8 appear the 
curious little muscles which have 
the power of erecting the hair in 
conditions of sudden fright or 
horror. They are, as is well 
known, much more active in ani- 
mals — for instance, the cat — 
than in mankind. 9 and 10 in- 
dicate a large, and 11 a small, se- 
baceous gland, both opening on 
the skin by the side of the shaft 
of the hair at 12. The small, 
black spot generally visible near 
the centre of an acne pimple is 
popularly supposed to be the 
head of a flesh-worm, which can 
be squeezed out by pressure at 
the sides of the papule. In 
reality, however, the yellow 
thread which looks like the body 
of a worm, is only the hardened 
secretion of a sebaceous gland, 
the top of which, being exposed to the air, has collected dust and dirt, 
and so become black. 

Treatment. — No advantage is gained by squeezing out these little 
46 




A Magnified Sebaceous Gland. 



722 SKix diseases. 

plugs of fatty matter, as in most cases the bruising of the parts more 
than compensates for any benefit afforded by the relief of internal pres- 
sure in the pimple from retained secretion. A great many local applica- 
tions for the cure of acne are offered for sale, some of which are com- 
posed of powerful poisons, and are liable to do great and permanent in- 
jury. A safe and often useful lotion is made of precipitated sulphur, 
variously combined with mucilage of sassafras-pith, glycerine and cam- 
phor; or an ointment of precipitated sulphur, with vaseline, a drachm to 
the ounce, or white precipitate with vaseline, half a drachm to the ounce, 
may be employed. 

Accessory Treatment. — The most important part of the treatment is 
attention to any general derangement of health, especially of the diges- 
tive apparatus, or, in females, of the menstrual function. Internally 
one-quarter grain of calcium sulphide three or four times a day is often 
beneficial. 

Diet. — Errors in diet will often bring out a crop of acne, and articles 
of food which contain fried butter or fat of any kind, appear to be apt to 
have this effect. Pastry of all varieties, particularly mince-pie, buck- 
wheat and other hot cakes, sausage, cheese and nuts should all be avoided, 
as well as spirituous and malt liquors in every form. Although the treat- 
ment and hygienic care, as thus advised, will generally diminish the ac- 
tivity of the eruption, they may not always effect a cure, and consolation 
must be sought in the fact that it seldom persists unless kept up by im- 
prudence, after the period of maturity in the organism has been attained. 

SKIN DISEASES DUE TO VEGETABLE PARASITES. 

Causes. — It is now generally admitted that the fungus growths . found 
so constantly in and among the epithelial scales of the epidermis are 
the causes, and not the mere accompaniments, of a curious group of 
skin maladies. The development of fungus not only invades the skin, 
but affects also the hair and the hair-follicles. Though the variety of 
vegetable growth differs in the different diseases, each presents the same 
general features, consisting of microscopic threads named mycelium, cor- 
responding to the stem of a larger plant like a grape-vine, and micro- 
scopic seeds sometimes produced in bunches like grapes, and called spores. 
The full recognition of the fact, as it is believed to be by the present 
writer, that the fungous growth is the essential cause of the whole disease 
is vitally important, because upon it depends the system of preventing 



RING-WORM OF THE HEAD. 



723 



these maladies from spreading to healthy persons, by total destruction of 
the spores or seeds of the respective diseases. 

A Case in Point — In the instance of a member of the author's family, 
a little girl was infected with the fungus of Favus just underneath the 
tip of her chin, probably from spores left by some diseased child on the 
sill of a car window, from which she had been looking out, and at the 
time of being attacked with this complaint, which was fortunately rec- 
ognized at once, and put an end to by appropriate treatment, she was in 
perfect health. 

RING-WORM OF THE HEAD. 

Symptoms. — Tinea tonsurans or ring-worm of the head is the most 
common of these vegetable parasitic diseases. It shows itself as a dry, 
scaly patch, rounded or oval in outline, which gradually grows larger 
and larger, the hairs dying and dropping out at the centre, so that 
ultimately a bald spot of from half an inch to two inches in diameter is 
left. The same fungus which produces this malady 
in the head sometimes develops among the hair of the 
beard, producing what is called tinea sycosis or bar- 
ber's itch, and upon the other parts of the body where 
it is denominated tinea circinata or common ring- 
worm, with which, however, no worm has anything 
to do. 

Further Symptoms. — Eing-worm of the scalp com- 
mences usually as a little pimple, which soon spreads 
and takes on its characteristic ring-like appearance, 
showing a circle of minute scales, pimples and vesicles 
at the circumference of the patch. As the disease ad- 
vances the hairs included in the circle become dull, 
dry, twisted and easily broken off, whilst the epider- 
mis and stumps of the hairs become covered with a 
The Effect of Ringworm greyish-white powder, consisting chiefly of the vege- 

on the Hair. 

table growth. 

Illustration. — If one of these broken hairs is put 
into a drop of caustic potash solution, and examined under a high power, 
such as 250 diameters of the microscope, its shaft can be seen as repre- 
sented, in the figure, penetrated with the mycelium of the fungus, called 
the tricophyton tonsurans, and floating around may often be detected 
separate spores of the same plant as indicated at the upper part of the 
wood-cut on both sides of the hair. 




724 SKIX DISEASES. 



RING-WORM OF THE BODY. 



Tinea circinata, which is also denominated herpes circinatus and 
ring-worm of the body, begins like that upon the head with a small 
pimple, but soon spreads with great rapidity, and the rings of eruption 
may attain a diameter of four or five inches. 

Characteristic. — The great characteristic by which this affection can 
almost always be recognized is its healing up in the middle, so that the 
appearance is presented, after a time, of a patch of healthy or slightly 
reddened skin, surrounded by an angry, red ring about a quarter of an 
inch wide. Such an arrangement of the eruption is peculiar to ring-worm 
and suggests that the fungus in its growth at the centre of the ring has 
exhausted some material found in the skin which is necessary for its de- 
velopment. Were this not the case it would almost certainly continue to 
flourish in the middle, as well as at the edges, so that the course of ring 
worm affords a strong argument in favor of that part of the germ theory 
which supposes that the immunity conferred by one attack of small-pox, 
for instance, is due to the exhaustion in the entire system of some in- 
gredient necessary to the growth of the specific small-pox fungus. 

BARBER'S ITCH. 

Character. — Tinea sycosis, or barber's itch, is the variety of the dis- 
ease in which its vegetable cause happens to develop upon the chin of 
an adult, male patient. A great amount of irritation is usually set up,- 
perhaps, from the roots of the hairs constituting the beard, extending 
more deeply into the substance of the true skin, and the plant therefore 
producing a deeper-seated inflammation of the parts as it grows down 
along the sides of the hair-follicles, than in the non-hairy portions. Hence 
large papules, and even pustules resembling those of acne in its aggra- 
vated state, are apt to be formed, and the itching and burning, as well 
as the disfigurement, are occasionally very troublesome to the patient. 
Perhaps among the vegetable parasitic diseases there is none to which 
persons are more liable to be exposed than this tinea sycosis or, as it is 
commonly called, the barber's itch. 

Causes. — As before observed, any one of the innumerable epidermic 
scales, continually shed from human integument and constantly floating 
in the atmosphere around us, whence they are deposited with other ma- 
terials in the form of dust, may be freighted with spores, or seeds enough 



barber's itch. 725 

of the fungus which causes tinea, to infect thirty, forty or fifty individuals 
should they meet with proper conditions for growth and reproduction. If 
persons fully realize this truth they can, of course, readily understand 
that all the ordinary precautions usually resorted to in barber's saloons, 
to wit, those of having separate cups, razors and brushes for each indi- 
vidual customer only diminish the danger of infection, and by no means 
insure a certainty of escaping the disease. For not only is the air of the 
room liable to carry separate epidermic scales, which may each convey 
the infection, but many of the operations connected with the process of 
shaving are still more likely to be the means of communication. For 
instance, the razors which are employed, even if they be individual prop- 
erty, are all sharpened with the same strap, upon which may have been 
spread, a few moments before you enter to be shaved, a few score epi- 
thelial cells from a case of tinea, one or two of which, should they acci- 
dentally adhere to the surface of your razor, as it certainly is quite pos- 
sible for them to do, would be amply sufficient to implant the disease 
upon your face. In like manner the towels which are used, the brushes 
and combs, and even more certainly the hand of the barber himself, may 
prove the most efficient carriers of contagion which could possibly be 
devised. 

Precautions. — In order to prevent the spread of these vegetable para- 
sitic diseases the precautions already suggested must be rigidly enforced. 
All articles of clothing which have been worn in contact with parts of the 
body where the parasite grows should be purified by immersion in boiling 
water, or, if the nature of the material does not permit this, by baking at 
a heat of 250° Fahrenheit. All bed linen, bandages, brushes, combs and 
towels, or other articles suspected of similar contact, should be treated in 
the same way; and, of course, should be used by no other person until 
thus purified. The patient, if a child, should be kept by itself as far as 
possible, and those having charge of the case should thoroughly wash 
themselves after handling the parts affected. It is probable that the use 
of a strong carbolic acid soap, or of sulphite of soda or chlorinated soda 
solution would add to the security against attack, and with such pre- 
cautions there is little danger that the malady will be transferred to 
others. Of course after proper treatment has once been put into opera- 
tion, the danger of infection is still further diminished. 

Treatment. — 1. The essential point in treatment is to apply to the 
roots of the hairs a preparation which will kill the fungus, just as weeds 
are destroyed in an asparagus bed by sowing the ground with salt. In 



726 SKIN DISEASES. 

order to do this, the hair — if any exists — should first be removed, and 
the surface made as clean as possible. \Yhen the hair is not very thick. 
or has already been nearly destroyed by the disease, a cure may perhaps be 
effected by lotions or ointments of sulphuric acid, carbolic acid or sali- 
cylic acid. An ointment of verdigris is a favorite home remedy, and 
often succeeds after causing a good deal of unnecessary irritation. 

2. Tincture of iodine, applied twice a day for fourteen days, and 
the spot then covered with the ointment of corrosive sublimate, of about 
two grains to the ounce, is an effectual method of treatment, which may 
be employed with great caution in obstinate cases, or the following solu- 
tion applied at night: Hyposulphite of soda, one drachm; water, one 
ounce. Where the hair is very thick and strong it is sometimes necessary 
to pull it out with tweezers, as will be directed in speaking of favus, al- 
though this severe operation is, happily, not often required. 

SCALD HEAD. 

Character. — Tinea favosa or favus, called also scald head and honey- 
comb ring-worm, is characterized by its peculiar dry, sulphur-yellow 
crusts, in the form of little cups about a quarter of an inch in diameter. 
In advanced cases, however, these cups run together, so that their well- 
defined form can, perhaps, with difficulty, be recognized, except at the 
edge of a patch. A peculiar mouse-like odor is emitted from a child's 
head bearing a good crop of favus, this being probably produced by the 
spores of the fungus coming in contact with terminal branches of the 
olfactory nerve of the observer. On careful inspection, each cup is usually 
seen to surround a hair, and there is commonly little trouble in detecting 
the fungus spores and mycelia on microscopic examination. 

Causes. — Although this disease is more frequently met with upon 
the heads of neglected, ill-nourished children than elsewhere, there is 
little doubt that any one of these spores of the achorion schoenleinii, as 
the fungous cause is denominated, might, under favorable circumstances, 
germinate and give rise to an abundant crop of favus in the hair, beard, 
or skin of the most vigorous individual upon whom they happened to be 
deposited. 

In some cases the fungus of favus attacks the nails, developing be- 
neath them and by the pressure which it causes producing their absorption 
and perforation. Much local inflammation about the root of the nail is 
thus set up. 



itch (scabies). 727 

Treatment. — The treatment of favus consists in removing the crusts 
by softening with a poultice, cutting or shaving off the hair, and then 
rubbing in thoroughly sulphur or tar ointment. If the spot is small a 
weak solution of corrosive sublimate may be painted over it, but this 
powerful poison requires very careful management. In obstinate cases it 
may be necessary to pull out the hair, either by the process of avulsion, 
where a cap made of adhesive plaster is suddenly torn off the head, bring- 
ing the hair with it, or by extracting six or eight hairs at a time with 
tweezers. This latter operation, called epilation, is denominated by Sir 
E. Wilson "the purgatory of avulsion," and condemned as little less cruel. 

Brown Patches. — Tinea versicolor or chloasma depends on the growth 
in the epidermis of a fungus similar to that of ring-worm, but bearing its 
spores in heaps like bunches of grapes. The disease, which is seldom 
troublesome, is characterized by brownish-yellow, slightly scaly, irregular 
patches, which appear on the front of the chest and sides of the neck. It 
may also affect other parts of the body. As it does not penetrate deeply 
into the epidermis it is easily cured by painting with tincture of iodine, 
tincture of chloride of iron, or solution of sulphurous acid. 

ITCH (SCABIES OR CHIGGER). 

Causes. — Scabies or the itch, the most important skin disease caused 
by an animal parasite, was called in former times, when its true cause was 
but little understood, the seven-years' itch, because it was so hard to cure. 
At present it is universally admitted that the whole cause of this most 
annoying malady is the itch insect, or itch-mite, which is represented in 
the cut on the next page as it appears under the microscope if magnified 
about two hundred diameters. From the irritation set up by the parasite, 
and still more from the scratching to which it drives the unfortunate pa- 
tient, vesicles, pimples and pustules are formed and grouped together in 
every variety. 

Symptoms. — 1. The itching, which is terribly severe even in daytime, 
is generally much worse at night after becoming warm in bed. The fa- 
vorite haunts of the insect upon its human domain are the hollows of 
the elbows and knees, the front of the wrist and the backs of the hands 
just below the roots of the fingers ; but it is also found in other portions 
of the body where the skin is tender. The palms of the hands and the 
soles of the feet are not infrequently infested, notwithstanding the integu- 
ment is thick in these parts. In a vast majority of cases showing the 



28 



SKIN DISEASES. 



discrete or separate eruption on the palms and soles it is due to either 
scabies or syphilis, and the presence of itching in the former and its 
absence in the latter of these two diseases enables us to distinguish them 
with great certainty. 

2. The accompanying eruptions of scabies vary somewhat in their 
character according to situation. Thus the prurigo of itch is generally 
best defined upon the forearms, the lower part of the abdomen, and the 
upper and inner portion of the thighs. A vesicular eruption is more fre- 
quent about the fingers and breasts 
of thin-skinned people, and pustules 
are met with in children especially 
on the hands, feet and hips. 

3. In searching for a specimen 
of the insect, which can be seen 
quite distinctly with a good mag- 
nifying glass, it is well to look for 
one of the pimples, which has, ex- 
tending from it, a little whitish line 
about an eighth of an inch long and 
generally somewhat curved. This is 
the burrow of the female insect, in 
which she has laid her eggs and is 
raising a happy little family to fol- 
low her example and live off the fat 
of the land they inhabit. If the top 

The Itch insect Magnified Two Hundred Times. ° f the buiT0W ls Scratched through 

very carefully at its outer end with 
the point of a fine needle, and then the tiny round dot which may be found 
there picked out on the needle and transferred to a slip of glass, positive 
evidence of the nature of the disease can be at once detected by suitable 
examination under a microscopic or hand-magnifier. 

Illustration. — The adjoining figure represents one of these burrows 
of the acarus scabies or itch insect, and in it is seen the mother of the 
family at the upper extremity, whilst eggs and young in various stages of 
development are depicted in different portions of the gallary excavated 
for their accommodation in the epidermis of their hospitable host. 

Treatment. — The treatment of scabies should be by applications which, 
whilst they tend to kill the insects, will increase as little as possible the 
irritation of the skin. If this irritation is not already too great, the 




LICE. 



729 



patient should go into a warm bath and scrub himself with brown or soft 
soap for half an hour ; he should then lie in the bath for another half hour, 
and after being thoroughly dried, rub himself with the compound sulphur 
ointment all over, except the head, for twenty minutes, allowing the oint- 
ment to remain on the body all night. This whole process should be re- 
peated every night for three times, which will probably end the lives of 

the itch insects and so terminate the 
malady. 

Disinfection. — In order, however, 
to avoid being reinfected from the 
clothing upon which some of the acari 
or their eggs may remain, every article 
that will bear washing should be thor- 
oughly boiled, and those pieces of ap- 
parel which would be injured by water 
should be several times pressed with a 
hot iron, so as to completely destroy 
the parasites. 

Further Treatment. — When the 
skin is very irritable the application 
of Peruvian balsam or the styrax oint- 
ment should be tried at first, and it 
ought to be remembered that even in 
■jEp^«v^ those whose skins are not remarkably 

tender the sulphur ointment, if used 
very vigorously, is apt to produce an 
eczematous eruption, which, however, 
quickly subsides on the cessation of 




The Burrow of the Itch Insect. 



the application. 



LICE. 

Treatment for Lice. — The three kinds of pediculi or lice which infest 
the head, the body and the pubes of man, differ in their appearance under 
the microscope, being apparently each best fitted for the special part it 
has to play in tormenting the human family. They can all be defeated 
in this great business of their lives by strict attention to cleanliness, fre- 
quent bathing, and the application of mercurial ointment diluted with five 
times its bulk of lard, For the purpose of avoiding salivation, this oint- 



7-30 SKIN DISEASES. 

nient should not be used directly after a bath, nor rubbed in very strongly, 
nor, in fact, allowed to remain in contact with the skin any more than 
necessary, or a one to one thousand solution of bichloride of mercury may 
be applied. 



PART XII OF BOOK IV 

Tells of the bones and muscles of the human body 
and the diseases to which they are subject. 



Abdominal Muscle 752 

Abscess within a Joint 74 2 

Ankle-to-Knee Bones 737 

Arm Bones 735 

Leverage of 744 

Atrophy of the Muscles 746 

Attachment, Muscular 743 

Bones 733 

Ankle 737 

Arm 735 

' Brittleness 74° 

Chest 739 

Chicken 734 

Chondroma 74° 

Diseases of the 733 , 74° 

Dislocation of 739 

Face 738 

Inflammatory Affections 740 

Knee 737 

Leg 737 

Marrow of the 734 

May be United 733 

Necrosis 74° 

Nodes 740 

Number of 733 

Osteoma 740 

Osteomalacia 740 

Osteomata 741 

Softening of 740 

Synovitis 741 

Skull , 737 

Spine 738 

Structure of 734 

Thorax 739 

Wrist 735 

Brittleness of Bone 740 

Canals, Telescopic View of the 734 

Chest Bones 739 

Muscles 752 

Chicken Bones 734 

Chondroma 740 



73 



Coxalgia ....74a 

Detecting Trichinae 751 

Discovery of Trichinae 749 

Diseases of the Bones 733, 740 

of the Muscles 733, 746 

Dislocation of Bones 739 

Epidemics of Trichiniasis 750 

Exhaustion Caused by Trichinae ....748 

Face Bones 738 

Muscles 745, 752 

Flexor Muscles 745 

Fluid, Synovial 735 

Foot Muscles 752 

Forearm Muscles 752 

Formation of Skull 738 

Fracture, Repair of 739 

Fragilitis Ossicum 740 

Hand Muscles 752 

Head Muscles 752 

Hip Disease 742 

Hip Muscles 752 

Human Skeleton, Parts of 736 

Hypertrophy of the Muscles 746 

Inflammatory Diseases of Muscles.. 746 

Intercostal Muscles 745 

Involuntary Muscles 743 

Joint, Abscess within 742 

Joints, Kinds of 735 

Knee-to-Ankle Bones 737 

Leg Bones 737 

Muscles 752 

Leverage of Arm 744 

Leverage, Muscular 744 

Longest Muscle 745 

Marrow of the Bones 734 

Muscles 742 

Abdominal 752 

Atrophy of 746 

Chest 752 

Degeneration of 753 

Diseases of the 733, 74& 

I 



IXDEX TO PAET XII OF BOOK IT. 



Flexor 745 

Foot 752 

Forearm 752 

Hand 752 

Head 752 

Hip 752 

Inflammatory Diseases of 746 

of the Face 745, 752 

Hypertrophy of 746 

Intercostal 745 

Involuntary 743 

Leg 752 

Longest '. 745 

Neck 752 

Number of 744 

Shoulder 752 

of Spinal Column 745 

Thigh 752 

Voluntary 743 

Muscular Attachment 743 

Leverage 744 

Muscular System 742, 752 

Composition 742 

Involuntary 743 

Mechanism 743 

Voluntary 743 

Muscular Function 742 

Myositis 753 

Necrosis 740 

Nodes 740 

Number of Bones 733 

of Muscles 744 

Neck Muscles 752 

Ossification 753 



Osteoma 740 

Osteomalacia 740 

Osteomata 741 

Paralysis Caused bj^ Trichinae ....748 

Pott's Disease 742 

Repair of Fractures 739 

Shoulder Muscles 752 

Skull Bones 737 

Skull Formation 738 

Softening of Bone 740 

Spine Bones 738 

Spinal Column, Muscles of 745 

Sprains, Nature of 737 

Structure of Bones 734 

Synovial Fluid 735 

Synovitis 741 

Thigh Muscles 752 

Thorax Bone 739 

Trichinae . . 747 

Characteristic Sign of 748 

Discover}- of 749 

Effects of 747 

Exhaustion in 748 

How they Breed 747 

Method of Detection . . '. 751 

Paralysis in 748 

Trichinae Spiralis, Size of 749 

Vitality of 750 

Trichiniasis 746 

Epidemics of 750 

Tumors 753 

Vitality of Trichinae 750 

Voluntary Muscles 743 

Wrist Bones 735 



ILLUSTRATIONS 



Bones of Forearm Acting as 

Levers 744 

Calcified Trichinae 751 

Encysted Trichina 747 

Human Skeleton, Parts of 736 m 



Muscular System 752 

Trichina Cyst 749 

Trichina and Its Cyst 750 

Trichina Spiralis in Human 

Muscles 746 



CURATIVE MEDICINE 



PART XII. 
DISEASES OF THE BONES AND MUSCLES 

Bones. — The skeleton is the framework of the body, and is composed 
of an articulated assemblage of hard organs, the bones. 

It serves to preserve the shape of the body; forms cases for the pro- 
tection of the vital organs, and gives attachment to muscles and forms 
levers of movement. 

Number of Bones. — The number of distinct pieces or bones compos- 
ing the skeleton varies at different periods of life. Some remain distinct 
from the first moment of their development, such generally being of the 
simplest form, such as the bones of the carpus or wrist, and the patella or 
knee cap. Others, which are viewed as single bones in the adult, not only 
consist of several pieces in the beginning, but in the progress of develop- 
ment have other pieces successively added, as in the case of the vertebra? 
or bones of the spine and the thigh bones. 

May Unite Bones — Again bones considered as distinct pieces when the 
body has arrived at maturity, at a later period may become united with 
those which are contiguous, as in the coossification of the cranial bones. 
Therefore in the adult skeleton the number of bones to which we usually 
refer are two hundred and six, exclusive of the teeth and sesamoid and 
wormian bones, which are not uniform in number. Of this number 
twenty-six are found in the backbone or spine ; twenty-two in the skull 
and face ; the ribs count twenty-four, twelve on each side, whether the per- 
son be man or woman; each arm has thirty-two bones, and each leg has 
thirty. These bones vary very much- in size, shape and thickness, and all 
have been named and described with great minuteness by anatomists. 

Composition of Bones — The bones under every modification of shape 
and mechanical arrangement are constituted by precisely the same elemen- 

(733) 



< 34 DISEASES OF THE BOXES AXD MUSCLES. 

tary matters, the principles of which are an animal and an earthy sub- 
stance, in intimate combination. 

Phosphate of lime is the most abundant mineral material, being about 
51 parts in the 100 of bone. Carbonate of lime, 11.3 parts; fluoride of 
calcium, 2 parts. 

The animal matter of bone is gelatinous, allied to cartilage ; originally 
every bone is developed from cartilage by ossification. 

The mineral matter of bone increases with age ; making bones of 
the old more brittle. There is more of it also in some bones and parts of 
bones than in others. 

Structure of Bone — A good idea of the structure of a bone may be 
gained by picking the second joint of a chicken or turkey clean, and then 
sawing off about an inch of the upper end and splitting this piece in half 
lengthwise with a hatchet or strong knife. This thigh-bone of a turkey 
corresponds to the femur or thigh-bone in a human being, where it lies 
near the centre of the leg and reaches from the hip to the knee. Its 
upper end may be recognized by its having upon it a single round knob, 
which formed part of the hip-joint. 

Marrow of the Bone — On examining such a bone it is found to be hol- 
low in the middle, and partly filled with a fatty substance called the 
marrow of bone. In this marrow run important little blood-vessels, which 
carry the blood to nourish the bone, and from it they pass and repass to 
minute channels running lengthwise in its substance, which are called 
the Haversian canals, after the name of the physician who first discovered 
them. In dried bones, and especially when they have undergone pro- 
longed bleaching in the open air, such as those of a long dead horse or 
cow, these Haversian canals may be readily seen, looking like fine pores 
in the broken ends of the bones. 

Telescopic View of the Canals. — Under the microscope they are dis- 
covered to be encircled with rings of lacuna, or little holes in the bone sub- 
stance, each of which communicates with its neighbors by very minute 
branching tubes. During the life of an animal the lacuna are filled with 
soft, jelly-like bone-corpuscles, but in dried bones these gelatinous bodies 
shrivel up, leaving the lacuna empty, except of air, which, by refracting 
light differently from what the solid bone does, makes the lacuna look like 
black dots under the microscope. 

Bones of a Chicken. — If the breast-bone of a young chicken is ex- 
amined it will be found that its smaller end is made up of the tough, milk- 
white or semi-transparent substance called gristle or cartilage. When a 



STRUCTURE OF BONE. 735 

chicken is first hatched nearly all its bones are chiefly composed of carti- 
lage, and as it grows older they gradually become more and more ossified, 
that is, changed into bone. But certain portions of the body commonly 
remain cartilaginous through life, as, for instance, the gristly bands which 
fasten the ribs to the breast-bone, and the rings of the trachea or windpipe. 

Bones of Arm. — The bones of the arm, counting from the shoulder 
downward as it hangs at the side, are first the humerus or arm-bone, which 
extends to the elbow, and next the two bones of the fore-arm, which make 
up the part from the elbow to the wrist, and are named the radius and 
ulna. The latter of these two bones projects on the under side of the arm, 
and the radius has the hand attached to it, and is rolled part way around 
the ulna every time the hand is turned over from the position of prona- 
tion, or lying with its palm downward, to that of supination or lying upon 
its back. This is a very important movement, and great care must be taken 
by the use of properly padded splints to save it, when the radius and ulna 
of the fore-arm are fractured by accident, as very frequently happens. 

Bones of Wrist. — The wrist or carpus is composed of eight small 
bones, each with a hard name derived from Greek or Latin, and the palm 
of the hand is formed by four of the metacarpal, a word meaning beyond 
the wrist bones, the metacarpal bone of the thumb making the fifth. The 
bones of the fingers consist of three rows of phalanges, the thumb having 
two phalanges only. 

Besides the bones mentioned, anatomists reckon the shoulder-blade, or 
scapula, and the collar-bone, or clavicle, as belonging to the arm, or, as 
they name it, the upper extremity. 

Kinds of Joints. — The joints of the arm exemplify the two chief kinds 
of articulation made use of in the human body, namely, the ball and 
socket joint, of which the shoulder is an example, and the hinge-like joint, 
of which the elbow is a good illustration. The joints between the meta- 
carpal bones^fcd the first row of the phalanges of the fingers, that is, those 
at the roots of the fingers, are imperfectly formed ball and socket joints, 
and allow, as anyone can see in his own hands, of a good deal of lateral or 
sidewise, as well as backward and forward motion. The other articula- 
tions of the fingers are hinge- joints, and like the hinges of a gate, permit 
only of a back and forth motion. 

The Synovial Fluid — The ends of bones where they rub against each 
other inside the joints are covered with firm smooth cartilage, and to 
diminish the friction as much as possible these polished surfaces of 
cartilage are kept slippery by a peculiar liquid named the synovial fluid 



'30 DISEASES OP THE BONES AND MUSCLES. 



PARTS OF THE HUMAN SKELETON. 

Top Central Plate. — This shows the bones of the cranium, or head. 
eight in number. The large frontal bone forms the forehead. The 
articulation of the teeth are prominent. It also shows the facial bones, 
or those of the face, fourteen in number. 

Middle Central Plate. — This shows the bones of the chest ; the sternum, 
or breast bone, in the centre ; the ten true and two floating ribs on either 
side, and part of the backbone, to which the ribs are attached. 

lower Central Plate. — This plate shows the bones of the pelvis. Pelvis 
means basin. It is the basin or girdle by which the bones of the lower 
body, as the hip bones, are joined to the upper. The two large side bones 
are the os innominata, or unnamed bones. The central triangular bone is 
the sacrum, a composite bone, forming the union between the vertebrae 
and os coccyx, or tail end of the backbone. 

"Upper Left-Hand Plate — This represents the eight bones 'of the carpus 
(wrist) ; the five of the metacarpus (between wrist and phalanges), and 
fourteen bones of the phalanges (battle rank bones), twenty r seven in all. 

Next Figure Below. — This is the sacrum, detached from the pelvic 
girdle. It is also seen in lower middle plate. It is called sacrum (sacred), 
because it was of old offered up in sacrifices. 

Third Left-Hand Figure. — This is a section, or single joint of the 
backbone, or spinal cord. 

Bottom Left-Hand Plate — This represents the femur, or great thigh 
bone. It is cylinder-shaped, and the largest, longest and strongest bone 
in the body. 

Upper Bight-Hand Plate. — This represents the bones of the foot. 
They are divided into three classes. 1. Tarsus, or ankle bones, seven in 
all. 2. Metatarsus (between tarsus and phalanges), five in all. 3. 
Phalanges (battle-rank bones), fourteen in all, a total of twenty-six foot 
bones. 

Middle Bight-Hand Plate. — This represents a part of the backbone or 
spinal column. It consists of a series of vertebra?, within which is the 
spinal cord or nerve, to injure which means paralysis or death. 

Lower Bight-Hand Plate. — This is the humerus (shoulder), or bone of 
the upper arm. It is the only bone in the upper arm, and it revolves on 
the scapula (shoulder-blade) above, and the ulna and radius of the fore- 
arm below. 



km $ 




Parts oftfye //urn an Ske/eton 



PARTS OF THE HUMAN SKELETON. 737 

or "joint-water." This synovial fluid, called also the synovia, acts the 
part of oil to a door hinge, and when sometimes in old people the synovia 
becomes scanty, their joints will creak and grow stiff, jnst as the hinges 
of a door do for want of oil. The ends of the bones in a joint are held 
in place by a tough, firm wrapper, called the capsular ligament, which 
encloses them tightly on all sides, and also prevents the synovia from 
escaping and being lost. 

Bones of Leg. — In general arrangement the bones of the legs are very 
similar to those of the arms, making allowance for the difference in func- 
tion of the two pairs of limbs. The thigh-bone or femur is the longest 
and strongest bone in the body, as might be expected from the larger 
share of work in walking, running and leaping it has to perform. It is 
articulated (or jointed) to the pelvis at the lower corner of the body by 
the hip-joint, a ball and socket articulation, which allows of considerable 
movement in every direction. 

Knee to Ankle. — From the knee to the ankle, the leg, like the fore- 
arm, is furnished with two bones. One of these, called the tibia, is the 
shin-bone, forming the front of the leg and the inner side of the ankle, 
that is, the side next the other limb. The bone on the outer side of 
each leg and each ankle is named the fibula, and is much smaller than 
the tibia, its partner in the business of supporting the weight of the 
body. The ankle or tarsus is composed of seven bones instead of eight, 
as are found in the carpus, and it is articulated below and in front, near 
the middle of the foot, with five metatarsal bones. At the front, ends 
of the metatarsal bones are jointed on the toes, each with its three rows 
of phalanges, except the great toe, which, like the thumb, has but two. 

Nature of Sprains. — The ankle-joint is more apt to be "sprained" or 
"strained," than any other, and this accident, therefore, requires a few 
words of explanation here. A strain of a joint is the result of moving 
the bones which compose it too far, or in an unnatural direction, so that 
the capsular and other ligaments are stretched or perhaps torn a little 
by the force applied. A strained joint is very painful, apt to swell 
rapidly, and often proves troublesome for months, or even years, if not 
properly treated. Until a doctor comes, the injured articulation should 
be placed in an elevated position, so that the blood will drain away from 
it, kept perfectly quiet, and covered with cloths wrung out of hot or cold 
water, so as to reduce the danger of inflammation. 

Bones of Skull. — The bones of the skull or cranium are broad, com- 
paratively thin, and curved in such a way as to make a hollow case or 
47' 



73$ DISEASES OF THE BONES AND MUSCLES. 

oval box, shaped a good deal like an egg, for the protection of the brain, 
which is placed inside of them. The most important are the frontal or 
forehead bone, the two temporal or temple bones and the occipital bone, 
which is at the back of the head. These bones are united together by 
seams or sutures, consisting of a curious kind of dove-tailing, which fas- 
tens them so firmly together that, in their natural state, it is impossible 
to get them apart without breaking them. 

Character of Skull Formation — The arch form of the skull makes 
it much more capable of resisting blows upon the head; but if these are 
so severe as to fracture the bones, especially if they are dented in so as 
to press upon the brains, unconsciousness is often very quickly produced. 
This would happen much more frequently were it not for the layer of 
spongy matter interposed between the hard plates which form the cranial 
bones. 

Bones of the Face — The bones of the face are comparatively light 
and thin, except the lower jawbone, into which are set the lower teeth, 
and which is the only bone about the head which is furnished with a 
movable joint, except the occipital bone, where it rests upon the neck. 

Bone of Spine — The spine or backbone is made up of , twenty-four 
vertebrae, the sacrum and the coccyx. These latter bones seem to be each 
composed of several vertebrae, which, for the purpose of being rendered 
stronger, have grown fast together. The uppermost vertebrae is called 
the atlas, because upon it the head is supported ; and the second is named 
the axis, because upon it the atlas, and with it the whole- head, turns, as 
in shaking the head negatively. The upper seven vertebrae are called 
the cervical or neck bones; the next twelve are designated as the dorsal 
or back vertebrae; and the last five are named the lumbar vertebrae or 
vertebrae of the loins. These twenty-four bones are fitted together in such 
a way as to form a continuous tube, which receives and protects the spinal 
cord or spinal marrow just as the upper continuation of the spinal cord — 
that is, the brain — is encased and protected by the bones of the skull. 
The vertebrae are jointed so as to allow considerable motion, both sideways, 
forward and backward, and have between each pair a cushion of fibro- 
cartilage, which serves to preserve the brain from injury by the shocks 
and jars which would otherwise be given to it in jumping, running and 
various other movements. The sacrum, which is continuous with the 
vertebrae, is united with two large, flat and irregularly-shaped bones, to 
form the pelvis or basin at the lower part of the trunk. The pelvis sup- 
ports the spine and the organs in the abdominal cavity, and is in its turn 



DISLOCATION OF BONES. JSd 

sustained on each side by the thigh bones, which prop it up at the hip- 
joints, as already indicated. 

Bones of the Thorax or Chest. — The heart and lungs are protected 
by a bony cage composed of the twenty-four ribs, which lie a little be- 
neath the skin of the thorax or chest and in thin persons can be easily felt 
at the sides or near the breast-bone. This breast-bone or sternum is sit- 
uated directly in the middle or front of the thorax and has the front ends 
of the ribs attached to it by cartilages, named the costal or rib-cartilages, 
which allow of the outward and npward movement of the ribs, necessary 
in breathing. 

The back or posterior ends of the ribs are jointed on to the verte- 
brae of the spinal column in such a way as to allow of needful motion, 
and yet secure sufficient stability and firmness. 

Dislocation of Bones. — When a dislocation occurs, or, as it is com- 
monly called, a bone is put out of joint, the bones composing an articu- 
lation have been pulled or twisted so hard as to displace them, breaking 
some of the ligaments which are arranged to keep them in their proper 
positions. 

Example of Dislocation. — Generally, a person whose arm, at the 
shoulder, for example, is dislocated, suffers a good deal of pain and loses 
the use of the limb until the bones are put back in their places again, 
or as it is called, the dislocation is reduced. 

A dislocation is one of the heavy penalties people often have to pay 
for imprudent over-exertion in lifting and wrestling, or for carelessly 
letting themselves have falls and hard knocks, or becoming entangled in 
railway accidents. 

Repair of Fractures. — The repair of broken or fractured bones is a 
wonderful process of nature, in which a material called callus, at first like 
putty, is formed around the broken ends, holding them together, feebly 
at first, but afterward it gradually hardens, uniting them more firmly 
indeed. 

Since this "knitting" of the broken bones may occur in almost any 
position they happen to lie in, or are pulled into by the irritated muscles 
in the neighborhood, it is evidently very important that they should be 
put and kept in exactly the right place. For this purpose there are many 
ingenious splints and bandages devised and used by surgeons. See Acci- 
dents and Emergencies and Surgical Diseases, 



740 DISEASES OF THE B02\ES AHT> MUSCLES. 



DISEASES OF THE BONE. 

Inflammatory Affections — These sometimes follow wounds, but are 
more common as result of syphilitic or scrofulous disease. There is swell- 
ing and pain of affected part (especially at night). Unless overcome in 
early stage, necrosis is apt to follow. 

Necrosis. — This disease is akin to mortification of the flesh and is 
sometimes called Death of the Bones. It may occur from injuries to and 
inflammation of the periosteum or may be due to phosphorous poisoning. 
There is dull, deep-seated — sometimes acute — pain, followed by increase 
of size and the formation of new bone around the old. There is tenderness 
and distension and a breaking down of tissue with a discharge of pus 
and of small particles of bones. Blood poisoning frequently ensues from 
absorption of dead bone tissue that has not found outlet. To prevent this 
an incision should be made over a swelling in bone troubles if pus be sus- 
pected and thus permit escape of diseased parts. This should only be 
done by a skilled surgeon and under thorough antiseptic conditions. Tem- 
porary relief is obtainable by poultices and quieting fomentations. Surg- 
ery is usually necessary, all diseased bone being scraped away. 

Nodes. — These are hard, bony swellings, which are apt to occur as 
tertiary symptoms of constitutional syphilis. They are most common in 
long bones and are frequently found on the front surface of shin-bone. 
They are often painful for a time, particularly at night, but yield promptly 
to treatment with the iodide of potassium in the majority of cases. 

Softening of Bone (Osteomalacia). — This is an uncommon disease ob- 
served in adults ; seldom seen in males, occurring in greater frequency in 
females. It is characterized by a softening of the bones, rendering them 
very liable to break or bend on the application of little force; resulting 
from absorption or deficiency of the earthy matters in the bones. 

Brittleness of Bone (Fragilitis Ossicum) — This is an affection of bone 
in which the inorganic are out of proportion to the organic constituents, 
rendering the bones brittle; there is an apparent increase of the earthy 
matters, with a diminution of the vascularity of the bone. Children and 
young persons seem to suffer most from this disease, and in many instances 
an hereditary tendency can be traced. 

Osteoma (Chondroma) — The bones are subject to tumors, to cartila- 
ginous or other growths. They form hard rounded tumors, fixed to their 
point of origin. They may attain a huge size — but are usually small. 



DISEASES OF BONES. 741 

They grow slowly without pain or other symptoms except such as may be 
caused by their bulk or pressure, and interfere with the functions of 
neighboring nerves. 

Osteomata are liable to inflammation and necrosis, but never under- 
go malignant or cancerous degeneration. Chondromata may not only 
become inflamed, and necrosis and sloughing follow; but it becomes can- 
cerous in some instances ; for instance, after an injury to a bone, a chon- 
droma may appear and develop with terrible rapidity, and upon its re- 
moval may return, become cancerous and form secondary tumors else- 
where. 

Treatment. — If osteomata or chondromata are removed whilst small 
the operation is to be recommended, but when left until a huge tumor 
has developed, of the nature of which no doubt can be entertained, any 
interference is of questionable propriety. 

Synovitis. — Among the important diseases of the joints must be men- 
tioned synovitis or inflammation of the lining membrane, by which the 
synovia or joint-water is secreted. This disease, usually attended with 
severe pain, and when the joint is a large one accompanied with much 
constitutional disturbance and fever, appears in two forms, the acute and 
the chronic. 

Causes. — The acute form is usually the result of injury, which may 
be very slight in its character, as even the least puncture of the joint 
by which air can enter is liable to produce it. Acute synovitis runs its 
course in ten or twelve days, causing much swelling and severe suffering 
on the slightest movement of the limb to which the joint is attached. The 
chronic form is commonly a continuation of the acute, and may itself 
result in softening and what is called pulpy degeneration of the synovial 
membrane. 

Treatment — The treatment of synovitis is by free leeching of the 
affected part; perfect rest in bed, with the limb elevated and secured in 
a splint if needful ; low diet with saline purgatives, such as epsom salts 
or seidlitz powders, and anodynes to relieve pain. In the chronic form 
small blisters and painting with tincture of iodine are likely to prove 
useful. Inflammation of the synovial structure of the joints is apt to take 
on a rheumatic, scrofulous or syphilitic character in persons who are con- 
stitutionally under the influence of these taints. In such instances the 
appropriate treatment for them, as already pointed out, is to be associated 
with that for ordinary synovitis. 

Ulceration of the cartilages may occur in a joint as a consequence of 



742 DISEASES OF THE BONES AND MUSCLES. 

long-continued inflammation, causing intense pain, and usually disabling 
the limb. Its liability to occur renders the prompt treatment of synovitis 
doubly important. 

Abscess (Coxalgia). — Abscess within a joint is rare in healthy per- 
sons, but in the scrofulous it is by no means uncommon, and in strumous 
children abscess in the hip- joint, causing the lamentably frequent affec- 
tion, coxalgia, is a malady of much importance. 

Treatment. — The general treatment in these sad cases is that already 
indicated for scrofula, but the local trouble should be immediately at- 
tended to by an experienced surgeon, and remedied as far as possible by 
the aid of the complicated apparatus devised for the purpose. 

Pott's Disease. — This consists of a tubercular inflammation of the 
bodies of the vertebrae or spinal bones, and their cartilages; and is most 
common in children between two and ten years of age, although it may 
occur at any age. In some cases the affection appears to follow a slight 
injury to the spine in those of tubercular or strumous tendencies, in others 
the disease develops without apparent exciting causes. 

Symptoms. — Rigidity of spine, tenderness and local pain are the 
prominent early symptoms. Abscess may occur early, but is most com- 
mon in the late stages. Deformity or spinal curvature usually occurs as 
a result of the disease process, depending upon the amount of breaking 
down in the bones and the falling together of the vertebrae, and may be 
gradual or rapid in its development. Treatment is as indicated in article 
on Coxalgia. 

THE MUSCULAR SYSTEM. 

Muscular Function. — The power which moves different parts of the 
frame, according to the directions of the will, as, for instance, the legs, in 
walking, is produced by the contraction of muscles. These muscles form 
the lean meat of animals and of the human body, and, except in very fat 
people, make up a larger portion of the bulk of the frame than any of its 
other constituents. 

Composition. — They are composed, as is readily seen in a piece of 
fresh beef or mutton, of long strings of reddish material, which, under, the 
microscope r are found to be made up of a multitude of fine, beaded 
threads, arranged in small bundles, and called the ultimate muscular 
fibres. They exercise power in moving the limbs, and so forth, by shorten- 
ing up or contracting when excited by the nervous fluid, sent to them 
through the nerves from the brain, as ordered to do so by the will. 



THE MUSCULAR SYSTEM. 743 

Mechanism. — The exact mechanism of moving the arm, for instance, 
by the process of contraction, may be easily understood from the picture 
shown on page 752, in which it is readily perceived that the shortening up 
of the muscle must pull up the hand, bending the arm at the elbow-joint, 
and changing the position from that represented in the second, to that 
shown, in the third figure. Precisely the same kind of operations accom- 
plish the motions of lifting the feet in walking or climbing, swinging the 
arm in throwing a ball, opening and shutting the mouth, and, indeed, of 
most of the voluntary movements of which we are capable. 

Voluntary and Involuntary. — But whilst many of the muscles are con- 
trolled by the will and are, therefore, called voluntary, many of them are 
not so ruled, and hence have received the name of involuntary. 

Most Important Involuntary Muscles — Among the most important of 
the involuntary muscles are the heart, the intercostal muscles, the muscles 
between the ribs which help to expand the lungs in respiration, and the 
muscular fibres of the alimentary canal, which aid in pushing along the 
food in digestion. Fortunate is it for us that such is the fact ; for other- 
wise, when our wills were off duty, as in sound sleep, the operations of 
these vital organs would stop, and life, which depends upon them, soon 
cease. 

Muscular Attachment. — The muscles are usually attached to the bones, 
and move them by sinews or tendons, which are made of white, fibrous 
tissue, the strongest and most flexible material in the body. These ten- 
dons are like long, round, white cords, such as may be seen in the lower 
part of the leg of a chicken. The largest tendon in the human body is 
that of the heel, called the tendon Achilles, which is the continuation of 
the big muscle of the calf of the leg. This powerful muscle is used in 
jumping and, since it acts at a great disadvantage, is necessarily very 
strong in order to be able to throw the entire body forward, as in making 
a leap. 

Origin and Insertion. — As a general, but by no means universal, rule, 
a muscle has one attachment which is fixed, commonly spoken of as its 
origin, and a second, called its insertion, upon which it acts by drawing it 
toward the origin when the muscular substance contracts. Muscles 
mostly pass in a straight line between their two attachments, but some- 
times they act around an angle by sliding over a pulley, or by means of 
a small bone in the tendon, like the knee-pan. The muscles are so attached 
that they are always slightly on the stretch, and thus, at the moment they 
begin to contract, they are in an advantageous position to bring their 



744 



DISEASES OF THE BONES AND MUSCLES. 



action to bear on the bones which they move. When the contraction 
ceases, the bones are drawn back to their former position without any 
sudden jerk. 

Muscular Leverage. — The muscles commonly act upon the bones as 
levers, by working upon the short arm of the lever, so that more direct 
force is required on the part of the muscle than there is weight in the 
body moved. From this arrangement, however, the indispensable advan- 
tage is gained that the small contraction of the muscle causes an extensive 
movement of the part acted upon, and much greater rapidity of motion is 
secured. Each of the three orders of levers is met with in the different 
bones of the human skeleton; often, indeed, all three varieties are found 
in the same joint, as for example, the elbow, where the simple flexion and 
extension of the biceps and triceps muscles, which are large, fleshy masses 
on the front and back of the arm, between the shoulder and elbow, afford 
excellent illustrations, as shown in the accompanying figure. 

Illustration of Leverage. — The arm is used as 
a lever of the first order when the triceps is caused 
to contract, and by pulling upon the upper end of 
the forearm moves the hand around l the elbow- 
/C^^tfW j 0in t 7 which serves as a fulcrum. This is shown in 

F $\^^ the upper diagram in which the hand is repre- 

rV sented as striking a blow with a dagger. 

Again the arm furnishes an example of a 
lever of the second order, when the hand resting 
on a point of support, such as a table, acts as the 
fulcrum, and the triceps muscle pulling on the 
upper end of the ulna or smaller arm bone, by 
straightening the arm lifts a weight placed upon 
*f tffo it in front of the elbow. 

Jll The third order of levers is exemplified by 

VI the arm when bent by the contraction of the bi- 

^ H g =fe ^5& cops in ordinary flexion of the elbow. Here the 

fjQI l1 muscle, which is the power, is placed between the 

fulcrum, which is the lower end of the humerus at 
Bon A3 Levels 5"SK Vree ine the elbow-joint, and the weight, which is lifted in 

the palm of the hand, as shown in the lower dia- 
gram. 
Number of Muscles.— The whole number of muscles in the human 
being is not far from five hundred, mostly arranged in pairs on opposite 





THE MUSCULAR SYSTEM. 



745 



sides of the head, body or limbs. It is, therefore, manifestly impossible 
to describe them all in detail here, and yet there are a few which are 
important enough to require notice. 

Important Muscles of the Face. — Among the muscles of the face should 
be mentioned those of the eye, six in number, four of which turn the eye- 
ball up or down, inward toward the nose or outward toward the temple, as 
becomes necessary to see an object distinctly. The muscles of expression 
are especially attached about the mouth, and produce their effects by puck- 
ering up the lips, as in whistling; drawing up the corners and widening 
the mouth, as in laughing ; pulling down its angles, as in weeping, and so 
forth. The masseter muscles placed inside the cheeks between the upper 
and lower jaws are very strong, and enable human beings to chew up some 
very hard articles of food in the operation of mastication, as has been 
already explained. — 

Flexor Muscles. — The action of the large muscle of the front of the 
arm, called the biceps or two-headed muscle, has been already described. 
The muscle of the forearm, which shut the fingers as in clasping the 
hand, are called the flexors, because they flex or bend the fingers. The 
tendons by which their power is conveyed may be readily felt on the inside 
of the wrist of a man who tries to shut his hand when the fingers are 
forcibly held open by another person. The forearm muscles which open 
out the fingers after the hand is closed, in doubling up the first for in- 
stance by the flexors, are called the extensors. The tendons of the ex- 
tensor muscles, when the latter are strongly contracted, show very dis- 
tinctly on the back of the hand, as straight, hard cords, running from the 
root of each finger to the middle of the wrist. 

Muscles of the Spinal Column — The spinal column is almost sur- 
rounded, except in front, by a thick mass of muscles, which gives the great 
strength required by many kinds of laborers, such as porters who carry 
heavy loads upon their backs. The muscles of the leg, which are needed 
in walking, running and jumping, are very large and strong, correspond- 
ing to the hard work they are called upon to perform. 

The Longest Muscle — The longest muscle in the body is the sartorious 
or tailor's muscle, which is so named because it helps to bend the lower 
limbs into the cross-legged posture so frequently adopted by tailors. It 
lies on the inside of the thigh, is thin and narrow, but sometimes measures 
over two feet in length. 

Intercostal Muscles. — The intercostals are flat, thin layers of muscular 
fibres, which extend from the lower edge of each rib, except the last pair, 



'46 



DISEASES OF THE BO^ES AND MUSCLES. 



to the upper margin of the rib next below. In this way they fill up all the 
spaces between the bars of the bony cage in which the lungs are contained, 
and, when they contract, pull up these bars or ribs so as to widen and 
deepen the cavity of the thorax, and so cause air to be drawn into the lungs. 

DISEASES OF THE MUSCLES. 
Inflammatory Disease — Inflammatory disease of the muscular system, 
except as it is connected with rheumatism or pyemia, is extremely un- 
common. When it occurs it is liable to go on to suppuration, and the for- 
mation of abscess. The pain is dull and aching rather than acute, and the 
disease is to be treated as already directed in speaking of the manage- 
ment of boils. 

Hypertrophy and Atrophy. — These occur in muscles and produce ef- 
fects important or otherwise, according to the position of the muscle in 
the animal economy. The most important hyper- 
trophy is that of the muscle composing the heart, the 
influence of which has been detailed in the article on 




valvular disease affecting this organ. 



Contractions.— Palsy and spasm in various forms 
have also been considered in the chapter on diseases 
of the nervous system, upon which these disturbances 
chiefly, thought not entirely, depend. 

Trichiniasis. — The most important disease of the 
muscular system not yet discussed is its infection 
with parasites,, and particularly with the trichina 
spiralis or pork worm, which, in consequence of the 
late embargoes upon American hams and bacon, has 
assumed a national or, indeed, an international im- 
portance. The great fatality in many cases of 
trichiniasis, as the malady produced by the trichina 
has been named, and the ease with which the whole 
trouble can be avoided by a proper understanding of 
the nature and origin of the affection, render a full 

account of the entire malady and its means of prevention singularly 

appropriate to a popular work like the present one. 

The Trichina Spiralis. — The trichina spiralis, which is next, perhaps, 

to the echinococcus, the most dangerous animal parasite infecting man, is 

found also in pigs, foxes, guinea-pigs, rats, cats, mice, marmots, polecats. 

badgers, and more rarely in some other animals, including the dog. A 



Trichina Spiralis 
Human Muscles. 



DISEASES OF THE MUSCLES. 



747 



physician of Philadelphia found that of ten cats which he dissected in 
1879 nine were infested with trichinae. 

Sources of Trichinae — Pigs, from which the human race is most apt 
to become diseased with trichina, are supposed to become themselves in- 
fected, chiefly from eating rats, the offal of other pigs, and the excreta 
of human beings containing trichinae. It is doubtful whether a single case 
of trichiniasis in man ever occurred where the patients became infected 
otherwise than by eating raw or underdone pork, and the most common 
sources of infection are sausages, ham and bacon. 

How Trichinae Breed. — If the trichinae existing in diseased pork are 
very young they may be simply digested, when they reach the human 

stomach, without being developed. 
But if the parasites have attained their 
fuller growth, the cysts which contain 
them are alone dissolved by the gastric 
juice, and the embyro is set free. 
These embryos, after they pass through 
the pylorus and duodenum, soon be- 
come mature, and their thread-like ap- 
pearance renders them quite easily 
recognizable by the naked eye. Count- 
less eggs are now discharged by the 
females, and in about a week's time 
the new brood of trichinae hatched out 
from these eggs begin to make their 
way to the muscles, either by boring 
their way through the soft tissues, or 
by being carried along by the current 
of blood in the blood-vessels, or per- 
haps by both of these methods of 
progression through the body. These 
larval trichinae attain their full size in 
about two weeks from the time they 
leave the egg. The males and females 
are each about one-thirtieth of an inch long and about one seven-hun- 
dredth of an inch broad. 

Effects of Trichinae. — In some few favorable cases severe gastro- 
intestinal inflammation is set up, and the parasites are violently expelled 
by diarrhoea, without being able to enter the muscles at all, so that if it 




Encysted Trichina More Highly Magnified 
Showing Structure of the Parasites. 



748 DISEASES OF THE BONES AND MUSCLES. 

were possible to detect the malady with certainty at this stage, nature 
thus suggests the appropriate treatment by drastic purgatives. In the 
majority of instances, however, the migration of immense numbers of 
larval trichinae from the intestinal canal takes place, and occupies in gen- 
eral about four days only. In this brief space of time even the most dis- 
tant muscles of the body may all be invaded. 

Symptoms. — Among the earlier symptoms of the trichina disease are a 
general feeling of debility and discomfort, and a loss of appetite, to which 
succeed nausea and vomiting, diarrhoea, prostration of strength, and a sen- 
sation of stiffness about the neck, arms and legs. These evidences of illness 
resemble, it will be observed, to a great extent, the first stage of typhoid 
fever, for which the cases are usually mistaken if there is no point in the 
history of the patient to suggest trichiniasis. The further progress of the 
parasites through the tissues sets up high fever, with frequent pulse and 
copious offensive perspirations, although the temperature of the body sel- 
dom or never reaches the elevation which characterizes that of typhoid. 
For some days the stiffness of the limbs seems to increase, while all the 
muscles become painful, swollen, and very sensitive to the touch. 

A Characteristic Sign. — About the end of the first week the attention 
of the attending physician is usually awakened (if it has not previously 
been aroused) to a suspicion of the trichina disease by the appearance of 
an edematous swelling of the eyelids and root of the nose. This is often 
the first characteristic sign of trichiniasis, and should be looked for at this 
period of the illness in all cases of supposed typhoid and rheumatic fever. 
During the second week movement of the intercostal muscles in respira- 
tion grows very painful, thus preventing to a great extent the necessary 
repose of the patient. If the diaphragm is invaded, severe hiccough is 
apt to come on, and when the larval trichinae commence to infest the 
laryngeal muscles hoarseness and loss of voice make their appearance. 

Cause Paralysis and Exhaustion. — When a large quantity of trichinous 
meat has been eaten, so that the immigration into the muscles of the 
afflicted patient is by millions, they soon cause an almost paralyzed con- 
dition, attended by excessive exhaustion. The facial edema continues 
through the second week, when it generally disappears, and is followed by 
swelling of the feet and legs, and ultimately of the trunk. At the end of 
the third week, if the patient survives to this period, the pulse and respira- 
tion are very frequent, the tongue is red and dry ; the mouth can scarcely 
be opened, the sweating is profuse, the pain so severe that little or no sleep 
can be obtained, and there is great anxiety or delirium, death frequently 



DISEASES OF THE MUSCLES. 



749 



occurring in the fourth or fifth week, with symptoms of profound ex- 
haustion. 

Complications. — Complications, such as pneumonia, peritonitis and 
pleurisy, are not uncommon, but in favorable cases when the number of 
trichinae is comparatively small, or the constitution of the patient un- 
usually vigorous, the pain, swelling and diarrhoea begin to abate, the op- 
pression of breathing passes off, the desire for food returns, sleep is ob- 
tained, and the anemic patient enters upon a slow and tedious con- 
valescence ; the parasites having become encysted within the muscles, these 
gradually become acclimated, as it were, to the presence of the foreign 
bodies, and slowly regain most or all of their original powers and 
functions. 

Further Symptoms — After piercing the fibrous 
sheath of the muscular fibre bundles, the embryonic 
trichinae become encysted within lemon-shaped capsules 
(generally one worm in each capsule), of a sort of con- 
nective tissue, in which they have some freedom of 
movement. After a time, these capsules, which, of 
course, are fixed to one spot in the muscle, become 
calcified, a process which occupies in man about two 
years. During this period there is often, for a time, in 
patients who recover, some loss of power, for a while 
almost complete, in muscles or groups of muscles; but 
not infrequently, after this stage is reached, entire re- 
covery ultimately seems to take place. Still, this in- 
fested condition of the muscle, which probably exists in 
thousands of people who walk about utterly unconscious of it, may be the 
yet undetermined cause of rheumatism and paralysis, or promote the 
development of consumption and other wasting diseases. 

Size of Mature Trichinae Spiralis. — The mature trichinae — the males 
being about one-eighteenth and the females about one-eighth of an inch 
long — live in the intestines for six or eight weeks. They never reach 
the soft tissues of the body, in which their young larvae are so abundant, 
but are discharged, from time to time, with the excreta of the patient, 
either alive or after their death has occurred. 

Discovery of Trichinae. — Trichinae, as well as cysticerci, were first dis- 
covered in human beings in the dissecting room, by Dr. Simon, in 1835. 
Professor Leidy was the first to detect them in the pig. They were* 
however, repeatedly observed without their true import being ascertained 
until 1860, when Dr. Zenker, of Dresden, explained their origin and 




Commencing 

Calcification 

of Trichina Cyst. 



50 



DISEASES <>K THE BOXES A.WD MESCEES. 



•elation to certain symptoms of obscure attacks of sickness, and described 
the disease trichinosis or trichuriasis. In the same year Leukart jmblished 
his elaborate and trustworthy investigations upon the subject of the 
trichina. Previous to 1860 the trichina had been identified only once in 
pork, although, as occurring in man, it had been well known for a quarter 
of a century. It is not decided how it will retain its vitality when encysted 
in human muscles. 

Remarkable Vitality of the Trichinae. — Professor Langenbeck, of Ber- 
lin, has reported a case where, in removing a tumor from the neck of a 
patient, eighteen years after the man had an attach of trichiniasis, which 
passed for poisoning at the time, he found living trichinae in the frag- 
ments of attached muscles; and it is stated on good 
authority that they have been known to exhibit signs 
of life after a still greater lapse of time. As in this 
instance, before Zenker's discovery, very many cases 
passed for poisoning, for- typhoid and rheumatic 
fever, and for other diseases. An epidemic involv- 
ing over five hundred persons in Blankenberg, Ger- 
many, was treated as an outbreak of gastro-rheumatic 
fever, and it was only several years afterward that 
the attention of one of the gentlemen who suffered 
from the disease being called to Zenker's discovery, 
he submitted to an operation for the removal of a 
small piece of one of his pectoral muscles, in which 
:ts cyst ell cvsted trichinae were detected, and the true nature 

ilcified. J 

of the disorder which had affected the five hundred 
patients many years previously was revealed for the first time. 

Epidemics of Trichiniasis. — In this country severe epidemics have 
occurred in New York, Mississippi and Iowa, and isolated cases are from 
time to time appearing in various other States. In 1875, it is stated, that 
there were some eighty cases of trichiniasis in Berlin, and about seventy- 
five near Hanover. A group of cases occurred in 1882 in Bridesburg, and 
another near New York. In 18 74 there was quite a severe epidemic in 
the family of a pork packer residing in Buffalo, New York. The disease 
is as rare in Prance as it is common throughout the German Empire. 

Vitalty of Trichinae After Death of Infected Hog. — In pork the 
trichinae may be found either encysted or naked among the muscular 
fibres. It is not certain how long they may live after the pig is killed, 
but they are known to be capable of propagation after remaining for 




Trichina and 
Completely Calci 



DISEASES OF THE MUSCLES. 



in 



one hundred days in putrid pork. The frequency of the disease in swine 
is probably as great, if not greater, in America than elsewhere; but here 
mankind is not so often infected, because less raw or under-done sausage, 
ham, bacon, and so forth, is eaten with us than in Europe. Of 1,394 hogs 
taken at random, and examined by the Chicago Academy of Sciences, 
twenty-eight were found to be infected with trichina?; but this large pro- 
portion can only be accounted for on the supposition that an epidemic 
among swine was then raging. 

Method of Detecting Trichinae. — The editor of the American Journal 
of Microscopy recommends that in examining the flesh of swine suspected 
of being infected with trichinae, the following method should be adopted : 
The parts of the animal to be first tested are the diaphragm, the tenderloin, 
and the muscles of the head and throat. In the ham, the most likely place 
to find the parasites is where the muscle ends in tendon. A thin slice 
should be cut off with a sharp scalpel, or with a pair of scissors curved on 
the flat. This thin section should then be soaked for some minutes in 
acetic acid, spread out on a glass slide, and covered with a thin glass in 
the ordinary way ; or, if the section happens to be very thick, a compres- 
sorium, in which the two plates of glass are forced 
together by means of a lever and screw, will be found 
very useful. 

A little instrument constructed on the plan of 
the compressor mm, and called a "trichinoscope," is 
sold to supply the popular demand for home pro- 
tection against trichinae. 

Infected Pork Should be Destroyed. — All pork 
which has been found to contain trichinae should be 
seized, condemned and destroyed, either by fire or 
by strong mineral acids, such as the sulphuric or 
nitric. Mere burying of poisonous meat of this kind 
is obviously not sufficient. Moreover, the question 

Human Muscle Containing d x 

calcified Trichinae. ag to whether owners of such carcasses should not 

(Natural Size.) 

be compensated for all property confiscated, is well 
worthy of consideration; because if such was the 

rule, butchers and dealers would have no inducement for concealment and 

fraudulent sale. 

Only Safe Rule. — In spite, however, of any apparently perfect system 

of inspection, such as that adopted in Germany, dangerous meat, from 

some cause or other, will necessarily escape observation, so that the only 




'52 DISEASES OF THE MUSCLES. 



THE MUSCULAR SYSTEM (See Adjoining Plate). 

The plate presents a comprehensive view of the front muscles of the 
body. They may be grouped and viewed thus : 

Head Muscles. — 1. These are seen above the eyes, and are used for 
elevating the upper eyelids and corrugating the forehead. 

Face Muscles. — 2. These are muscles of expression and mastication. 
Those about the eyes are used in winking and opening and shutting. Those 
seen at either side of the nose lift the cheeks and lips. Those at the 
sides control the lower jaw in eating. 

Neck Muscles. — 3. These serve to lower and raise the head and turn 
it from side to side. 

Shoulder Muscles. — i. These embrace the shoulders and upper arm. 
They are the great lifting and hitting muscles. The prominent one on 
the upper arm is the biceps muscle, or muscle with two heads. 

Muscles of Forearm. — 5. These control rotary, flexor and extensor 
motion, from the elbow to the wrist. 

Hand Muscles. — 6. These control all hand motions — opening and 
shutting, rotation, flexor and extensor movements. 

Chest Muscles — 7. These are radiating from sides to centre. They 
control the twisting, elevation and lowering of the upper part of the body. 

Abdominal Muscle. — 8. This is seen in the centre, in white. It is 
intimately connected with breathing and raising and lowering the dia- 
phragm. At its top is the solar plexus , the spot upon which prizefighters 
seek to deliver their knockout blows. 

Hip, Thigh and Leg Muscles. — 9. These powerful muscles cooperate 
for every kind of movement and exhibition of strength. The two strap- 
like muscles of the upper leg are the sartorial, or tailor's muscles, which 
enable us to cross our legs. 

Lower Leg Muscles. — 10. These are also powerful, and possessed of 
rotary, flexor and extensor power. They largely control the feet in walk- 
ing, operating clear to the ankle joint. 

Foot Muscle. — 11. These control from instep to toes, each toe having 
its elevating and depressing muscle. The rotary motion of the foot is 
imparted wholly from the ankle. 



DISEASES OF THE BOXES AND MUSCLES. 753 

safe rule for us to adopt, and to urge upon everybody else, is never to 
eat any pork which has not been thoroughly cooked. 

It is not safe to trust to pickling and smoking, even when these 
processes are combined, as is ordinarily the case, and it must be borne 
in mind that meat is seldom thoroughly cooked when cut in slices more 
than an inch thick. 

The fact that two dangerous and often fatal maladies like trichiniasis 
and cysticercus disease, both of which are generally beyond the reach 
of medical treatment when once they have infected the human system, 
are not infrequent from eating pork which has been imperfectly cooked, 
should render the employment of this culinary precaution in regard to 
all meats universal, especially as it is a safeguard so easily applied. , 

Myositis — This affection consists in an inflammation of the voluntary 
muscles, and may arise from injury to or overuse of a muscle, from 
gout or rheumatism, from secondary syphilis, or from infection followed 
by suppuration. 

Treatment — The treatment for injury or overuse of muscle is ab- 
solute rest of muscle and the local application of anodyne lotions. 

If due to rheumatism or syphilis, prompt relief will follow treatment 
appropriate to these affections. 

Degeneraton of Muscles — Fatty degeneration is occasionally observed 
in muscular tissue — in which the tissue is converted into a fatty granular- 
mass. 

Treatment. — By use of passive motion, massage and electricity to im- 
prove nutrition of the muscles. 

Ossification. — Ossification of a portion of a muscle, or more fre- 
quently of its point of insertion into a bone, is occasionally observed as 
a result of long-continued irritation. Its course is slow and unaffected by 
treatment. 

Tumors. — Muscles may be the seat of cancerous, syphilitic, vascular, 
cartilaginous or osseous growths. The treatment depends entirely upon 
their nature; non-malignant growths can often be removed by dissection; 
cancerous or malignant growths involving muscles of the extremities 
should be cut out or, as many cases call for, prompt amputation of the 
limb. 

4S 



PART XIII OF BOOK IV 

s 

Tells of the diseases to which children are particu- 
larly susceptible, giving the newest and most reliable 
treatments. 



Acute Infectious Diseases 757 

Acute Poliomyelitis 777 

Bed, Wetting of 775 

Chicken-pox 767 

Nursing in 768 

Treatment of 768 

Children, Diseases of 757 

Convulsions in Scarlet Fever 763 

Diphtheria 764, 768 

Diagnosis of 770 

Nursing in 770 

Symptoms of 769 

Treatment of 770 

Diseases of Children 757 

Eruption, Length of, in Measles 758 

German Measles 761 

Description of 761 

Infantile Paralysis 777 

How to Prevent Spread 779 

Infectious Diseases 757 

Measles 757 

Characteristics of 757 

Diagnosis of 758 

Description of 757 

German 761 

Length of Eruption 758 

Remarks Concerning ." 760 

Swollen Glands in 758 

Symptoms of 758 

Temperature in 758 

Treatment of 758 

Mumps 773 

Symptoms of 77s 



Nursing in Scarlet Fever 764 

Paralysis, Infantile 777 

Poliomyelitis, Acute 777 

Round-worms 776 

Treatment of 777 

Scarlet Fever 762 

Convulsions in 763 

Description of 762 

Diagnosis of 763 

Diet in 764 

Features of 763 

Nursing in 764 

Remarks Concerning 765 

Symptoms of 762 

Treatment of 764 

St. Vitus' Dance 774 

Nursing in 775 

Swollen Glands in Measles 758 

Tape Worms 776 

Treatment of 777 

Temperature in Measles 758 

Thread Worms 776 

Treatment of 777 

Urine, Incontinence of 775 

Wetting the Bed 775 

Whooping-cough 772 

Nursing in 77^ 

Symptoms of 772 

Treatment of 773 

Worms 77<\ 

Round 776 

Tape 776 

Thread 776 



ILLUSTRATIONS 

Chicken-pox 767 I Scarlet Fever 762 

Measles 758 I Scarlet Fever (Scarlatina) 762 

755 



CURATIVE MEDICINE 



PAET XIII. 
DISEASES OF CHILDREN 

Proneness of Children to Certain Diseases. — While the diseases inci- 
dent to those between three and fifteen years of age, which constitutes the 
period of childhood, are not confined exclusively to this time of life, and 
while they are few, if any, which may not occur also among infants or 
adults, children are particularly prone to the development of certain ail- 
ments which are rarely seen among those either older or younger. Many 
of the acute infectious diseases, such as scarlet fever, measles and chicken- 
pox belong more especially to this period, first, because children seem par- 
ticularly susceptible to them; and, second, because, as they reach an age 
when they begin to mingle with others, they become liable to exposure to 
contagion, and having once had them they become, as a rule, immune, or 
free from liability to their recurrence, from the well-known fact that most 
of these diseases generally occur only once in a lifetime. 

As these constitute a large proportion of what are ordinarily known 
as children's diseases, it will be appropriate to consider them first. 

ACUTE INFECTIOUS DISEASES 

MEASLES. 

General Description. — This disease, known also as morbilli and 
rubeola, is highly contagious, being conveyed not only by the touch and 
breath of the one affected, but also by infected articles and by a third per- 
son. Of all the contagious diseases it is the most liable to recur, there 
being sometimes, though not often, several attacks in the same person. 

Characteristics — It is characterized by fever, catarrhal symptoms and 
an eruption. Unless complicated by more serious ailments, such as 

(757) 



Y5S DISEASES OF CHILDREN. 

bronchitis, which is the most frequent, it is rarely fatal if malignant 
forms such as hemorrhagic and black measles be excepted. From ten 
lo twenty days elapse after exposure to contagion before the symptoms 
develop. 

Symptoms. — The ordinary symptoms of a cold in the head, with 
feverishness and often headache and nausea are usually first noticed, 
being accompanied or soon followed by cough. These persist with in- 
creasing fever until, usually on the fourth day, an eruption appears, 
beginning on the forehead, neck and face, and during the next twenty- 
four hours gradually extending over the entire surface of the body. It 
consists first of distinct, slightly raised red spots resembling flea-bites, 
which disappear momentarily on pressure; they gradually increase in size 
and sometimes join each other, becoming confluent and making continu- 
ous patches of dusky redness, between which healthy skin may be seen. 

An entire day before the eruption appears, examination of the inner 
surface of the cheeks will reveal the presence of bluish-white spots. 

Length, of Eruption. — The eruption remains at its height only about a 
day, when it begins to fade, and in two or three days it has entirely dis- 
appeared. To a less extent than in scarlet fever, desquamation of a fine 
branny character follows, more especially when the eruption has been in- 
tense. 

Temperature. — The temperature, which during the first few days con- 
tinues to rise, gradually declines when the eruption appears. 

Swollen Glands. — At the height of the disease the glands of the neck 
and the features are swollen, and the eyes are sensitive to light and af- 
fected with a profuse watery discharge which may become thicker. 

Diagnosis. — Measles may be mistaken for scarlet fever and for Ger- 
man measles. Its rash, however, is more blotchy and less uniform than 
that of the other diseases and does not appear as early as does that of 
scarlet fever. The catarrhal symptoms are more pronounced, while in 
scarlet fever sore throat is a prominent feature. 

Treatment. — 1. For the fever, from five to ten drops of sweet spirits 
of nitre in a teaspoonful of solution of acetate of ammonium, or simply 
in sweetened water, every two or three hours, will not only reduce the tem- 
perature but act on the skin and kidneys. 

2. If a laxative is needed give a half wineglassful of citrate of mag- 
nesia every half hour until the desired effect is produced. Or give one- 
twelfth of a grain of calomel every hour. This will be helpful also in 



MEASLES. 759 

settling the stomach if it is irritable, especially if combined with two 
grains of bicarbonate of soda. 

3. For diarrhoea, which sometimes occurs, give a teaspoonful of chalk 
mixture every two or three hours, with five or ten drops of paregoric and 
two or three grains of subnitrate of bismuth. 

4. For the inflamed eyes, bathe them with tepid water and drop into 
them every hour or two a few drops of a solution of twenty grains each 
of borax and boric acid and an ounce each of rose water and camphor 
water. The surface of the eyeball may be thoroughly cleansed with this 
solution, by gently separating the lids with the thumb and forefinger of 
the left hand and carefully expressing a medicine dropper full of the 
liquid into the corner of the eye. Before using it the liquid should in- 
variably be made lukewarm by immersing the bottle containing it in a 
vessel of warm water for a few minutes. 

5. The cough will be relieved by freely drinking flaxseed tea, with 
a little sugar and lemon juice, or by a half teaspoonful of brown mixture 
given every two hours. Camphorated oil may be applied to the chest 
every few hours, and a thin sheet of cotton wrapped around the chest to 
protect from liability to cold. If persistent, the cough may be benefited 
by the following, given in doses of a teaspoonful every two or three hours 
to a child from five to ten years old : 

Carbonate of ammonium 16 grains 

Chloride of ammonium 24 grains 

Syrup of wild cherry enough to make 3 ounces 

Or one-half teaspoonful of elix terpen hydrate and heroin every 2 or 
3 hours. 

6. During convalescence it is advisable to give some such recon- 
structive and tonic as syrup or solution of hypophosphites, a teaspoonful 
three times daily, or a like amount of a good extract of malt, with or 
without cod-liver oil. This will aid in the prevention of serious consti- 
tutional and pulmonary ailments which sometimes occur as sequels of 
this disease. 

Nursing. — The patient should be kept in bed and protected from 
exposure to cold, as the chief danger is from liability to bronchitis and 
pneumonia. Bathing the body with lukewarm water every few hours, 
uncovering only a small portion of the surface at a time, will add to com- 
fort and aid in reducing fever. The room should be kept darkened on 
account of the condition of the eyes. When the eruption appears to be 



760 DISEASES OF CHILDBED. 

delayed or does not come out well, warm baths and hot drinks should be 
employed. 

Diet. — Plain, simple, nutritious diet, such as is suited to all fever 
cases should be given. Milk and broths will be found useful as a founda- 
tion for other articles of food. 

General Remarks — Any case of measles should be treated as a serious 
disease, and is epecially dangerous to children under five years of age and 
those constitutionally weak. It kills usually by causing pneumonia, ab- 
scess of the lungs, or in the ear, and very frequently causes consumption. 
It injures the eyes, which is due to their covering membrane being in- 
flamed. Deafness is a frequent result, following abscess of the ear, which 
is noticed by the attendant as a yellowish discharge of pus (matter) run- 
ning from one or both ears. This abscess may cause inflammation of the 
membranes of the brain (meningitis) by breaking through the base of the 
brain, and may be fatal. 

It is a mistaken idea and a wrong one to purposely expose a child to 
measles hecause "they might as well contract it while young/' 

Measles is one of the most contagious diseases of childhood. ISTinety- 
eight per cent, out of every one hundred children who have not had 
measles will take it by coming in contact with another case. It is "catch- 
ing" four days before the "rash" or breaking out in the skin occurs, and 
remains so until the falling off of the bran-like skin flakes is completed, 
a total period of twenty-one days. 

The early symptoms of measles begin as an ordinary cold. The child 
coughs, sneezes, has a running nose, the eyes are red and injected, there 
is a slight fever, loss of appetite and general restlessness at night. Chil- 
dren attending school with these symptoms should be sent home, and if 
a general epidemic breaks out, it is better to close and disinfect the school. 

Every case of measles must be reported promptly to the Board of 
Health by the physician or guardian of the child. The neglect of parents 
to summon a physician on account of the expense or fear of quarantine 
and ignorance chiefly in regard to the dangers of measles, are main factors 
in causing the spread of epidemics. Children treated at home do get well 
without a physician, but the danger lies in the child being allowed to get 
up and go to school or play with other children before the time of "catch- 
ing" is over. Because your child has recovered rapidly is no reason why 
your neighbor's child should be exposed and possibly have a severe illness 
followed by pneumonia, abscess of the ear, deafness, etc., and death in 
many cases. 




/ 



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j 



E. J. S. 



MEASLES (Rubeola). 

Fifth and Sixth Days. 



GEKMAK" MEASLES. ?61 

All sufferers from measles should be removed to a room which can 
best be shut off from the rest of the house; carpets, curtains, necessary 
furniture and clothing should be removed. Kill all flies in the room and 
screen the windows and doors if necessary to keep others out. Lower 
the curtains to protect the patient's eyes from direct, bright light. Keep 
patient in bed continuously until all fever, cough and rash have disap- 
peared. Allow windows of room to remain open, but do not expose 
patient to draught. Fresh air will not hurt if child is warmly clad. Mem- 
bers of the family who have not had the measles should stay in the house. 
This is necessary, for they are liable to catch it at any time and give it to 
others before the rash appears. Adults who have had measles can go 
about their occupations, but must not go near the patient or attend 
churches, theatres or other public gatherings. School teachers should not 
attend school if measles is in their home. Children who have had measles 
may go to the homes of relatives if there are no children, and their person 
and clothing have been disinfected. They cannot attend school, how- 
ever, until fourteen days have elapsed and must not return or visit home 
until the room where the patient has been ill in, has been disinfected and 
the quarantine lifted. 

Dishes, etc., used by the patient must be dipped in a solution of 
chloride of lime before- being taken to the kitchen. One-half pound of 
lime to a pail of water is strong enough for disinfection. Napkins, towels, 
bed linen, etc., must be dipped in the above solution before being removed 
from the room. Remember it is cheaper and easier to follow the above 
precautions than to have another case in your own house, and is neces- 
sary to prevent your neighbors from contracting the disease. 

GERMAN MEASLES- 

General Description — German or French measles, known also as 
rotheln and rubella, is a contagious disease, usually mild in character, 
having as its main features fever and eruption. It resembles in some re- 
spects genuine measles. After exposure to contagion, from ten to twelve 
days elapse before the symptoms develop. 

Symptoms. — Frequently the first symptom, and always early in the 
course of the diseases, is the appearance of an eruption on the face, which 
during the first day spreads to the body and extremities. It consists of 
reddish spots, rather brighter than those of measles, which like those in 
that disease are somewhat raised and disappear on pressure. In the course 



762 DISEASES OE CHILDREN. 

of two or three days it fades away and is followed by slight branny des- 
quamation. Accompanying this are slight fever and mild catarrhal symp- 
toms, with quite frequently swelling of the glands of the neck. 

Diagnosis. — The diagnostic points to be observed are sufficiently noted 
in the section on measles to which the reader is referred. 

Treatment. — Karely is more treatment needed than the spirits of nitre, 
recommended for the fever of measles, and for the itching of the skin, 
which is sometimes an annoying symptom, the surface may be dusted 
with compound stearate of zinc- with menthol. 

Nursing and Diet of a special character is not needed. 

SCARLET FEVER. 

General Description. — Scarlet fever is one of the most serious of the 
acute infectious diseases of childhood, and is characterized by fever, erup- 
tion and sore throat. It is known also as scarlatina, a term often erro- 
neously understood to mean a mild form of the disease. Though dis- 
tinctly contagious it is not so markedly so as measles, but infected arti- 
cles of clothing, and so forth, retain the power to convey the disease for 
long periods of time. One attack generally protects from another, al- 
though exceptions to this rule occur. From three to twelve days, and 
sometimes more, elapse after exposure to contagion before the disease de- 
velops. 

Symptoms. — These are usually sudden in their onset. The child pre- 
viously apparently well or merely languid is without assignable cause 
seized with vomiting or has a chill. High fever, with the temperature 
ranging from 103 degrees to 105 degrees, rapidly supervenes, the face is 
flushed, the throat is inflamed and dry, the head aches and the tongue is 
somewhat coated, with red points projecting above the surrounding sur- 
face, somewhat resembling a strawberry in appearance. 

Usually on the following day a scarlet eruption appears, first on the 
chest, and extending rapidly over the body, being most marked in the 
flexures of the joints and where the surface of the skin is particularly sub- 
jected to pressure or heat. This redness may be quite uniform or may 
occur in patches, with intervening areas of healthy skin. On drawing the 
fingers quickly over the surface a white line appears, which is, however, 
replaced almost at once by the original efflorescence. On this red base are 
to be seen many distinct, bright, minute red points, and occasionally larger 
red spots. The inflamed surface occasions itching of varying intensity and 



SCAELET FEVER. 



763 



swelling of the skin. In the course of two or three days the eruption grad- 
ually fades, and with this the temperature declines. The outer layer of 
the skin now gradually peels off in flakes of variable size, the palms of the 
hands and the soles of the feet usually being the last to undergo this pro- 
cess. Until this has entirely ceased, and it may be prolonged to six or 
eight weeks, the danger of conveying the disease persists, inasmuch as the 
source of contagion lies largely, though not exclusively, in these particles 
of skin. 

Prominent Features of the Disease — Among the most pronounced fea- 
tures of the disease are the swollen glands of the neck and the inflamed 
condition of the throat, which may be so marked as to produce patches 
resembling those seen in diphtheria. These consist of a membranous exu- 
date which sometimes extends from the throat into the adjacent passages, 
causing serious complications. Among these is inflammation of the middle 
ear, with perforation of the ear drum, one of the most frequent causes of 
deafness. Frequently the kidneys become involved, acute inflammation of 
greater or less intensity occurring. Recovery from this, however, is usual. 

Convulsions. — Convulsions may be present either from the kidney 
complications or from profound impression on the nervous system by the 
poison of the disease. In the latter cases the disease assumes a malignant 
type, with excessive temperature, delirium, stupor and often diarrhoea and 
vomiting, as symptoms which rapidly lead to a fatal issue, sometimes 
within a few hours. On the other hand, cases occur which are so mild as to 
be scarcely recognizable as genuine scarlet fever, except from observation 
of a sequel and inquiry as to preceding circumstances. A physician, for 
instance, may be consulted for edema or dropsy of the extremities, indi- 
cating the existence of kidney affection, and on investigation may ascer- 
tain that a few weeks before the child had had a slight rash, followed by 
desquamation, without complaining sufficient to be kept in bed, and that 
there is a history of its having been exposed to the contagion. Such a 
record would justify the diagnosis of scarlet fever. 

Irregular Manifestations — Besides these variations from the usual 
type of the disease there are irregular manifestations, such as the hemor- 
rhagic form, and grave complications such as gangrene and heart disease, 
which cannot, however, within the limits of this article, receive more than 
passing mention. 

Diagnosis. — 1. Acute exfoliative dermatitis is a disease of the skin in 
which marked desquamation occurs, resembling in this particular scarlet 



Y&t DISEASES OF CHILDREN. 

fever. The throat symptoms, however, so significant of the latter disease, 
rarely occur, nor is the characteristic appearance of the tongue present. 

2. Measles — The throat symptoms instead of the catarrhal mani- 
festations; the sudden onset instead of the gradual development; the 
character of the eruption and the fact that it appears much earlier in 
scarlet fever, and the difference in the temperature record usually suffice 
to enable a diagnosis without much difficulty. 

3. German Measles. — This has already been discussed in connection 
with that disease. 

4. Diphtheria — From this disease it differs, in that the false mem- 
brane in the throat does not appear for a number of days after the begin- 
ning of the illness, whereas in diphtheria it is seen at once. The early ap- 
pearance and the characteristics of the eruption are also diagnostic points 
of value. 

Nursing. — A warm bath at the outset of the disease will promote 
the activity of the skin and aid in bringing out the eruption. Frequent 
sponging with lukewarm water throughout the attack is of advantage. 
When desquamation begins the surface of the body should daily be 
anointed with carbolized vaseline or other ointment oil to facilitate the 
process of scaling and to aid in preventing the small particles from be- 
coming scattered. Particular care should be exercised to gather all these 
and burn them. In order that all may be obtained a large sheet should 
be spread on the floor beneath the bed. The utmost caution should be 
observed to prevent the patient from taking cold, both during the attack 
and after convalescence is established, and for fully a week after the 
temperature is normal he should still be kept in bed. 

Diet. — Milk, broths and water may be freely given, and if the fever 
is high ice bags may be advantageously applied to the head. 

Treatment.— 1. For the throat symptoms, a spray of peroxide of 
hydrogen and water, equal parts, should be used ; or a saturated solution of 
chlorate of potash may be employed as a gargle. Cold applications to the 
neck are also useful. 

2. In severe cases stimulants may be required for the weak condi- 
tion of the heart. Half teaspoonful doses of whiskey, or ten-drop doses of 
aromaiic spirits of ammonia in water should in these cases be given every 
two hours. Drop doses of tincture of digitalis every three hours are also 
useful. 

3. In case the inflammation extends from the throat and involves, 



SCARLET EEVER. 765 

as it often does, the ear, the aid of a specialist in ear troubles will probably 
be required to save the patient from impairment of hearing. 

4. In inflammation of the kidneys, five grains of acetate or citrate of 
potash and a teaspoonful of infusion of digitalis every three hours will 
be proper for a child five years of age. 

5. The following is useful for the reduction of fever: 

Tincture of aconite 20 minims 

Solution of citrate of potash 3 ounces 

Give a teaspoonful in a little sweetened water every hour until the 
fever is reduced and the skin becomes moist. 

Another prescription is: Tincture of aconite root, 25 drops; salicylic 
acid, 1 drachm; syrup, 2 ounces. Teaspoonful every two or three hours. 
Or, tincture of iron in H\ T e to ten drop closes every four hours. 

The external use of fat, raw bacon is recommended in connection 
with which use a gargle composed of one teaspoonful of cayenne pepper, 
two teaspoonfuls of salt and half a pint of boiling water, to which, after 
straining, is added a pint of vinegar. Gargle the throat frequently with 
this mixture and adults may take one teaspoonful internally every hour, 
and children in proportionately smaller doses, according to age. 

General Remarks. — Scarlet fever is one of the most contagious dis- 
eases that attacks children and those of a run down constitution!. It is 
contagious in its mildest form and very often these mild cases are the 
ones which spread an epidemic, as they are overlooked by the guardians 
of the children and physicians unless very carefully examined, owing to 
the absence of the rash, the child simply complaining of sore throat, tired- 
ness and loss of appetite. The severest cases can develop by coming in 
contact with the mildest ones. 

Scarlet fever is one of the most dangerous diseases of childhood, owing 
to its after-effects. The common after-effects are inflammation of the 
kidneys (acute nephritis), heart disease, abscess of the ear, the glands of 
the neck, and joint affections. Deafness may follow an abscess of the 
ear. If the abscess breaks through the floor of the skull, inflammation of 
the coverings of brain occurs (Meningitis). 

A case of scarlet fever may develop in one to seven days after a child 
or adult has come in contact with a case. 

A person catches scarlet fever by taking in the germs that have been 
shed or discharged from the nose and throat of the patient having the 



766 DISEASES OF CHILDREN. 

disease. The germs are usually inhaled or taken in through a sore or cut 
surface on any part of the body. 

The early symptoms of scarlet fever consist of vomiting and fever, 
and older children and adults complain of sore throat. A normal case 
shows a rash which appears in from twelve to forty-eight hours. It is 
seen first on the neck and upper part of the chest as fine, bright red, pin- 
point spots, which spread to the face, arms, legs and body of a well- 
marked case. The child is fiery red in appearance (the so-called lobster 
appearance). High fever occurs, and a discharge from the nose is seen. 
The throat is red, the tonsils show whitish or dirty yellow spots; the 
tongue is coated and red spots present themselves through the gray coat 
(Raspberry Tongue). 

Every case of sore throat in a child should be considered serious, and 
a physician summoned at once to say whether it is scarlet fever or diph- 
theria. Do not allow a child with a sore throat to play with other chil- 
dren, attend school, Sunday-school included, until the diagnosis is settled. 
The spread of scarlet fever can be prevented by placing the patient in a 
room for a period of from five to eight weeks, depending upon the time of 
peeling, when the large pieces of skin are thrown off, and all discharges 
from the nose, ear, etc., end. 

All cases must be reported to the Board of Health by the physician 
or guardian in attendance. The custom of placing a sign on the front 
and bac& doors of a house where the patient is confined must be permitted ; 
it acts as a warning to others and must not be removed until done so by 
the health authorities. If the patient is not sent to a contagious hospital, 
he or she must be placed in a room away from the rest of the family. 
Wherever possible a trained nurse or attendant should be placed in the 
room and should not leave it until the quarantine is lifted. ~No one should 
be permitted to visit the room but the physician, who should be furnished 
with a gown to wear upon entering and taken off when leaving. The room 
must be screened and all living flies and insects destroyed. Carpets, 
curtains, clothing, hangings removed wherever possible. A sheet dipped 
in a solution of chloride of lime (one-half pound of chloride of lime to a 
pail of cold water) must be hung over the doors of the room. As the germs 
of the disease settle everywhere in the form of fine dust, the nurse should 
wipe off all surfaces in the room and the door-knob with a cloth moistened 
in the chloride of lime solution. The hair of the nurse or attendant 
should be completely covered by a covering of washable material and the 
outer garment by a long gown or slip. If it is absolutely necessary for 

















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CHICKEN-POX. 767 

the nurse or attendant to leave the sick room, she must leave her shoes 
and coverings in the room. Outside the room she must wash her hands in 
the chloride of lime solution. 

Dishes, napkins, bed linen should not he removed or washed until 
dipped in the chloride of lime solution, kept at the sick room door. Bowel 
movements or urine carried from the sick room should be wrapped in a 
towel wet in chloride of lime solution. 

The health authorities demand that no teacher or scholar living in 
the house at the time of the outbreak or during the course of the disease, 
shall attend school of any kind until permitted to do so by them. 

Milk jars cannot be returned to the milkman until they have been 
disinfected under the supervision of the Board of Health. The Board 
of Health will not disinfect or fumigate until the case is through peeling, 
all discharges have stopped and the patient recovered. Peeling may not 
occur from five to eight weeks. The danger of contagion during this 
period can be lessened by greasing the surface of the skin with lard or 
cocoa butter, which prevents the scales from blowing around the room. 
The nurse can hurry the peeling by gently peeling the large flakes of skin 
off when loose and collect them in a vessel to be treated with chloride of 
lime solution. 

When the room is ready for disinfection, do not take out the cloth- 
ing of nurse, patient, or gown worn by the doctor, bed linen, etc. Spread 
them out in order to allow the disinfectant to readily reach them. 

In case of death, the funeral is usually ordered held within thirty- 
six hours and must be private. 

CHICKEN-POX. 

General Consideration. — Chicken-pox or varicella is a contagious dis- 
ease having an eruption of vesicles. It generally occurs in children under 
six years of age, though it is sometimes seen in adults. One attack confers 
immunity from a recurrence in the same individual. From ten to seven- 
teen days elapse after exposure to the contagion before the symptoms 
develop. 

Symptoms — Often the appearance of the eruption is the most marked 
symptom, although there is also slight fever which may be accompanied by 
chills, vomiting, headache and pain in the back and legs. The eruption 



T6S DISEASES OF CHILDREN. 

comes out during the first day, usually appearing first on the chest or back, 
though sometimes on the forehead in the form of red spots. Later they 
are seen also on the extremities. They vary in number from one or two 
dozen to several hundred. 

In the course of a few hours the papular spots become vesicular, filled 
with a turbid liquid, and these by the end of a day or so begin to dry. 
Fresh crops during the few days following continue to appear, so that by 
the third or fourth day they may be seen in all stages of development.. 
Itching is often quite marked, and scars are apt to result if the patient is 
not prevented from scratching. 

Diagnosis. — Failure to distinguish this disease from mild cases of 
small-pox has not unfrequently occurred. In the latter disease, however, 
the eruption does not appear until the third or fourth day of the disease, 
and it is first seen on the face and forehead. The vesicles are not present 
until the fifth or sixth day ; they become depressed in the centre and by the 
eighth day become pustular, not beginning to dry until after this time. 
The eruption is not seen in different stages of development as in chicken- 
pox. It is quite frequent in small-pox also to observe in the beginning of 
the attacks rashes resembling those of scarlet fever and measles. 

Nursing and Treatment. — A mild laxative and a simple fever remedy 
are all that are required. Five drops of sweet spirits of nitre in a little 
water every hour, if the fever is marked, will be sufficient. Most cases re- 
quire no treatment except isolation. 

The following contagious diseases differ from those already con- 
sidered, in the fact that they occur without eruption, namely, diphtheria, 
whooping-cough and mumps. 

DIPHTHERIA. 

General Consideration — This is a highly contagious constitutional dis- 
ease, having a local manifestation in the form of a false membrane, which 
occurs either on the skin, or, more often, on the mucous membrane. Its 
usual locations are the throat, nose and larynx. The disease may be very 
mild or it may be extremely fatal. Different epidemics exhibit different 
degrees of virulence, and the cases occurring early in a given epidemic are 
usually the most severe. It is communicated by inoculation, by contact 
with the person affected, by means of the saliva, the pharyngeal secretions 
and portions of membrane ; by exposure to the poison of the disease 
through the agency of infected clothing, bedding, apartments, and so forth, 
and through foul emanations. Defective sanitary conditions favor its de- 






DIPHTHERIA. 



769 



velopment. Its occurrence is associated with the presence of a certain 
special germ which is supposed to be the cause of the disease. In some 
cases, however, the germ cannot be found; in others it is seen only early 
or only late in the disease; while again the germ may be found in the 
throats of those who present no constitutional or local symptoms of the 
affection. One attack does not confer immunity from another attack, and 
the symptoms develop from two to twelve days after exposure to the 
contagion. 

Symptoms. — The initial symptoms are those ordinarily attending a 
slight cold, such* as a feeling of fullness and irritation of the throat, accom- 
panied by moderate fever, chilliness and general lassitude. Although it 
may be delayed for a day or two, usually within a few hours, examination 
of the throat reveals on the tonsils the presence of a small whitish-gray 
patch or patches of fibrinous exudate or false membrane, which spread 
with greater or less rapidity, often involving the pharynx and nose, and 
extending downward to the larynx, and so forth. The color soon becomes 
dirty gray or yellowish. If the membrane is removed new membrane 
rapidly forms in its place. With the progress of the case, if it is severe, 
the constitutional symptoms become more marked ; the glands of the neck 
swell ; delirium and stupor may occur ; the heart becomes weak and there 
is every indication of profound blood poisoning. This may indeed be man- 
ifested quite early in the course of the disease. With these grave symp- 
toms it is not infrequent for the temperature to be but slightly raised or 
even subnormal. The presence of a thick membrane is not necessarily in- 
dicative of the existence of a grave case, for severe symptoms are quite 
as apt to occur when the membrane is thin. There may be considerable 
destruction of tissue from the sloughing membrane, giving rise to intense 
fetor. 

When the membrane involves the larynx an additional element of 
danger confronts the patient in the mechanical obstruction of the air 
passages. The breathing is harsh and rasping, the voice often suppressed 
to a whisper, a brazen, croupy cough develops, pallor of the countenance 
and lividity of the lips may supervene, the patient struggles for air and 
unless speedily relieved death from suffocation occurs. 

In the milder cases of tonsillar and pharyngeal diphtheria, after per- 
sisting for a few days, the membrane gradually disappears, coincident with 
which there is decided amelioration in the symptoms. Even in mild cases, 
paralysis of the muscles of the throat is quite apt to occur, causing diffi- 

40 



770 DISEASES OF CHILDREN. 

culty in swallowing liquids, which often regurgitate through the nose. 
Kenal complications sometimes occur. 

Diagnosis — Iu mild cases of diphtheria affecting the tonsils alone, 
it is difficult and sometimes impossible to distinguish them from cases of 
tonsillitis with exudation. As a rule, however, the thickness and gray 
color of the membrane, its tendency to spread, the glandular involvement 
and the general severity of the symptoms in diphtheria simplify the mat- 
ter of diagnosis. The presence of the Klebs-Loefner bacillus, the germ 
already alluded to, may be taken as confirmatory evidence of the disease. 

In the present state of knowledge it does not seem possible to dif- 
ferentiate with absolute certainty between membranous croup which is 
non-infectious in character and which is probably relatively infrequent, 
and diphtheria affecting the larynx. The absence of constitutional symp- 
toms and of local manifestations of diphtheria elsewhere, and inability 
to demonstrate the presence of the germ in portions of expectorated mem- 
brane are presumptive evidence of the non-contagiousness of the attack. 

Cases of diphtheria sometimes occur in which there is an erythe- 
matous rash which may lead to confusion in diagnosing them from 
scarlet fever. For the points of distinction the reader is referred to the 
article on the latter disease. 

Nursing. — The air of the room should be kept warm and moist, espe- 
cially where there is a tendency to laryngeal involvement. Fresh air 
should be freely admitted and disinfectants employed to keep it pure. 
Pieces of ice may be allowed for the patient to suck and cold applications 
be made to the throat. Liquid nourishment should be systematically given. 

Treatment. — 1. In severe cases whiskey should be given every two or 
three hours in teaspoonful doses to sustain the vital forces. 

2. The use of calomel and corrosive sublimate has its advocates, and 
while other plans of treatment are now more generally in use the benefit 
from their employment under suitable conditions seems incontrovertible. 
The writer has seen numerous cases in which the most violent symptoms, 
growing steadily worse, abated with surprising rapidity in response to the 
administration of from five to ten grains of calomel given hourly to a child 
until several characteristic movements of the bowels were produced. Cor- 
rosive sublimate in doses of about 1-100 grain have then been advantage- 
ously employed. 

3. The local employment of lactic Rcid. one drachm to three ounces 



WHOOPING-COUGH. 



771 



of lime-water, or of pancreatic extract, pepsin or vegetable pepsin, for the 
purpose of dissolving the membrane is advocated by some. Inasmuch, 
however, as the constitutional symptoms persist in spite of the removal 
of membrane and as its presence is usually not a menace to the patient 
the advantage of the practice is not apparent. It is of benefit, however, 
to use antiseptics locally. Peroxide of hydrogen diluted with an equal 
amount of water may be used as a spray every hour or two or weak 
solutions of formalin. 

4. Iron and chlorate of potash have long been used, both for their 
local effect and their constitutional action. A mixture of this sort is of 
benefit : 

Tincture of chloride of iron i%. drachms 

Chlorate of potash 48 grains 

Glycerine 4 drachms 

Water enough to make 3 ounces 

Dissolve, and give a teaspoonful every two hours. 

5. When the larynx is involved inhalations of the vapor of lime-water, 
especially in combination with liquor potassse in the proportion of one 
drachm of the latter to one pint of the former, aid in dissolving the 
membrane. A blanket should be suspended over the bed in such a way as 
to form a tent, beneath which should be used a croup kettle or steam 
atomizer containing the liquid. 

6. In cases which become progressively worse, and in which the signs 
of non-oxygenation of the blood indicate that death is imminent, tracheot- 
omy in which the trachea is cut open, or intubation, in which, without cut- 
ting, a tube is inserted into the larynx through the mouth, will often save 
life if resorted to sufficiently early. 

7. Tonics and reconstructives are needed in convalescence, and 
quinine, iron, arsenic and the hypophosphites, and the use of the most 
nutritious foods are indicated. 

8. Antitoxin. Within the last few years the use of antitoxin, both as 
a means of prevention and of treatment, has been warmly debated. While 
its enthusiasts favor its employment in every case presenting symptoms of 
diphtheria, without even waiting to establish a diagnosis, in case doubt 
as to the character of the ailment exists, the more conservative men in the 
profession, who still have faith in its utility and efficacy, believe that the 
field for its employment should probably be limited to cases which present 



772 DISEASES OF CHILDREN. 

methods of treatment. To procure good results, however, the remedy 
should be used as early as possible in all cases. 

The improved methods in the manufacture of this product and its 
increasing reliability are fast gaining advocates for its more universal 
adoption. 

In a child over two years of age from 1,000 to 1,500 units is the usual 
dose, or if the case is very severe, 2,000 units. The serum is very slowly 
injected beneath the skin, in the loose cellular tissue, preferably at the 
side of the abdomen, and allowed to be absorbed without friction. In 
from twelve to eighteen hours the dose is repeated if there is no improve- 
ment, and a third dose, usually of one-half the amount first used, may even 
be necessary. As an immunizing agent 1,000 units may be employed. The 
immunity conferred does not last a great while, probably less than thirty 
days, so that with new exposures, repeated immunization is necessary. 

# WHOOPING-COUGH. 

General Consideration. — Whooping-cough or pertussis is a contagious 
disease, mainly of childhood, characterized by catarrh of the air passages 
and a significant cough. It is communicable from person to person by the 
breath and bodily exhalations and by the agency of apartments which have 
become infected. It is not the harmless disease which it is so often re- 
garded as being, for aside from the deaths which result from the disease 
itself, there are very many which are indirectly traceable to it, owing to 
complications and the after-effects of the disease. 

Symptoms. — For a week or ten days these are the symptoms of an 
ordinary cold, with cough, slight fever, and so forth. The cough gradually 
increases in severity and assumes the spasmodic character which gives to 
the disease its name. The paroxysms consist of a series of short expulsive 
coughs, in which the child often becomes blue in the face and apparently 
on the verge of suffocation, when a long drawn, noisy, whooping inspiration 
occurs. Thick stringy mucus is expectorated, often with vomiting, and 
sometimes with hemorrhages from the nose, lungs and so forth. Several 
of the attacks may follow each other in close succession and then a respite 
of varying length occurs. After several weeks the paroxysms become less 
frequent and less violent, and finally cease, although for many months 
mild attacks may be induced by transient colds, crying, and so forth. 
While one attack usually confers immunity, it is frequent for other mem- 
bers of the family in which the disease occurs to be affected by a nervous 
cough, closely simulating the true disease. 



MUMPS. Y73 

Nursing. — Except in very severe cases, with complications, or where 
the patient becomes exhausted from loss of food, it is not necessary to 
confine him to the bed or the house. An abundance of fresh air is desir- 
able, although this must be secured without exposing other children to the 
danger of infection. 

Treatment. — 1. Inhalations by means of a steam atomizer or croup 
kettle, of medicated steam often afford relief to the paroxysms, limiting 
their frequency and severity. For this purpose carbolic acid, which may 
be advantageously combined with an alkali is recommended, as in the 
following formula, used by Dr. J. Lewis Smith, late of "New York, and 
Dr. John M. Keating, late of Philadelphia : 

Crystallized carbolic acid 3 grains 

Borax 20 grains 

Bicarbonate of soda 20 grains 

Glycerine 1 ounce 

Water 1 ounce 

Some of the crude coal tar products, such as cresol, have proved 
markedly beneficial by inhalation. 

2. Internally, belladonna has long been employed with a fair measure 
of success. For a child of five years, six or eight drops of the tincturte 
should be given night and morning, until the characteristic dryness of the 
throat is produced. 

3. Antipyrine in doses of three or four grains several times daily is 
often helpful, but must be given with care on account of its depressing 
effect on the heart. 

4. Bromide of potash, from three to five grains, every three hours is 
useful where the nervous element of the disease is prominent. 

5. Bromoform, a drop for each year of the child's age, given every 
three or four hours, is one of the most satisfactory of the more modern 
remedies. 

MUMPS. 

General Consideration. — Mumps, parotitis or parotiditis, is an infec- 
tious disease in which inflammation and swelling of the parotid gland 
occurs. Its symptoms develop from twelve to twenty-one days after 
exposure to the contagion. Unless complications occur, it is not a serious 
malady. 

Symptoms. — Slight fever, swelling and tenderness of the parotid, 
and sometimes submaxillary and sublingual glands, with or without pain, 



774 DISEASES OF CHILDREN. 

are the main symptoms. The swelling extends both in front of and 
behind the ear, and eating, swallowing and even speaking may be difficult. 
The secretion of saliva is at times increased, at others, diminished. 
Either one or both sides may be affected, and in the former cases the im- 
munity which is conferred by one attack is limited to the side which was 
involved. After lasting for a week or ten days, recovery rapidly takes 
place. Among the complications are the occurrence of orchitis and oc- 
casionally of mastitis. 

Nursing. — Care should be taken to avoid exposure to cold and the 
patient should be fed on liquid and soft foods. 

Treatment. — Nothing more than a mild laxative and a slight fever 
mixture is required. Either heat or cbld, whichever is most comfortable, 
may be applied, and an ointment of ichthyol and lanoline one part to 
four, or camphorated oil. 

MISCELLANEOUS DISEASES. 

In addition to the contagious diseases, both eruptive and non-erup- 
tive, are several which, though not confined exclusively to children, occur 
so often in them as to require consideration. 

ST. VITUS' DANCE. 

General Consideration. — St. Vitus' dance, or chorea, is a disease of the 
nervous system, characterized by involuntary and irregular muscular 
movements, without consciousness being suspended. There is a marked 
connection between this disease and the occurrence of acute rheumatic 
fever or inflammatory rheumatism and of endocarditis, or inflammation 
of the membrane lining the heart's cavities. It more frequently is seen 
in those having a pronounced nervous temperament and there appears 
often to be a family predisposition to the disease. 

Strong emotional occurrences, such as deep grief, fright, and so forth, 
are sometimes the exciting causes, as are also great nervous strain and 
mental application. 

Symptoms Every effort of the patient to perform a voluntary mus- 
cular act is attended by irregular spasmodic movements, over which he 
has no control, and the stronger the effort made, the more pronounced is 
this condition. The symptoms generally come on gradually, though some- 
times suddenly, beginning usually in the hands and arms and extending 
to the face and legs. One or both sides may be involved and the move- 



INCONTINENCE OF UBINE. 775 

ments may be general or confined to a few muscles. During sleep they 
are rarely continued. The disease may last for a few weeks only, or may 
persist in spite of treatment for many months or even years. It fre- 
quently recurs, especially in the spring of the year. 

Nursing. — 1. Rest in bed, quiet and separation from those members 
of the family who are not actually engaged in taking care of the patient 
should be secured. The general improvement of nutrition by means of 
good food and tonics should be aimed at and efforts made to overcome 
any impairment of the digestive function. After a few days of rest, which 
in very severe cases may have to be obtained by gentle restraint of the 
active muscles, massage and carefully regulated Swedish movement will 
be of advantage. Spraying the spine with ether is sometimes beneficial. 

2. Iron in assimilable form, as the peptonate, is useful. The ar- 
seniate of iron in doses of 1-100 of a grain or more three or four times a 
day is an eligible preparation. 

3. Arsenic in the form of Fowler's solution (liquor potassse ar- 
senitis) is more employed than any remedy. For a child of eight years 
five drops may be given in water three times a day after meals, and the 
amount increased until the constitutional effect is produced. 

4. Strychnine has also been employed in many cases with good re- 
sults. Beginning with a dose of 1-150 of a grain it may be increased 
until its physiological effects are noticeable. 

INCONTINENCE OF URINE (Wetting the Bed). 

General Considerations — Incontinence of urine or eneuresis is a dis- 
ease frequently occurring in children, both in acute and chronic form. 

Sometimes due to malformations of the bladder it is more often 
caused by irritation due to too great acidity of the urine, stone in the 
bladder, phimosis and the presence in the rectum of worms or of a fissure. 
Or it may be due to weakness of the muscles of the sphincter controlling 
the bladder, to their being in an irritable condition, or to an excessive se- 
cretion of urine. It is the form occurring at night with which we are 
particularly concerned. 

Treatment — Manifestly the treatment must depend on the condition 
present. 

1. Too great acidity is readily cured by administering liquor po- 
tassse (solution of potash) in five-drop doses every three hours in a wine- 
glassful of water, and continuing it for a while after the urine has become 
neutral or alkaline in reaction. 



776 DISEASES OF CHILDREN. 

2. Where there is too great contractile power of the muscles, bella- 
donna should be given in five-drop doses of the tincture, at bed-time, to 
a child of five years, to be increased if not productive of good results 
until pronounced dryness of the throat occurs. If it is beneficial it may 
have to be continued for some time to avoid a relapse. 

3. Where there is a lack of tone to the muscles, extract of nux vomica 
and ergot are often useful. 

4. An excessive amount of urine may be controlled by limiting the 
fluids taken before retiring for the night. 

5. The other causes of incontinence must receive their appropriate 
treatment. 

The following prescription is useful in many cases: 

R. — Tr. Belladonna i%. drachms 

Syrup ergota fid 3 drachms 

Syrup rhubarb i ounce 

Syrup q. s. ad 4 ounces 

A teaspoonful three or four times a day for a child of five and larger doses in 
proportion to the age. 

WORMS. 

General Considerations. — Several forms of worms infest the intestinal 
tract, the most common of which, in this country, are the "round worm/' 
"thread worm" and "tape worm." 

Round Worms. — The round worm or ascaris lumbricoids is reddish 
or yellowish-red in color and cylindrical in shape, with tapering extrem- 
ities, resembling somewhat the ordinary earthworm. From the intestinal 
canal it may travel to any part of the alimentary tract, and has been 
found in other parts of the body. They may occur singly or in large 
numbers. 

Thread Worms. — The thread worm, pin worm or oxyuris vermicular is 
is a small whitish worm inhabiting the rectum and colon. 

Tape Worm. — Of tape worms there are two kinds common in man, 
the taenia solium or pork tape worm and the tssnia saginata or beef tape 
worm. The latter is the larger, often being twenty or more feet in length. 
Its head is provided with "suckers," by means of which it adheres to the 
mucous membrane of the intestine ; the pork worm has also hooks which it 
inserts and secures a firmer hold. The entire body may be cast off, yet if 
the head remains a new body will grow in the course of a few months to 
as large a size as the first. The body is composed of small flat segments, 
appearing like a piece of tape marked into squares or oblongs. Separate 



INFANTILE PARALYSIS. 777 

segments or continuous ribbons of segments are often passed and are for a 
short time endowed with slight mobility. 

Symptoms. — Various nervous and digestive disturbances may be pro- 
duced by the presence of worms, or there may be no constitutional symp- 
toms whatever. The thread worm causes intense itching in the rectum, 
especially at night. 

Treatment. — 1. Round Worms. — Santonin, three grains, or given in 
divided doses, followed by a saline laxative or a dose of calomel, is one of 
the most satisfactory plans of treatment. It may need to be repeated on 
several successive days. 

2. Thread Worms — Santonin and laxatives are also useful in treating 
this form of worm. Injections of quassia and water (a handful to a 
quart), of salt water or of carbolic acid and water (ten grains to a pint) 
are also advisable. 

3. Tape Worm — For two days before beginning the treatment the 
diet should be light, and for a full day only milk with a little bread should 
be allowed. A laxative should be given, and on the following day a 
drachm or two of the oil of male fern, preferably in capsules. This 
should be followed in about two hours by a dose of castor oil or of citrate 
of magnesia. 

When the worm is passed careful examination should be made for 
the head. An infusion of pomegranate root, or its active principle pel- 
letierine, is also one of the best remedies known. Or three or four ounces 
of pumpkin seeds may be bruised, soaked for twelve hours in water, and 
the liquid, or preferably the entire preparation, taken at once. 

INFANTILE PARALYSIS (Epidemic Acute Poliomyelitis). 

Infantile paralysis is a disease which, no doubt, has existed un- 
recognized for centuries. It has spread throughout this country with 
great rapidity within the last ten years. It is highly contagious and its 
seriousness must be appreciated when we consider its high death rate of 
15 to 30 per cent, in recent epidemics which occurred in different States. 
The serious danger in contracting infantile paralysis lies in its leaving 
the patient in most cases, a hopeless paralytic and deformed, rendering 
them sometimes a helpless victim and a care upon their parents' or society. 
It makes its appearance suddenly and silently into a community and 
strikes down a playful and healthy child ; sometimes attacking adults, but 



778 DISEASES OE CHILDBED. 

it is considered essentially a disease of childhood. Thus in a few days or 
weeks numbers of healthy children will be afflicted and rendered per- 
manent paralytics or killed by the disease. 

Infantile paralysis is one of the most baffling diseases with which 
science and physicians have to deal, as its cause and transmission are not 
definitely known. It has been proven, however, that it is a germ disease 
by Dr. Flexner, of the Rockefeller Institute, Xew York, who has pro- 
duced the same symptoms of disease in monkeys by injecting into their 
brains and spinal cord an emulsion of a cord taken from a human or other 
animal that has died of the disease. The germ which causes infantile 
paralysis is evidently too minute to be seen by the present magnifying 
lens of the microscope. It is supposed that the disease is caught by com- 
ing in direct contact with a sufferer from the disease. Flies are con- 
sidered as a means of spreading the disease from one child to another. 
Dr. Pierson, of the Medical Corps of the United States Army, stationed 
at Fort Gibbon, Alaska, learned while treating some cases of epidemic 
acute poliomyelitis which occurred among the Indians during the sum- 
mer of 1913, that the epidemic had been preceded by a severe epidemic 
of "Distemper" among the Eskimo dogs, and these attacks of distemper 
resembled the symptoms which the Indians suffered from; furthermore, 
the dogs died in a day or two and were paralyzed in the legs. These facts 
led him to suggest that there is a possibility of the epidemic having started 
among the dogs and contracted by the Indians who live in a dirty state 
and in close contact with them. He also suggests that as the distemper 
occurred in the summer months, that flies may have carried the disease 
from the dogs to the Indians. The disease always disappeared when 
frost came and fly time was over. He also observed that white people 
whose dogs had distemper, did not contract infantile paralysis, due to 
the fact that their dogs did not live in close contact with them, were 
kept clean and the people lived in a sanitary manner with screened 
windows and very few flies about. Thus in time science may prove that 
dogs and other animals with distemper may be suffering from the same 
disease from which the epidemics of infantile paralysis develop in the 
human race. 

The symptoms of infantile paralysis show themselves without warn- 
ing in an apparently healthy child or adult. There may not be another 
case of the disease in the neighborhood or country, when suddenly the 
victim complains of headache, fever, nausea and vomiting, often rigidity 



INFANTILE PARALYSIS. 770 

of the neck and spine and pains in the arms and legs of varying intensity. 
If the patient doesn't die within two or three days, paralysis occurs in one 
to six days which involves the legs and the npper part of the body. The 
paralysis may clear up after recovery. As a rule, though, the child is 
left a permanent paralytic and helpless in one or more limbs, etc. This 
paralysis is due to the poison of the germ causing the disease affecting 
the brain, spinal cord and nerves to the muscles, etc., of the body. 

If a person is exposed to a case of infantile paralysis, it will be 
between two to ten days before they show symptoms of the disease. 

How to Prevent the Spread of Infantile Paralysis The guardian or 

parent of the child which shows any of the above symptoms of this fright- 
fully contagious disease must summon a physician who must notify the 
local health authorities. Place the child in a screened room away from 
other members of the family, secure a nurse or attendant and whenever 
possible move the patient to the Contagious Hospital, as this is too dan- 
gerous a disease to be treated at home. ~No one must enter or leave the 
room except the physician and he must wear a gown upon entering the 
room, protect his' hair with a suitable covering and remove them after 
leaving the room, and disinfect his hands in some disinfectant solution 
as bichloride of mercury (1 to 2,000) or carbolic acid (5 per cent.). The 
nurse must wear a cap and gown and change her clothes when leaving the 
room and disinfect her hands. All discharges from the patient must be 
collected and disinfected with chloride of lime solution (one-half pound 
to a pail of water), also all bed linen, clothing, dishes, etc., must be 
dipped in this solution before being taken to the kitchen and scalded. 

Hang a sheet over the door dipped in chloride of lime solution. Don't 
allow a fly or other insect to live in the room. Don't allow family pets to 
remain in the house. Chain them outside. Destroy all food from the 
patient's room. Don't allow anyone in the sick room but the physician, 
nurse or attendant. 

When the case has recovered, the Board of Health will disinfect the 
room. Be sure and leave all carpets, curtains, clothing, bed linen, nurse's 
clothes, etc., spread out upon chairs and tables so that the disinfectant 
can come in contact with them. 

Persons in the house must obey strictly the rules of quarantine and 
prevent the spread of this disease. They must not attend to business 
unless they bathe and wash their hair if exposed. Do not wear the clothes 
which were worn when in contact with the sufferer until fumigated by 



780 DISEASES OF CHILDREN. 

the Board of Health. Public places where numbers of people congre- 
gate, must be avoided. Milkmen must not remove bottles until told to 
do so by the Board of Health. . 

Remember, infantile paralysis occurs in the summer months. So 
kill all flies, and screen windows and doors. 



PART XIV OF BOOK IV 



Treats of the various diseases and conditions which 
may be treated surgically. It is, of course, merely 
descriptive, as under no circumstances but the most 
urgent, where a physician may not be obtained, 
should the layman attempt an- operation of any sort. 



Abscesses 802 

Acute 802 

Chronic 802 

Forms of 802 

Acetanilid 7&7 

Acute Inflammation 798 

Antipyretics 801 

Arm, Fracture of 807 

Astringents in Inflammation 800 

Bacillus of Tuberculosis 784 

Bacteria 783 

And Sunlight 784 

Growth of 784 

Bacteriology 783 

Bandaging 805 

Splints 807 

Bites of Insects 797 

Blood-vessels, Tying of 795 

Boils 803 

Boric Acid 787 

Broken Bones 804 

Setting of 805 

Carbolic Acid 786 

Carbuncle 803 

Cathartics for Inflammation 801 

Chemical Disinfection 786 

Chronic Inflammation 798 

Cleansing of Wounds 795 

Coccus of Erysipelas 785 

Contusions 789 

Counter-irritation 801 

Creolin 786 

Danger from Wounds 790 

Disinfection 7&6 

Chemical 786 

781 



Mechanical .' . 787 

Thermal 786 

Dislocations 808 

Symptoms of 808 

Drainage of Wounds 796 

Dressings for Wounds 789 

Dressing of Wounds 796 

Dry Heat for Intfammation 801 

Erysipelas, Coccus of 785 

Fainting Fit 794 

Felon 802 

Fomentation in Inflammation 800 

Foreign Bodies in Throat 809 

Fracture 804 

Kinds of 804 

of Arm 807 

of Legs 808 

Fractured Bones 804 

Furuncles 803 

Gangrene 803 

Germs 783 

Pus-producing 784 

Gun-shot Wounds 797 

Handkerchief, Substitute for Tourni- 
quet 793 

Healing of Wounds 790 

Hemorrhage 792 

Arm Artery, Pressure on 792 

Arrest of 791 

Collar Bone, Pressure on 793 

Controlled by Compression 792 

Handkerchief Treatment 793 

Thigh Artery, Pressure on 794 

Thigh Wounds 794 

Tourniquet 793 



'82 



IXDEX TO PART XIV OF BOOK IV. 



Spanish Windlass 793 

Wounds Below Knee 794 

Hernia 810 

Hygienic Measures 801 

Hydrophobia 798 

Treatment of 798 

Infection of Wounds 789 

Inflammation 798 

Acute 798 

Cathartics for 801 

Causes of 798 

Chronic 798 

Dry Heat for 801 

Fomentation in .*. . 800 

Hygienic Measures 801 

Massage Used in 800 

Poultices for 800 

Stimulants Used for 802 

Stupes for 800 

Treatment 799 

Injuries Far from Home 805 

Insect Bites 797 

Insect Stings • 797 

Iodoform 787 

Keeping Broken Bone in Place 805 

Legs, Fracture of 808 

Lock-jaw 784 

Lysol 786 

Massage for Inflammation 800 

Mechanical Disinfection 787 

Microbes 783 

Micro-organisms 783 

Mortification 803 

Operating Room 787 

Operation, Preparations for 787 

Poisoned Wounds 797 

Poultices for Inflammation 800 

Proud Flesh 791 



Punctured Wounds 797 

Pus-producing Germs 784 

Rabies 798 

Rupture 810 

Salt Solution 787 

Setting of Broken Bones 805 

Sick-room, The 801 

Snake Bites 797 

Sorbefacients in Inflammation 800 

Spanish Windlass 793 

Splints 807 

Sterilization 786 

Stimulants for Inflammation 802 

Stings of Insects 797 

Stupes for Inflammation 800 

Sunlight and Bacteria 784 

Surgical Diseases 783 

Thermal Disinfection 786 

Thigh Wounds 794 

Throat, Foreign Bodies in 809 

Tuberculosis Bacilli 784 

Tourniquet 793 

Ulcers 803 

Whitlow 802 

Wounds '. 789 

Below Knee 794 

Cleansing of 795 

Cleansing of 796 

Danger from 790 

Drainage of 796 

Dressings for 789 

Dressing of 796 

Gun-shot 797 

Healing of 790 

Infection of 789' 

Poisoned 797 

Punctured 797 

Yeast Germs 783 



ILLUSTRATIONS 



Application of a Bandage 805 

Artery of the Arm 793 

Bone Fractures 806 

Checking Hemorrhage in Hand or 

Wrist 794 

Course of Femoral Artery 795 



Dislocation of Lower Jaw 809 

Dressing for Broken Leg 808 

Fracture of Both Bones of Forearm.. 807 

Fracture of Humerus 808 

Main Artery of the Arm 793 



CURATIVE .MEDICINE 



PAKT XIV. 

SURGICAL DISEASES 

BACTERIOLOGY, INFLAMMATIONS, CONTUSIONS, WOUNDS, ETC. 

Bacteriology — Bacteriology is the science which treats of germs. 
Their discovery within a few decades has wrought a revolution in surgical 
treatment. E"o intelligent understanding can be had of the principles of 
surgery without at least some elementary knowledge of bacteriology. Tor 
its more complete discussion see the special article upon the subject. 

Micro-Organisms, Germs, Bacteria or Microbes are minute vegetable 
cells, most of which can be seen by the microscope only. They are widely 
distributed, being in the air we breathe, food, water, in the soil, on vege- 
table and animal matter either living or dead. They form a microscopic 
flora, a vast vegetable world, with varieties probably as innumerable as 
the vegetation with which we are so familiar. Some microbes when intro- 
duced into the system are non-disease producing, harmless. Others are 
pathogenic or disease producing, most virulent in their action. 

Yeasts include several species of germs, the action of which, in bread 
raising and in producing alcoholic fermentation, is familiar. They are, 
for the most part, harmless to the human system; one variety, however, 
grows upon the mucous membrane as thrush. 

Molds represent another class, familiar to us in their growth upon 
old leather and upon stale bread. 

Bacteria. — The sub-class of germs known as bacteria are the ones of 
chief interest to the surgeon. Of the three forms, coccus, berry-shaped or 
round ; bacillus, rod-shaped, and spirillum, corkscrew-shaped ; the latter 
plays no role in surgery. 

(783) 



784 SURGICAL DISEASES. 

Growth of Bacteria. — Bacteria may multiply with amazing rapidity. 
Under ideal conditions a single cell in one day will have sixteen million 
descendants, and in three days the mass of new cells would weigh 7,500 
tons. Multiplication is chiefly by subdivision, one cell dividing into two, 
the two into four and so on; or by "seeds," called spores. 

Soil for Bacteria. — They require a suitable substance or "soil." Some 
grow better upon living matter, others upon dead. Most of them are 
readily grown artificially upon the blood serum of an animal, a suggestion 
as to the favorableness of the human tissues for a soil. They need heat 
and require water. Most grow better when exposed to the oxygen of the 
air, but a few better when air is excluded. 

Lock-Jaw — The bacillus of tetanus or "lock-jaw," is one of the latter 
class. The dust of out-buildings, the soil of gardens are favorable places 
for the growth of the tetanus bacillus. "Rusty" nails are common about 
such places. A wound is received by such a nail. The patient possibly 
develops lock-jaw, not because (as is popularly believed) the nail was 
rusty, but because, among the minute particles of dirt upon the instrument 
were the germs of the disease. The depth of this small wound, the 
superficial tissues closing and excluding the air, thus give a most favorable 
nidus for the growth of the tetanus bacillus. 

Sunlight and Bacteria. — Sunlight antagonizes the growth of most 
germs. Temperature is a most important factor. The body temperature 
is a favorable one for many pathogenic germs. Freezing, or even a tem- 
perature of 200 degrees Fahrenheit below zero, does not kill bacteria, 
but only arrests their growth. Favorable temperature will again restore 
their activity. High temperature, on the contrary, destroys them. The 
Jewish idea of purification by fire was based upon a scientific fact. As a 
practical fact boiling water kills in a few minutes most disease-producing 
and death-dealing germs. 

Special Surgical Germs — There are quite a known number of germs 
which are particularly the surgeon's enemies. Such are the following: 

Pus-Producing Germs. — Pus-producing (pus being commonly called 
^matter") micro-organisms, of which there is a large variety of cocci, 
must always be reckoned with. It must be understood that pus can be 
formed only by the presence, growth and action upon the tissues of some 
of this variety of germs. The formation of pus is called suppuration ; the 
term purulent means pus-like or forming pus. 

The Bacillus of Tuberculosis forms "cold" abscesses, produces "white 
swelling," Pott's disease, scrofulous conditions, besides the dread disease 






GERMS OF DISEASE. 785 

of consumption of the lungs. There is not a tissue of the human body 
which it may not ravage. 

The Coccus of Erysipelas, the coccus of gonorrhea, the bacillus of 
tetanus, the bacillus of syphilis are common combatants of the surgeon. 

Introduction of Microbes into the System — A most important and 
practical question arises, How do disease-producing germs gain entrance 
into the living tissues ? We daily breathe, eat and drink germs and are 
clothed in them. All common objects, including clothing, coming in con- 
tact with the skin, deposit bacteria upon it, so that unless rendered free 
from them, by special means, there is no portion of the skin upon which 
they do not exist. Keen says that the hands of the bride at the altar are 
surgically filthy. 

Abundance of Germs. — Germs being plentiful in air, food and drink 
there is scarcely any portion of the lining or mucous membrane of the 
alimentary (food) canal or of the respiratory passages but what is in 
contact with them. Let the skin and mucous membrane be healthy and 
very few microbes enter the tissues; they are cast off harmlessly. But 
let there be inflammation or some unhealthy state of the surface, espe- 
cially some "raw" spot, though ever so little, a prick, a scratch, the 
slightest break of skin or mucous membrane and the door is wide open 
for the entrance of the host. 

Tissues that Assist Germs. — Providentially, certain tissue elements, 
notably the white blood cells and blood serum, have great capability of 
destroying germs which gain ingress into the system. "There is a battle 
royal between the invading host of germs on the one side and these 
defensive elements upon the other." If, for a time, the germs gain the 
ascendency, manufacturing their poisonous products, as they do, the 
subject is ill. Whenever the protective elements are conquerors the sub- 
ject remains unharmed — in health. If, for any reason, a person becomes 
debilitated, the germ killing power of the tissue cells is less vigorous ; 
if any portion of the body becomes injured this reduces the cell vitality 
at such site. The latter conditions thus render the tissues a favorable 
soil for germ growth. 

Definition of Terms. — A germicide or disinfectant is an agent fatal 
to bacteria. The destruction of germs in clothing, in excrement, in a 
wound, on the hands, and so forth, is called disinfection. Disinfection of 
a wound, dressings or instruments is called" sterilization. An antiseptic is 
an agent which retards or prevents the growth of germs. By sepsis or 
infection is commonly meant a condition in which disease-producing germs 
50 



786 SURGICAL DISEASES. 

are present, e. g., a septic or infected wound. Asepsis means, commonly, 
the absence of bacteria. 

Disinfection or Sterilization. — The paramount object of the surgeon in 
every operation to-day is to have the field of operation and all objects 
coming in contact with the wound as free from bacteria as may be — to do 
an aseptic operation. If the area of operation is already infected, for 
example, an abscess to be opened, he uses the antiseptic method. Three 
means of sterilization are available, as follows : 

1. Thermal Disinfection consists in the use of heat in the form of 
boiling water, steam or hot air. By this means everything concerned in 
an operation may be sterilized except the skin of the patient and the 
operator's hands. In a modern hospital special sterilizers are used in 
which dressings, towels, sheets, operating gowns and so forth, are sub- 
jected to steam under high pressure. These articles, wrapped in sheets 
or placed in sterile jars, are not disturbed until the time of operation and 
are then handled with sterile hands. As a practical fact, simple boiling 
for fifteen minutes is a most efficient method of sterilizing, and the one 
which is universally used for instruments. Any clean, flat pan may be 
used for boiling the instruments. A teaspoonful of cooking soda to the 
pint of water should be added. 

2. Chemical Disinfection. — Many chemicals will kill bacteria, but the 
most reliable and the one most common is bichloride of mercury or cor- 
rosive sublimate. (Bear in mind that it is a rank poison.) It is used in 
the strength of 1 part of the drug to 1,000, 2,000 or more of water. Seven 
and a half grains make, when added to a pint of water, a 1 to 1,000 
solution. It is put up in tablets, each one containing seven and a half 
grains, heedless to say, it is not used upon mucous or serous membranes 
except in very weak solutions (1 to 4,000 or more). It cannot be used 
for the sterilization of instruments as it corrodes all metallic substances. 

Carbolic Acid is valuable as a germicide in the strength of 1 to 40 
or 1 to 20 parts of water. In such strength of the solution instruments 
are sometimes placed during operation, and it is occasionally used in 
cleaning the skin. 

Creolin and Lysol may be used in one per cent, or two per cent, 
solutions upon the skin or instruments, but are chiefly employed in the 
former strength for vaginal and uterine douching. 

Hydrogen Peroxide is an excellent agent for cleansing infected wounds. 
The common form should be diluted one-half or two-thirds. It is most 
conveniently used with an atomizer. 



OPERATING ROOM. 



787 



Normal Salt Solution, made by adding a teaspoonful of table salt to 
each pint of water and boiling to sterilize, is mildly antiseptic in action. 
It is much used for flushing out cavities of the body, e. g., the abdomen 
where strong antiseptics are injurious. It is often used with great ad- 
vantage to cleanse large superficial wounds, such as burns or to saturate 
dressings applied wet. As a simple ready household remedy for cleans- 
ing wounds, gargling the throat, and so forth, it is frequently valuable. 

Boric Acid in a saturated solution (fifteen grains to the ounce of 
water) is mildly antiseptic and is very commonly employed for cleansing 
wounds of the mouth, nose, for washing the eye in inflammations. It is a 
useful remedy and may be employed freely with impunity upon the most 
delicate tissues. In the form of powder it is frequently, with good effect, 
applied to cuts or other wounds. 

Iodoform, in powder, is a valuable antiseptic and is much used for 
dusting purulent or suppurating areas. It is particularly useful in tuber- 
culosis foci. Cheesecloth impregnated with it is largely used for drain- 
ing wounds, keeping abscesses open, for packing cavities to arrest the 
oozing of blood. 

Acetanilid, a white powder, is a fair substitute for iodoform, except 
that it probably does not benefit tuberculous conditions and should be 
used with caution. 

3. Mechanical Disinfection — This consists practically of thorough 
washing with soap and warm sterile water. It will be described in detail 
under the next heading. 

Preparations for an Operation. — The patient should be prepared the 
day previous. Suggestions for such preparation are found in the chapter 
upon Anesthesia. A room for operation should contain as little as is 
essential for the necessities of the case. Some graver operations, such as 
those upon brain, lungs or abdominal cavity had much better be done in 
a hospital with all modern equipments and conveniences. However, the 
room of a private house may be rendered fit. 

A Fit Operating Room. — A room should be well lighted and ventilated 
and warm. The day before operation curtains, all hangings and carpets 
should be removed. The floor must be thoroughly scrubbed, the walls 
and ceiling brushed, or better, washed. Air, unless dust-laden, does not 
carry germs in sufficient numbers to infect the wound seriously. The 
room is to be well aired and dried. The day of operation a table (a 
kitchen table does well) is provided for the patient upon which are placed 



788 SURGICAL DISEASES. 

a folded comfortable or folded blankets. A rug or piece of carpet is 
spread beneath the table. 

Other Preparations. — Two or three other tables or stands are placed 
near for instruments, basins and dressings. Buckets for the slops should 
be placed near. Several gallons of water thoroughly boiled must be pro- 
vided. A portion should be hot, but much of it should be cooled by set- 
ting it aside in clean vessels under cover. A half dozen clean sheets 
and a dozen small towels should be at hand. A stove furnishes heat for 
boiling the pan containing instruments. 

The Surgeon's Preparation. — The surgeon and his assistants remove 
their coats and roll the sleeves above the elbows. The hands and arms are 
to be freed so far as possible from germs — to be disinfected. A common 
and good method is as follows: Trim the nails short, clean well under 
them, removing also any excess of skin at the roots. Scrub the hands and 
forearms very thoroughly for five minutes or more with hot sterile water 
and a good soap, such as castile. A nail brush must be used ; scrub very 
carefully about and under the nails and between the fingers. Give par- 
ticular care to the creases of the hands. The nails are again cleaned with 
a knife and the hands afterward scrubbed. The hands are now thor- 
oughly washed in plain sterile water and had better be dipped in alcohol 
for a few moments. The hands are last scrubbed for at least a minute in 
bichloride of mercury, 1 to 1,000, careful attention being given to the 
region of the nails. 

The surgeon and assistants now envelop themselves in sterile gowns 
and scrupulously avoid touching any object which had not been sterilized. 

The Assistant's Duty. — Meanwhile one assistant has sterilized the skin 
of the patient. The field of operation, including a wide area about the 
place of incision, should have been, the day before, shaved if hairy, ster- 
ilized, and meanwhile protected with sterile dressing. Whether so or 
not, the part, by the method used for the surgeon's hands, is disinfected 
immediately preceding operation. Sterile sheets and towels are now 
spread over the patient about the area of operation, leaving only a small 
portion exposed. With sterilized instruments and sponges (the latter 
preferably being a small strip of cheesecloth rolled into a mass) sterilized 
material for tying blood-vessels and suturing the wound, the surgeon is 
disappointed if he does not have an aseptic wound — one that heals readily 
without pus formation. In such an operation chemical antiseptics, which 
are irritant, are avoided. If, however, a purulent condition existed prior 
to operation, e. g., an abscess, chemical disinfectants, notably corrosive 



CONTUSIONS AND WOUNDS. 7'89 

sublimate solution, are, in addition to the former method, freely used, and 
the wound is probably left wide open for drainage of the pus. 

Infection of Wounds — Any wound accidentally received is infected, 
from the instrument wounding, from clothing, soil ground into it, in fact, 
anything coming in contact with it. One object of highest importance is 
the disinfection of such wound. For further discussion see Wounds. 

Tying and Sewing Wounds — For tying or ligating blood-vessels, silk 
or catgut, usually the latter, is used. For sewing or suturing a wound, cat- 
gut, silk, silk-worm gut, or silver wire are common. Catgut must be pre- 
pared by a special process. The other material is best sterilized by boil- 
ing. 

Dressings for Wounds — Dressings may be made of any material which 
readily absorbs wound fluids. Cheesecloth is best. This, together with 
gowns, sheets and towels is not readily prepared without special sterilizers. 
In emergency, however, after boiling, drying and wrapping them in sheets 
or towels they may be baked. Or clean unsterilizecl sheets and towels 
may be wrung out of bichloride of mercury solution and thus, damp, be 
put about the site of operation. Unsterilized dressings may be treated 
likewise, and so placed upon the wound. 

CONTUSIONS AND WOUNDS. 

Contusions. — By a contusion or bruise is meant the crushing or lacera- 
tion of tissues beneath the skin, the latter remaining unbroken. Blood is 
poured out into the injured tissue making it "black and blue." The ef- 
fused blood will, as a rule, be gradually absorbed and the injured tissue re- 
stored. Suppuration or gangrene rarely occurs. 

Symptoms. — The symptoms are swelling, tenderness, numbness, fol- 
lowed by aching pain. Discoloration sooner or later appears. Loss of 
function may occur, and, in severe contusions, shock may be great. 

Treatment. — If shock is present, reaction from it should be secured by 
rest in bed, stimulation and external heat. Rest and elevation of the 
injured part are of prime importance. Application of cold is indicated, 
except in very grave contusions, and in the feeble and aged. Heat, in- 
stead, is indicated in such cases. Compression by firm bandage is usefn"! 
for the arrest of hemorrhage and to antagonize swelling. 

Accessory Treatment. — The constitutional treatment is the same a? 
that for inflammation. Massage, liniments, applications of ichthyol oint- 
ment and motion are essential in the late stages of contusions. 



790 SURGICAL DISEASES. 

Wounds. — A wound is an injury in which there is a break or division 
of the tissues by some sudden force. In the sense here used, the term in- 
cludes tearing or dividing of the skin. Wounds comprise cuts, stabs, gun- 
shot wounds, bruised and torn wounds, poisoned wounds, and so forth. 

Danger from Wounds — The danger of a wound depends upon its depth 
and' size, and above all upon the importance of the underlying parts in- 
volved, such as arteries and nerves, or vital organs, such as the heart and 
lungs. Stabs and gunshot wounds are generally far more dangerous than 
would appear from their size, because they are apt to involve vital portions 
of the frame, and also because pieces of i:he weapon or of the bullet may 
be left remaining in the wound, as was the case with the lamented Presi- 
dent Garfield. 

Healing of Wounds. — The healing of wounds occurs in two ways : 

By First Intention. — In the first place, a wound may heal by primary 
union, or, as it is also called, union by the first intention, without the for- 
mation of any pus or matter, and leaving only a very line-like scar. This 
mode of healing should always be sought for, but can seldom be obtained, 
except under the following conditions, to wit : when the sides of the wound 
can be accurately fitted together, and are not subsequently displaced by 
bleeding or the exudation of matter, also when the wound is left quiet and 
protected from outward injury, and when it is kept free from impurity. 

Healing by Second Intention. — The second mode of healing takes 
place slowly, with suppuration and the formation of little rounded knobs, 
called granulations, all over the raw surface, and leaves a large, red scar, 
ultimately becoming dead white. This second and far inferior method 
of healing is observed when the favorable conditions just mentioned are 
absent, as for example, first, when so much of the skin has been destroyed 
that the edges of a wound cannot be brought together, as in wounds 
caused by cannon balls or shells, in scalp wounds from blunt instruments, 
or where the edges of wounds are so torn and bruised that their life is 
crushed out ; second, where the edges of wounds are separated after they 
were adjusted, by blood being effused, or by the formation of pus ; third, 
when the injured parts have been disturbed, as, for instance, in the leg, 
by standing or walking, or the hand and arm by working, and so forth ; 
or, if the wounded party has been badly transported from the scene of the 
accident ; or, lastly, when the wound was dirty and had not been properly 
cleansed or disinfected, because want of cleanliness leads directly to putre- 
faction and the formation of pus, and it is especially the matter formed in 



TREATMENT OF WOUNDS. 791 

the process of suppuration which separates the sides of wounds and pre- 
vents their healing by the first intention. 

Proud Flesh. — When the wound does begin to heal in the second and 
inferior method, granulations form, which are often called proud flesh, and 
are especially dreaded by ignorant persons as dangerous intruders into a 
sore. These granulations by degrees organize into a living tissue of great 
firmness, and after they have filled up the cavity of the wound to the 
level of the surrounding cutaneous surface, or sometimes a little above it, 
they cover themselves with epidermis and constitute a scar. 

Symptoms — The symptoms of a wound are constitutional and local. 
The constitutional or general effect of a serious wound is called shock. In 
shock, sudden depression of the vital powers occurs. There is general 
weakness; a faintness, with sometimes loss of consciousness; the pulse is 
feeble and rapid; skin pale, cold and clammy; the bodily temperature is 
lowered ; nausea with vomiting may occur. Loss of blood may be a strong 
factor in producing shock. 

Reaction from Shock — During and following the arrest of hemor- 
rhage, reaction from shock is to be sought by raising the feet and lowering 
the head; at least place the head flat, and the lower extremities quite as 
high as the head; wrap the patient in warm blankets and surround him 
with hot bottles, hot bricks and so forth. 

Stimulants. — A tablespoonful of whiskey or brandy may be given by 
mouth every half hour. An enema of black coffee one-quarter pint and 
whiskey two tablespoonfuls is excellent. Injections under the skin of 
whiskey, strychnine, digitalis, are invaluable. In the graver forms the in- 
jection of large quantities of warm normal salt solution beneath the skin, 
into the bowel or into the veins should be practiced. 

Local Symptoms. — These are hemorrhage, pain, loss of function and 
gaping of the wound edges. 

Treatment of Wounds. — The steps in treatment of a severe wound are 
given in order as follows: 

Arrest of Hemorrhage. — The fact that hemorrhage may readily prove 
fatal, or, as it is popularly phrased, the person may easily bleed to death, 
is so important that a detailed discussion is needful. Every wound bleeds, 
because in every wound blood-vessels are injured. But the kind of hemor- 
rhage, as well as its danger, varies with the size and the nature of the 
blood-vessels which have been divided. If the blood does not flow freely, 
but trickles from the wound, one may conclude that only small blood- 
vessels have been severed. When dark blood wells out in a steady stream, 



792 SUKGICAE DISEASES. 

and when the flow is increased by pressure above the injured spot, that is, 
nearer the heart of the patient, a large vein has been opened. Lastly, when 
bright, red jets spurt out of the wound, forcibly, and in jerks, an artery is 
divided and danger to life is great and inrrnediate. 

Smaller Wounds. — Unimportant hemorrhages from very minute ar- 
teries, and from veins of only moderate size, can generally be arrested by 
pressure upon the wound itself, or by pressing the sides of the cut against 
each other, or it may stop of its own accord in consequence of the mouths 
of the vessels contracting and the blood in the wound coagulating into a 
tough, viscid mass. 

Hemorrhage from an injured vein, as, for example, that from the 
giving way of a varicose vein in the leg, is sometimes difficult to check, on 
account of the pressure of some light article of clothing, such as a garter, 
above the bleeding point. On loosening this, slight pressure upon the 
wound and elevation of the foot above the level of the hip surface to arrest 
the bleeding. 

Control of Hemorrhage by Compression. — If, however, bright, red blood 
continues to flow, in spite of pressure over the wound, a large artery must 
have been injured, and speedy death from loss of blood must be appre- 
hended. In such instances, prompt aid is necessary, and a physician or 
surgeon should at once be sent for. 

Where to Place Pressure — Until he arrives any intelligent person can 
probably succeed in checking the flow of blood by making very firm pres- 
sure on the wound itself, if it is small, or on the trunk of the artery above 
the wound. The injured limb should be raised, as this lessens the force of 
the pulse in it, and, of course, the violence of the flow of blood. After cut- 
ting the clothing away from the source of hemorrhage, a folded piece of 
clean linen, or a pocket-handkerchief, should be laid on the wound, and 
fastened firmly down by means of a bandage or another handkerchief. 
But if, in spite of this, the blood still continues to run, the trunk of the 
artery between the heart and the wound must be sought for and firmly 
compressed by the fingers, the handle of a large key, or some other suitable 
object. In certain parts of the body the arteries lie so near the surface 
that they can be effectually compressed with the fingers. 

Pressure on Arm Artery. — In the upper part of the arm the main 
artery courses along the inner side, nearly in a line with the inner seam 
of the coat or dress sleeve, as is shown in the accompanying figure. By 
feeling along the place indicated by the dotted line, it is easy in any spare 
person to discover the strong pulsation of this large artery of the arm, or 



THE TOURNIQUET. 



793 




brachial artery, as it is technically called. The artery may be compressed 
in this position by placing a thick stick between the arm and the chest, 

and tying the arm tightly to the body, or by 
pressing the artery firmly against the bone 
of the arm with the thnmb, as shown in the 
illustration. 

Pressure at Collar Bone — Sometimes, 
when the wound is higher up on the arm, or 
in the arm-pit itself, it may be necessary to 
compress the artery at a point nearer the 
heart; and this can usually be accomplished 
by making pressure with the thumb or a big 
key, just behind the collar-bone, as is also 
indicated. 

The Spanish Windlass. — If it is found 
difficult to continue the application of force 
in these situations, or if the only person 

Diagram of Main Artery of the Arm. , , n ,1 re i -i . i 

present must leave the surrerer whilst he 
hurries off for assistance, the little device known by the name of the 
Spanish windlass should be resorted to. To apply this, take a large 
handkerchief and fold in it a rounded pebble about an inch in diameter, 
or any other smooth, hard body of similar size; fold the handkerchief 
cravat-shape, and tie it loosely about the limb, at the point where pres- 
sure is to be made upon the artery; and then, putting a stout stick 
beneath the loop, twist it around so as to tighten the handkerchief and 
bring a strong pressure upon the stone underneath the loop on the side 
opposite to the stick, which in its turn compresses the artery and stops the 
flow of blood. This is, of course, a much more painful, as it is a more 
powerful method than pressure by a bystander's thumb or finger; but in 
urgent cases it may be needful to call it into service in order to save life. 

The Tourniquet. — The Spanish windlass is a rough imitation of the 
surgical instrument called a tourniquet, which is far preferable as a means 
of arresting hemorrhage whenever it can be procured. As soon as a tour- 
niquet can be obtained, it should be substituted for the primitive and 
painful windlass, which, if continued several hours upon a limb, might 
itself lead to mortification of the part, and perhaps to a fatal result. 

Treatment With a Handkerchief. — In order to check bleeding from 
wounds in the arm below the elbow, or about the hand, where workmen 
of all kinds are particularly apt to receive injuries, take a large hand- 




704 SURGICAL DISEASES. 

kerchief, as before, and tie up in it a stone or a potato of the size of a 
walnut, or a simple, large, hard knot will perhaps answer the purpose. 
Then fasten it loosely about the arm, just above the elbow, as shown in 
the illustration, and bend up the forearm so as to make the knot press 
upon the large artery in its position in the hollow of the elbow, as in- 
dicated in the accompanying wood-cut. If the hemorrhage is found to be 
checked, the knot is in the right place at the bend 
of the elbow; but if blood continues to flow, 
straighten the arm, move the knot or stone a 
little, and try again. As soon as you find the 
flow of the blood is stopped, take another large 
handkerchief, or a strip of bandage, and fasten 
the wrist firmly to the shoulder, so as to keep up 
the life-saving pressure upon the blood-vessel at 

Method of Checking Hemorrhage 
the elbow. in the Hand or Wrist 

Wounds Below the Knee. — Hemorrhage from wounds of the leg, below 
the knee, or of the foot, such as are so often inflicted by the slipping of an 
axe or hatchet in chopping wood, may be controlled in a very similar way 
by tying a large pebble in a handkerchief, so as to make a knot the size of 
a turkey's egg, fitting it in the hollow of the knee, and then bending the 
leg up on the thigh in such a manner as to produce pressure upon the 
artery, on exactly the same principle as that displayed in the figure just 
above. When it is found that the knot is properly adjusted, so as to 
answer the purpose of arresting the flow of blood, the leg should bo 
secured in its doubled-up position in order to prevent a return of the 
hemorrhage, in consequence of the apparatus becoming displaced. 

Thigh Wounds. — For bleeding from wounds in the thigh, the artery 
must be compressed an inch or two below the middle of the groin, and 
about as far in front of the usual position of the inner seam of the 
pantaloons. The exact point is indicated by the marginal illustration, 
which shows very well the way in which the thumbs ought to be applied. 

Pressure on Thigh Artery — The femoral artery, or artery of the 
thigh, is so large and strong that its pulsation can usually be felt without 
much difficulty in thin or even moderately spare persons; and it is a 
good plan for every one to become acquainted, by examining his own body, 
with the location of this and other chief arteries. This point in the 
femoral artery is also a favorable one for making compression in bleed- 
ing wounds of the foot and log. 

Fainting Fit. — Tn whichever way bleeding from an important artery 



CLEAXSIXG of WOUXDS. 



Y95 



has been for the time checked, it must be remembered that it is very liable 
to burst out again the moment the pressure is relapsed or the obstruc- 
tion removed : also, that when a person faints from loss of blood the 

hemorrhage ceases whilst the heart is beating 
feebly in the fainting condition, and the blood may 
clot quite firmly in the mouths of the divided 
blood-vessels. When, however, the patient revives 
the renewed vigor of pulsation in the heart and 
arteries will generally drive out these recently- 
formed clots of blood, and the bleeding starts 
afresh with, perhaps, a speedily fatal result, if a 
most vigilant watch is not maintained over the 
wound. Where the hemorrhage is venous only, 
however, there is a good prospect that the clots of 
blood formed in the open mouths of the vessels 
will be able to resist the feebler pressure brought 
to bear upon them by the reviving circulation, 
and that bleeding will be effectually checked by 
the occurrence of the fainting fit. 

Tying of Blood-Vessels — In order to obtain 
primary union, it is necessary, in dressing a 
wound, to stop all hemorrhage. A surgeon grasps 
with forceps the end of any vessel that bleeds con- 
siderably, and before closing the wound ligatures or ties it. Sterilized 
catgut is best for ligatures, but silk, or even cotton thread that has been 
boiled, will answer. Simple twisting with forceps will arrest hemor- 
rhage of very small vessels, while oozing is generally controlled by pres- 
sure with compresses wrung out of water as hot as can be borne by the 
hand. 

Reaction from Shock. — See Shock. 

Cleansing of the Wound. — This includes the removal of both foreign 
matter visible to the eye, and the removal as well of microscopic germs 
which contaminate every accidental wound. Have at hand plenty of 
water and good soap. Scrub the wound and surrounding area thoroughly 
with soap, with scissors and forceps removing any visible foreign matter 
( splinters, bits of clothing, grains of dust or hopelessly damaged tissue). 
Wash with plain water and alcohol and irrigate with corrosive sublimate 
solution (1 to 1000). If the wound is of a hairy part, the area should be 




Course of ihe Femoral 
Artery. 



796 SURGICAL DISEASES. 

shaved. All blood clots should be removed and the wound left clean 
and dry. 

Provision for Drainage — Most accidental wounds, unless small and 
superficial, should be left partially open for drainage, so that infective 
material which it has not been possible to remove, may flow out. In such 
cases, a bit of rubber tubing may extend to the depth of the wound or a 
strip of iodoform gauze or plain sterile gauze may be gently inserted to 
the depth of the wound, one end of the strip protruding. A few strands 
of suture material well serves the purpose. 

Closing of the Wound. — Where confidence of thorough disinfection 
is felt, and the loss of tissue is not too great, the edges of the wound 
should be brought together and the tissues held in the relation they bore 
before injury. Sewing or suturing a wound is the best means to this end. 
Surgeons use special needles and a variety of suture materials : silk, silver, 
wire, silk-worm gut and specially prepared catgut. In an emergency, 
however, a large sewing needle and large-sized sewing thread, which have 
been boiled, may do good service. Interrupted stitches (each stitch tied 
separately) are usually the better. The edges of a superficial wound may 
be held together by strips of adhesive plaster placed outside of the dress- 
ing of the wound. Or, in slight cuts and abrasions, collodion painted 
over a bit of dressing is sometimes efficient. 

Dressing of the Wound — Any aseptic or antiseptic material which 
absorbs wound discharges freely, such as absorbent cotton, cheesecloth or 
even thin old muslin forms a good dressing. Sprinkling the wound freely 
with an antiseptic powder helps to prevent suppuration; dressings had 
better be applied moist, wrung out of bichloride of mercury solution (1 
to 2000). Plentiful dressings should be applied, sufficient to soak up the 
wound discharges and to protect from outside infection. A wound should 
be disturbed for dressing as seldom as possible. If the dressings become 
soaked with wound fluid, if there is much pain, or a rise of temperature 
indicates suppuration, the wound should be freshly dressed ; otherwise, the 
dressing should remain in place a week or ten days. 

Securing Best — In case of severe wounds, not only should the pa- 
tient rest in bed but absolute rest to the part should be secured. Com- 
pression by firm bandage, an easy position, fixation by splint or plaster 
dressing, support of the arm in a sling, these all give comfort and hasten 
healing of a wound. 

Constitutional Treatment. — General treatment should be according to 
the suggestions for the treatment of inflammation; in addition, watch for 



SNAKE BITES. 797 

suppuration, gangrene, erysipelas or tetanus. Temperature is a good 
index of the condition. 

Punctured Wounds. — Wounds made by sharp instruments (such as 
a dagger, a splinter, a fork prong, and so forth) have especial dangers, 
and require radical treatment. Foreign bodies are frequently left at 
the depth of such a narrow wound; the opening is small and readily 
closes, locking up infective material ; underlying organs of the abdomen, 
head or chest are liable to injury. Such wounds generally demand the 
attention of the skilled surgeon. He will usually probe for a foreign body 
and will generally open the wound to its depth, often incising it freely, in 
order to disinfect it properly and to allow for drainage. He will deter- 
mine whether underlying organs are injured and any treatment needed 
for such. 

Gun-shot Wounds. — The special dangers to be combated in gun-shot 
wounds are shock, hemorrhage and infection. Injury of vital organs 
is liable. In many cases it is better not to probe for a bullet. The ball 
should be searched for when it has surely carried in with it foreign bodies ; 
when it is in a vital organ, as the brain; and when its presence inter- 
feres with healing. 

Poisoned Wounds — Dissection wound is a term applied not only to 
wounds received by medical students and surgeons in their dissections, but 
to wounds sometimes received by butchers, cooks and fishdealers, who 
handle putrefying animal matter. Such wounds are particularly virulent. 
A wound of this character should be thoroughly washed, and the blood 
squeezed out of it. If a puncture, it should be freely opened and swabbed 
with pure carbolic acid, then washed with bichloride of mercury solution, 
and wet antiseptic dressing applied. Bites by animals should be so treated, 
the human bite being one of the worst. 

Stings and Bites of Insects. — For the more common and less poisonous 
wounds, applications of solutions of washing or cooking soda, ammonia 
water, iodine or lead-water and laudanum, give relief. The bite of a 
large spider or scorpion should be treated as a snake bite. 

Snake Bites — Copperheads, water-mocassins, rattlesnakes and vipers 
are the only poisonous snakes of the United States. We have a poisonous 
lizard known as the "Gila monster." A snake bite must be treated 
promptly and usually without proper appliances. When the bite is upon 
a limb, very tightly tie or twist a band or fillet around the extremity 
above the wound; several such bands are better. Cut out the wound at 
once, suck the wound, burn it with nitric or carbolic acid or heat. A 



798 SURGICAL DISEASES. 

hot iron is efficient; hunters may pour powder into the wound and apply 
a spark or lay a live coal upon it. Constitutionally stimulate freely 
with whiskey or brandy to sustain the system while it is ridding itself of 
the poison. Strychnine, ether and digitalis hypo dermic ally are valuable. 
The fillets should not be removed for some time, and then slowly, one at 
a time, the uppermost one first. 

Hydrophobia or Rabies — This is an infectious disease due to inocu- 
lation through a wound with the virus from a rabid animal. The animal 
may be a dog, a cat, a wolf, a fox or a horse. About 14 per cent, of the 
people bitten by mad animals develop the disease and die. 

Treatment of Hydrophobia — When a person is bitten by a supposed 
rabid animal and is seen soon after the injury, firm constriction of the 
part above the wound should be made, the wounded area should be freely 
cut out, burned with a hot iron or nitric acid and dressed with wet anti- 
septic dressing. If the patient is not seen within a few hours of the 
injury, cauterization will do no good. In any case, send the patient to a 
Pasteur Institute for preventive treatment. If the animal causing the 
wound was not rabid, treatment will do no harm; if it was mad, treat- 
ment will probably save the patient. 

INFLAMMATION. 

Definition. — Inflammation is defined as "the changes which occur in 
living tissue when it is injured, provided that the injury is not of such a 
degree as at once to destroy its life." Inflammation may end in return of 
the tissues to complete or partial health, or in their death. 

Causes of Inflammation — The causes of inflammation are predispos- 
ing and exciting. Predisposing causes are such as are present in the 
tissues and render them liable to inflame; any affection or indulgence 
which impairs the health or weakens the system is a strong predisposing 
cause. Exciting causes are injuries; for example, blows, falls, crushes, 
burns, and so forth. 

Symptoms of Acute Inflammation. — Symptoms are general or constitu- 
tional and local. The former are manifested chiefly as fever. The latter 
in an organ or a part, as heat, swelling, pain, discoloration and disordered 
action or function. Constitutional symptoms of acute inflammation may 
be absent, but in severe cases they are sure to occur, forming the symptom 
group known as fever — symptomatic or inflammatory fever. 

Chronic Inflammation. — This condition is gradual in onset and prog- 
ress. There are no constitutional symptoms due directly to the inflamma- 



INFLAMMATION. 799 

tion. As to local symptoms, there is pain, varying in degree and character ; 
swelling is often great ; function is more or less interfered with ; heat and 
discoloration are rare. 

Treatment of Acute Inflammation. — The prime rule of treatment is 
first to remove the exciting cause. If it be a splinter, pull it out ; if drink 
or indigestible food is inflaming the stomach, stop it; scrape out diseased 
bone, clean out the germs from an infected wound. Further treatment 
should be both local and constitutional. 

Local Treatment of Inflammation — Two agents are suited to the treat- 
ment of both the early and the late stages of an inflammation, namely, 
elevation and rest. Elevation combats engorgement of the part. A 
sprained ankle is more comfortable if put on a level equal with or higher 
than the body. Rest is of utmost importance. Rest of the patient in bed 
should be insisted upon in every severe inflammation. Rest to an in- 
flamed part is secured by various means. The partial, or better, the com- 
plete cessation of the usual action or function of an organ, is desirable. To 
an inflamed eye, rest is secured by dark glasses, a darkened room, or a 
pad to exclude the light; to a sprained joint, by an easy position and fixing 
it on a splint, or hanging the arm in a sling. 

Other Treatments. — In the early stage of an inflammation, when the 
vessels are engorged, local bleeding and cold are valuable agents. Local 
blood-letting is done by cutting, leeching or cupping. Neither of these 
should be done except under the intelligent guidance of a physician. 

Cold is highly valuable if used wisely; it is not to be used after the 
early stages, not to be too long continued or too intense ; it should usually 
not be used with the very aged or very feeble. 

Wet cold or dry cold may be employed. Wet cold is obtained by vari- 
ous fluids; ice water or water mixed with one-fourth the quantity of 
alcohol is good. One of the most common and best applications is lead 
water and laudanum. It is composed of one ounce of laudanum, one or 
two ounces of Goulard's extract, and one part water. A few layers of 
muslin or cheesecloth should be kept upon the part and should be fre- 
quently wet with the fluid. 

Dry cold is generally safer, more easily applied, more comfortable. 
Cracked ice is put into a rubber ice-bag or bladder, or wrapped in a piece 
of flannel, and so applied, several folds of flannel first being placed over 
the part. The immediate application of an ice-bag to a sprained joint is 
excellent treatment. In all applications of cold the part must be carefully 
watched to guard against too great interference with the circulation. 



800 SURGICAL DISEASES. 

Treatment in Later Stages — Treatment in the later stages of an in- 
flammation is directed toward promoting a reabsorption of the material 
which has been poured out, a clearing np of the wreckage. This is accom- 
plished by compression, the application of astringents and sorbefacients, 
massage and heat. 

Compression. — Compression is usually obtained by the firm applica- 
tion of a bandage. It should never be forcible, and if applied to a limb, 
should always include the distal extremity, e. g., the elbow or wrist should 
not be firmly bandaged without including the hand and all the part below 
the affected area. 

Astringents and Sorbefacients — Lead water and laudanum, before 
mentioned, has an astringent effect. Tincture of iodine diluted with from 
one to three parts of alcohol, painted from time to time over an inflamed 
area, is often useful. Ichthyol ointment is very excellent in inflammatory 
swellings. It is rubbed well into the part or applied upon a cloth. It 
is best prepared by mixing one part of ichthyol with one to three parts 
of lanolin. Mercurial or blue ointment is used in much the same way 
as is ichthyol ointment. 

Massage — Massage is a systematic rubbing and manipulation after 
the acute symptoms have subsided. Motion and massage prevent stiff- 
ness, promote circulation and absorption, and bring tone and health to a 
part. 

Heat. — Heat, either moist or dry, may do good and should generally 
be substituted for cold after a day or two. It then commonly gives 
greater comfort, relieving pain. Heat may be applied by fomentations, 
poultices, water bath or douche, and dry heat. 

Fomentation. — Fomentation is the application to the skin of a piece 
of flannel wrung out of a hot liquid, usually water, as hot as can be 
borne. It is covered by a rubber-dam, oiled silk, or waxed paper ; cotton 
should be placed outside the latter and the whole held in place by a 
bandage. A hot water bag placed over the bandage is useful. 

Stupes. — The turpentine stupe is made as above by sprinkling upon 
the wet flannel from ten to twenty drops of turpentine. 

Poultices — A poultice is a soft mass applied to a part to bring heat 
and moisture to bear upon it. Poultices may be of flaxseed, arrowroot, 
starch, bread and milk, and so forth. A poultice should be applied in 
thickness of half an inch, should be covered with rubber-dam, waxed paper 
or oiled silk and over laid by a hot-water bag. It should be removed before 
it cools, another being ready to apply at once. Where suppuration is 



HYGIENIC MEASURES. 801 

threatened or exists time is often wasted and suffering prolonged by con- 
tinued poulticing. This great blunder is common with the laity. In such 
a case, free opening by incision cannot be done too quickly. 

Dry Heat. — Dry heat can be easily applied with the hot-water bag, 
a bag of hot sand or meal, a hot plate or bottle. 

Counter-Irritation. — By counter-irritation we mean the use of some 
irritant upon a surface, thus attracting an increased quantity of blood and 
relieving thereby inflammation of a deeper structure. Blisters, mustard 
plasters, turpentine stupes, tincture of iodine, liniments, and so forth, 
are so used. 

Constitutional Treatment — General treatment may include general 
bleeding, circulatory sedatives, diaphoretics, diuretics, anodynes, anti- 
pyretics, stimulants and tonics. Hygienic measures are invariably de- 
manded, cathartics are usually indicated. 

Cathartics. — One of the first essentials in beginning inflammation, is 
free movement of the bowels. If this has not occurred spontaneously, one 
of several purgatives may be given. Calomel is often invaluable. It may 
be given in doses of one-tenth to one-fourth of a grain, repeated every 
hour until a grain or more is taken, or be given in one large dose of one 
to three grains. It may have to be followed by castor oil or epsom or 
rochelle salt. Either of the latter is sometimes excellent alone, a tea- 
spoonful of each or of both being given every hour until a movement 
occurs. A bowel injection or enema composed of glycerine one ounce, 
epsom salt one ounce, and enough soapsuds to make a pint is often helpful. 

Hygienic Measures. — These are of the utmost importance. Diet 
should be nutritious and easily digested. Milk is the ideal food. If 
peptonized it is more readily digested. Fermented milk known as koumiss, 
is excellent. Meat juice is highly nutritious. Meat broths are stimulat- 
ing but do not contain a large quantity of nutriment. Soups strained and 
skimmed may be borne. As a patient grows better, he may take soft eggs ? 
custard, junket, rice pudding, milk toast, boiled chops, oysters, and so 
forth. 

The Sick Room. — The sick room should be bright and well ventilated. 
The temperature 68 degrees Fahrenheit. Bed clothing should be clean, 
the patient should be sponged daily for cleanliness and to keep the skin 
active. A little alcohol added to the water makes a grateful sponge bath. 

Antipyretics. — Antipyretics are agents reducing temperature. If 
fever is excessive, it is best lowered by cooling drinks and the application 
51 



g02 SURGICAL DISEASES. 

of cold to the surface. The latter is most usually accomplished by ice- 
bags, by cold sponging or cold pack. 

Stimulants. — In low, long-continued inflammatory fever, some form 
of alcohol is most essential. It should, however, be given under the 
direction of a physician only. 

ABSCESSES, BOILS. 

Abscess. — An abscess is a newly formed circumscribed cavity con- 
taining pus. This new cavity is formed by the liquefying action of the 
bacteria upon the tissues. 

Forms of Abscesses. — The general classes of abscesses are acute, fol- 
lowing an inflammation, and that variously called chronic, cold, strumous 
or tubercular. The latter form is due to the bacillus of tuberculosis, and 
does not contain true pus. 

Acute Abscess. — As soon as it is determined that an inflammation has 
gone to suppuration, free opening should be made. After free opening 
and evacuation, an abscess cavity should usually be irrigated by an anti- 
septic fluid. If free opening has been made, hydrogen peroxide is ex- 
cellent for cleansing. This should be followed (unless abscess be of an in- 
ternal organ) by corrosive sublimate solution (1 to 1,000 or 2,000). 
Drainage by tube or otherwise should be provided and hot moist antiseptic 
dressings applied. Rest promotes healing. This is obtained by bandages, 
splints, slings, and so forth. 

Chronic Abscess — The tubercular cold, scrofulous, or so-called chronic 
abscess, is a cavity produced by the action of the bacilli of tubercle. ~No 
true pus is present unless pus organisms have also gained entrance. A 
cold abscess lacks inflammatory signs. There may be no constitutional 
symptom unless true suppuration is added. The general health of the 
patient is, however, invariably below normal. 

Treatment of cold abscesses is upon the general principles for the 
treatment of acute abscess, but should be trusted to none but a surgeon. 

Felon or Whitlow. — This is a violent rapidly-spreading inflammation 
of a finger or toe, usually the former, due to pus germs. The symptoms 
are throbbing pain, great tenderness, swelling, a dusky redness. In case 
of a deep felon redness and pain may extend up the arm, and there is 
usually fever. 

Treatment. — Rarely the application or iodine, cold, rest and elevation 
may afford relief. Generally, however, such treatment is worse than use- 



BOILS AND CARBUNCLES. 803 

less. Early free incision is very generally the only effective procedure. 
Incision, irrigation, antiseptic fomentations, and splinting, with elevation 
of the extremity, is the outline of treatment. 

Boils or Furuncles. — This is the most common form of superficial 
abscess. If not surgically treated, a boil will finally rupture, pus will flow 
out, and a "core" of dead tissue at last be discharged. The treatment 
consists of early crucial incision, removal of dead tissue, irrigation with 
peroxide of hydrogen and corrosive sublimate, and the application of hot 
antiseptic fomentations. 

Carbuncle. — This condition is a circumscribed infectious inflamma- 
tion of the deeper layers of the true skin and subcutaneous tissues. It 
ends in a slough. A carbuncle has many points of suppuration. It often 
causes profound constitutional disturbance, and may prove fatal in the 
aged and enfeebled. 

Treatment. — The best treatment is that of cutting out, under gen- 
eral anesthesia, the entire area infected. The large wound produced 
heals by granulation, or may later be skin-grafted. The wound is treated 
and dressed antiseptically. Secure rest and sleep with morphine, give 
nourishing diet and attend to the bowels and kidneys. 

Ulcers. — An ulcer is a loss of substance (due to inflammation) of a 
superficial structure. It is commonly known as a "sore." The causes 
are various. Blows may knock off the skin. Burns may cause extensive 
ulceration. General diseases, such as tuberculosis or syphilis, may predis- 
pose to ulcers. Bed sores are common. Varicose ulcers of the leg, due 
to enlarged veins, are frequently met with. 

Treatment. — Treatment consists essentially of removing the cause, so 
far as possible, and in treating the ulcer antiseptically. If a bed sore, 
remove the pressure ; if syphilitic, internal medication is imperative ; if a 
varicose ulcer of the leg, daily antiseptic cleansing should be practiced, 
and aseptic dressing should be applied. The most important factors, how- 
ever, in assisting nature to relieve the engorged veins are rest, eleva- 
tion, and firm, smooth bandage from the toes extending above the dis- 
eased area. 

Gangrene or Mortification — These denote the death of a part of the 
living body in mass. Putrefaction of the part occurs while it is attached 
to the living body. Gangrene results from a cessation of blood supply, or 
from obstruction of the outflow of blood from a part. Common among the 
causes producing such interference are a feeble heart and hard diseased 



804: SURGICAL, DISEASES. 

blood-vessels. Other causes are injuries, such as a crush, heat or cold, 
constitutional disease, such as diabetes. 

The aged and enfeebled with hard vessels, should avoid injuries, even 
slight ones, of the feet. The mere cutting of a corn too closely may lead 
to gangrene. Such a person should attend carefully to the general health 
and should especially keep the feet warm and comfortable. The treat- 
ment of gangrene demands all the skill of a competent physician. 

FRACTURED OR BROKEN BONES. 

Kinds of Fracture — Fractures are classified as of two kinds, the 
simple and the compound. A simple fracture is one in which the skin is 
not injured, so that no matter how much the bone is broken up, there is 
no communication of the fragments with the external air. A compound 
fracture is one in which the breaking of the bone is accompanied by a 
wound, caused either by the same force which produced the break, as, for 
instance, a bullet, or by the ends of the broken bones protruding through 
the skin. For example, a man may fall from a tree, breaking the femur 
or large bone of his thigh, and the broken end of the bone may be driven 
through the skin and into the ground. Compound fractures are much 
more dangerous than simple ones, chiefly because whenever the skin is 
broken there gain entrance to the tissues disease-producing germs, which 
set up the process of suppuration. 

Treatment. — Compound fractures are also more likely to be serious 
because the skin and muscles are much bruised. When, however, the 
wound which communicates with the fracture and makes it compound is 
small, an effort should be made to gain the advantages of a simple fracture 
by covering the opening in the skin with a clean cloth wrung out of 
corrosive sublimate solution (1 to 2,000) or wet with salt solution (one 
teaspoonful to the pint) until the surgeon arrives and takes charge of the 
case. This imperfect effort at antiseptic treatment must often fail, from 
the impossibility of applying it quickly enough, but it ought always to be 
tried. 

Recognizing Fractures. — We may recognize the fact that a bone is 
broken by the following indications: first, that the limb is shortened or 
bent where there is no joint ; second, by there being an unnatural degree 
of movement at the seat of injury; third, by the violent pain which 
attends a fracture; fourth, by the grating which may be felt, and some- 
times even heard, when the limb is moved. 



TREATMENT OF FRACTURES. 805 

Setting of Broken Bones. — This consists merely in pulling and press- 
ing the fractured extremities of the bone into their proper position. Such 
an operation, of course, requires a full knowledge of the anatomy of the 
parts and should, as a rule, be left for a skillful medical attendant, if he 
can be procured, within twelve hours. In the meantime the wounded part 
should be placed in the most comfortable, or rather the least painful, pos- 
ture, wrapped in cloths wet with laudanum, or lead-water and laudanum, 
and kept cold with ice, in order to prevent swelling and diminish the suf- 
fering as far as possible. 

Keeping a Broken Bone in Place. — When the physician succeeds in 
replacing the fragments, his next object is to secure them from being again 
deranged. This is usually accomplished by the aid of splints of various 
kinds, such as are shown applied to the arm on the following page. These 
splints may be made of wood, tin, pasteboard, or gutta percha, and are 
kept in place themselves by bandages or knotted handkerchiefs. In cer- 
tain cases, material, such as plaster of Paris or starch, which stiffens after 
it is applied to the limb, upon a bandage, can be employed with great 
advantage. 

Injuries Far from Home. — When a person is injured far from any 
habitation, and must be moved a considerable distance, if it is found that 
a bone has been broken, the first thing to do is to apply to the fractured 
limb a temporary splint. This will prevent the injury from becoming 
compound, if it is as yet only a simple fracture, and will save the wound 
from being irritated, if the injury is already a compound one. 

Bandaging — For the making of bandages and the various kinds see 
succeeding chapter. The operation of bandaging requires some prac- 
tical experience before it can be performed neatly. The idea, however, of 
the method of procedure,, winding the cloth smoothly around the arm, for 

instance, in a spiral direction, 
can be gathered from the 
illustration. Where the limb 
is conical, increasing in size 
from below upward, the only 
way to cause the bandage to 
lie evenly and be of much 
use is to make what are tech- 
nically called reverses, turn- 
ing the roll of linen over each 
Application of a Bandaee. tim e as it comes on top, as is 




mm), 






BONE FRACTURES 
806 



TREATMENT OF FRACTURES. 807 

represented in the wood-cut. The artist, however, has delineated the 
surgeon's fingers as being those of a left-handed man, a variety of the 
human species which, strange to say, is tenfold more numerous in pic- 
tures than in real life. The best substitutes for bandages available at a 
distance from human habitation are often to be found in handkerchiefs. 

Splints. — To obtain splints for the temporary support of fractures, 
the most varied articles have been pressed into service. Thin, light boards, 
like shingles or the sides of a cigar-box, which can be cut into any form 
desired, are often the best, but any object which may be trimmed or bent 
to suit the exigencies of the case, and is stiff enough to retain the form 
given to it, can be utilized. After preparing the splint it should be padded, 
for which purpose cotton-batting, tow, old rags, dried leaves, or hay may 
serve, these materials being bandaged fast to it on the side which is to 
come in contact with the injured member. The apparatus is then applied 
to the limb, an arm, for example, as shown in the figure below, and after 
carefully adjusting the injured member to the least painful position, as 

well as to that which is nearest 
its own natural shape, the splint 
or splints are fastened in place 
with several turns of the band- 
age applied as previously sug- 
gested. The adjoining wood-cut 
shows the method of applying 
the splints for a fracture of both 
bones of the forearm. After ar- 
ranging the arm and splints as 
depicted, the whole should be 

TreatmenttoflFracture of, Both Bones of the COVered in With a bandage, and 

suspended by a sling from the 
neck in such a way as to be carried by the patient across his chest. 

Fracture of Arm. — Fracture of the humerus or arm-bone between the 
shoulder and elbow should have applied curved splints made of thick paste- 
board, wet in boiling water and moulded to the shape, sheet gutta percha 
similarly softened, or tin, one on the inside and another on the outside, as 
represented in the figure. The fragments of the bone are to be adjusted in 
proper position, a bandage applied, and then the splints fitted and firmly 
yet not too tightly bound on with a bandage running from the tips of the 
fingers to the shoulder. Tf the roller is applied above only, the hand and 
fingers will swell up in consequence of the pressure, interfering very 




808 



SUEGICAL- DISEASES. 




Fracture of the Humerus. 



seriously with the circulation of the blood. In fractures of the arm it is 
always advisable to arrange the elbow bent at a right angle, because should 
the arm be left stiff, as may happen, 
perhaps with the best treatment, it is 
much more useful than when straight. 
Fracture of Legs. — In fractures of 
the legs, a contrary rule holds good, 
and the effort should always be to keep 
the broken limb as straight as possible. 
An excellent temporary dressing 
for a fracture of the leg below the knee 
is well indicated in the figure. The 
injured limb should be drawn out to as 
nearly its full length as can be borne, 
measuring it by the sound side to deter- 
mine this, and then the fragments of the bone pressed, if possible, to their 
proper places. The pillow which has previously been laid beneath the in- 
jured member is then doubled up, as shown in the cut, and fastened with 
three or four strips of bandage or with handkerchiefs. If the leg is much 
bruised, or the pain very severe, a soft linen cloth soaked in laudanum, or 
strong lead-water and laudanum, should be wrapped around it before 
being bound up in the pillow. 

Dislocations. — Continued displacement of the bones comprising a 
joint, after the ligaments have been more or less torn, constitutes a dislo- 
cation, or, as it is popularly described, "out of joint." These injuries 

are generally the result of ex- 
ternal violence, such as falls, 
blows, twists, and so forth, 
which have caused the limbs 
to move in a direction, or to 
an extent, for which nature 
had not adapted them. A 
familiar example of a disloca- 
tion is that of the lower jaw, 
and the position of the bones 
composing this important ar- 
ticulation in their disturbed or 
displaced condition is well shown in the marginal illustration. 

Symptoms of Dislocation. — In a general way, a dislocation is recog- 




Dressing for Broken Leg. 



TREATMENT OF FRACTURES. 



809 




Dislocation of Lower Jaw. 



nized, first, by the altered appearance of the joint, which is usually very 
apparent when compared with the corresponding joint on the opposite 

side; second, by the movements of 
the affected joint being lessened; 
third, by the fact that efforts to 
move the joint cause much pain; 
fourth, dislocation can usually be 
distinguished from fracture, which, 
when near a joint, is apt to give rise 
to all these symptoms, by the ab- 
sence of crepitus, as the grating 
noise produced by rubbing together 
the ends of the fragments is called. 
This sign, however, would, of 
course, prove falacious and mis- 
leading if both a fracture and a dislocation existed. 

Treatment. — The obvious treatment for a dislocation is reduction, or 
a replacing of the bones forming the joint again in their proper relations. 
In reducing a dislocation, not only should the operator have all his ana- 
tomy at his fingers' ends, but a vast amount of practical experience is 
often necessary to decide whether a dislocation is complicated with a frac- 
ture, or whether a dislocation or a fracture is the injury to be treated. 

So great and so permanent is the injury likely to result from the 
blunders of attempting to "reduce" a fracture, erroneously supposing it 
to be a dislocation, or vice versa, that no time should be lost by the sufferer 
in availing himself of the best medical services procurable. 

Foreign Bodies in the Throat. — Foreign bodies in the throat are some- 
times substances imprudently swallowed by mistake, such as fish bones, 
pins, and so forth, or coins, marbles, and other playthings half ignorantly 
introduced by children. If the breathing is not seriously interfered with, 
medical assistance, sent for at once, should be awaited, as peculiar for- 
ceps and other instruments will probably be necessary to extract the 
intruders. If choking to death seems imminent from pressure on the 
windpipe, thumping on the back, holding the patient up by the heels, and 
striving to hook out or push the foreign body, if it is not intrinsically 
dangerous, down into the stomach, may be tried. At the last gasp the 
operation of tracheotomy, or opening the windpipe, should be performed 
by any one who has the knowledge and the courage to attempt it. 



810 SURGICAL DISEASES. 

Rupture or Hernia. — By the above is commonly meant the protrusion 
of some organ of the abdomen through the walls of the latter. The most 
common contents of hernia are bowel or omentum. The commonest sites 
are at the navel and the groin. 

The fact that persons so affected are often induced to entrust them- 
selves to the treatment of quacks or charlatans is deplorable. Serious 
results often occur. There are only two forms of proper treatment, 
namely, either the wearing of a truss fitted and adjusted by a skilled 
person or submission to surgical treatment at the hands of a reputable 
surgeon for the radical cure of the condition. 



PART XV OF BOOK IV 

Treats of the anesthetics and soporifics, their prop- 
erties and the manner in which each is used. 



Anesthesia 814 

Care of the Patient After 818 

Complications in Giving 816 

Infiltration 819 

Preparation of Patient for 814 

Respiration in Giving 817 

Spinal 820 

Sylvester's Method 817 

Temperature of Room 815 

Anesthetics 814 

Discovery of 813 

General 814 

Local 819 

Anesthetization, Signs of Perfect . . . .816 
Artificial Respiration in Anesthesia. .817 

Bromides Used for Insomnia 821 

Chloral Purest Soporific 821 

Chloroform 817 

Giving of 817 

How to Give 818 



Cocaine Hydrochlorate 819 

Ether, Giving of 815, 817 

Ethyl Bromide 818 

Ethyl Chloride as an Anesthetic 819 

Eucaine Hydrochlorate 819 

Hypnotics 820 

Ice as an Anesthetic 819 

Infiltration Anesthesia 819 

Insomnia 820 

From pain 821 

Nitrous Oxide 818 

Rhigolene as an Anesthetic 819 

Respiration in Anesthesia 817 

Salt as an Anesthetic 819 

Sleep Producers t 820 

Soporifics 820 

Spinal Anesthesia 820 

Sulphonal a Sleep Producer 821 

Tetronal used for Insomnia 821 

Trional used for Insomnia 821 



811 



CURATIVE MEDICINE 

PAET XV. 
ANESTHETICS AND SOPORIFICS. 

Discovery of Anesthetics. — The victories of peace often far surpass in 
result the renown which they receive. Such was the achievement of 
Thomas G. Morton, a dentist, who, October 16th, 1846, for the first time 
produced complete anesthesia or insensibility to pain under a major sur- 
gical operation. This occurred in the clinic of the celebrated surgeon, 
Dr. John C. Warren, at the Massachusetts General Hospital. These men," 
by their discovery, not only wrought a revolution in surgery, but were 
victors over the horrible agony previously suffered at the hands of the 
surgeon. Their labors have brought to pass what Dr. Oliver Wendell 
Holmes has written: "The fierce extremity of suffering has been steeped 
in the waters of forgetfulness, and the deepest furrow in the knotted brow 
of agony has been smoothed forever." 

Spread of the Discovery. — News of this remarkable discovery seemed 
to be carried by the winds, and soon anesthesia was used in the clinics 
of the world. The following year, chloroform was introduced by Sir 
James Simpson, of Edinborough. Such a boon to humanity is beyond 
estimation. The agony suffered under a severe surgical operation only the 
few courageous ones enduring it and yet surviving can tell. Anesthesia 
now renders comparatively easy very many new procedures, especially 
those requiring the greatest delicacy of touch and accuracy in dissection 
of brain or amid vessels and nerves — procedures not possible in the haste 
necessary before the days of anesthesia. Then, too, the operations were 
formerly few; now relief is for the many. The numbers rapidly multi- 
plied, many fold. For example, in the Massachusetts General Hospital 
during five years previous to the introduction of anesthesia, only 184 
persons were willing to submit themselves to the ordeal of an operation. 

(813) 



811: ANESTHETICS AND S0P01UF1CS. 

In the five years following, 487 operations were done, and, in 1899, in 
the same hospital, 3700 operations were performed. Anesthesia is a 
benign alleviator of suffering, a merciful prolonger and saver of life, 

ANESTHETICS. 

Anesthetics, artificial means of producing insensibility or loss of 
feeling, are general and local. 

General Anesthetics. — The more common ones are ether, chloroform, 
nitrous oxide, and ethyl bromid. They are given by inhalation, and com- 
monly more or less mixed with air or oxygen. The chief uses of general 
anesthesia are, to abolish the pain of labor and surgical procedures; to 
produce muscular relaxation in ruptures, fractures and dislocations; and 
to enable the physician to make examinations otherwise painful. 

Preparation of Patient — In emergencies, a patient sometimes must 
needs be given an anesthetic without previous preparation, but, when 
time affords, preparation should never be omitted. The dangers from 
an anesthetic are commonly magnified by the laity, yet a skilled anes- 
thetizer, while not afraid, should have a wholesome respect for the com- 
plications which are always possible to arise. The better condition a 
patient is in at the time of giving an anesthetic, so much the less likely 
are serious results. Therefore the advisability of attention to the patient 
and his preparation previous to operation. The condition of lungs, heart, 
and kidneys is especially to be noted, the urine examined for albumen, 
casts and sugar. While the presence of the latter do not absolutely con- 
traindicate the giving of an anesthetic, yet they may at least influence 
in the selection of the kind, and lead to special necessary precaution in its 
giving. 

The Bowels. — The bowels should be freely emptied the day before 
or the morning of operation. This is well done by epsom or rochelle 
salts, one to two tablespoonfuls, supplemented, if need be, by an enema 
of soap-suds one quart, glycerin two tablespoonfuls, epsom salts two table- 
spoonfuls- The injection should be given a few hours before operation. 
The bladder should also be emptied immediately before operation. 

Rest and Sleep. — The patient should rest for twenty-four hours pre- 
vious, preferably in bed. He should have a general bath, that the skin 
may be active. Sleep should be secured the night previous; if there is 
nervousness, a warm bath at night may quiet, or it may be necessary to 
give a powder of potassium bromide, ten grains, or of trional, ten grains, 



ADMINISTRATION OF ANESTHETICS. 815 

in a little hot broth or hot tea; either may be repeated. The anxiety of 
the patient may interfere with digestion. At any rate, the diet for a day 
previous should be light, for example, broths, soups, soft eggs, bread and 
butter, toast. At the time of giving an anesthetic the stomach should be 
empty. If operation is to be early in the morning, no breakfast should be 
given. A small quantity of beef tea or of broth and a little brandy may 
be well. If the operation is not until midday, a light breakfast of beef 
tea or of broth and toast or a roll had best be taken. Never give any 
food within three hours of operation, and only a very moderate quantity 
of water within the same time. Matter in the stomach induces vomiting, 
and this endangers the patient to the entrance of portions of food into 
the windpipe. 

Temperature of Boom — The room should be warm, not less than 70 
degrees Fahrenheit, and the patient protected with sufficient blankets. 
If a light in the room in necessary, it should be above and some little 
distance from the patient. Ether is inflammable, and the vapor explosive, 
but the latter sinks to the floor. The clothing should be loose, particularly 
about the neck and body. If a woman, the corset should of course be 
removed to give opportunity, if only this once, for free breathing. The 
hair should be braided. A third party should always be present. The 
patient should lie upon the back with only a small pillow beneath the 
head. Take care that the limbs are not cramped or pressed upon. The 
lips and nose should be anointed with vaseline. Having spoken some 
cheerful, encouraging word to the patient, the anesthetizer examines the 
heart, notes the condition of the pulse and respiration, and, without fail, 
sees that any foreign bodies in the mouth, including false teeth, are 
removed. He is now ready for the administration of the anesthetic. 

Giving Ether. — The writer desires to state, in most emphatic terms, 
that an anesthetic should never be given by any but a skilled person or 
under the direction of such a person — one who can interpret danger 
signals, and can act promptly and intelligently. The limits of this work 
forbid giving detailed directions. Some of the salient points regarding 
the giving of ether may prove of benefit as well as of interest. 

What the Operator Will Have at Hand. — The anesthetizer will have 
at hand stimulants— brandy, strychnine, atropine, digitalis and a hypo- 
dermic syringe in working order. He will have a mouth-gag and tongue 
forceps, and needs at hand two or three small towels. Ether is best given 
upon some simple inhaler, such as an Allis, but may be well given upon a 
towel folded into a cone, or, if the face be anointed, the folded towel may 



816 ANESTHETICS AND SOPORIFICS. 

be placed flat over the patient's nose and month. Having gained the 
confidence of the patient, by assurances that he will give the anesthetic 
slow and will not choke him, the anesthetist says, "I want you to breathe 
through the inhaler a few moments to get used to it before I put any ether 
upon it. Now just a drop or two." So beginning, and continuing very 
f lowly, "feeling" his way, the anesthetist may have reasonable hope that 
lie will avoid any serious trouble in the stage of excitement. If choking 
cr coughing occurs at first, proceed very gradually, giving a breath or 
two of pure air, and the throat will soon become accustomed to the drug 
which at first irritates. Vomiting thus early demands the withdrawal of 
the drugs for a few moments, until the throat and mouth are freed from 
the vomitus. 

Pushing the Anesthetic. — After primary irritation ceases, the anes- 
thetic may be "pushed," more and more being added, until, when the 
patient is in the second semi-conscious excitable stage, he may be getting 
a large quantity. "Pushing" the drug at this point will quickly send the 
patient over the period of disturbance into the quiet of complete anes- 
thesia. If, however, very violent struggling with ridigity and great 
cyanosis, or blueness occurs at this time, it is generally wise partially to 
withhold the anesthetic for a few moments. 

Signs of Perfect Anesthetization. — A patient is known to be com- 
pletely anesthetized by the loss of consciousness, loss of motion, relaxa- 
tion of the muscles, loss of certain movements, e. g. 3 that of winking when 
the eyeball is gently touched. The breathing should be regular and quiet. 
The anesthetizer not only observes the movements of the chest in respira- 
tion, but notes by touch and sound the rhythmical inflow and outflow of air. 
The breathing and circulation are especial indexes as to the condition 
of the patient. The regularity, rate, and strength of the pulse should 
be frequently noted. Any marked variation from the normal should 
receive immediate attention. Stimulation may be needed or withdrawal 
of the anesthetic demanded. The color of the patient is also a valuable 
index. Great pallor generally indicates failure in the circulation; cyan- 
osis or blueness, that the inhalation of oxygen is insufficient. The latter 
generally calls for removal of the drug and a determination and correction 
at once of the cause of imperfect inspiration. 

Complications — Irritation apt to arise early in the administration 
has been alluded to. If vomiting occurs, the head is always to be turned 
to one side and the mouth wiped out. In a large majority of eases 
vomiting may be stopped by increasing the quantity of the anesthetic. 



ANESTHETICS. 817 

The Respiration. — Before complete anesthesia occurs the patient may 
"forget" to breathe; the word "breathe" spoken loudly into his ear will 
generally arouse him to efforts of respiration. If after complete anesthesia 
the respiration is abnormal, the immediate determination of the cause and 
its correction are imperative. A muscular movement at such time will 
generally indicate recovery from the anesthesia and the necessity for an 
increased quantity of the drug. Otherwise, the anesthetic should be 
stopped, the mouth gagged open, the tongue pulled forward with forceps 
or towel, and mucus collected in the throat wiped out. This will gen- 
erally be sufficient to restore breathing and to relieve the cyanosis, allow- 
ing the administration soon to be resumed. Should these means fail, 
artificial respiration should be instituted (which see below). The fooj: of 
the bed should be raised, fresh air admitted to the room, the patient well 
protected and surrounded by hot-water bottles. Meanwhile, various means 
of stimulation should also be used — hypodermic injections of strychnine, 
atropine, digitalis, ammonia ; injections into the bowel of hot black coffee 
and brandy ; a mustard plaster applied over the heart. 

Artificial Respiration. — Laborde's Method. The jaws are held apart 
and the mucus wiped from the mouth and throat. The tongue is grasped 
with forceps or the fingers covered with a towel, and is drawn every four 
seconds, strongly and quickly forward, and each time allowed to go 
gradually back. 

Sylvester's Method. — The former method should be used in conjunc- 
tion with this. The patient is in a recumbent posture. The operator 
grasps both the patient's arms near the elbow and draws them gradually 
outward and upward until they nearly touch the patient's head. They 
are thus held for two seconds, while air enters the lungs. The arms are 
then gradually lowered and pressed firmly against the side and front of 
the chest for two seconds, thus forcing air out of the lungs. The move- 
ment of elevation and depression should be made not more than fifteen 
or eighteen times a minute. 

Giving Chloroform. — Ether is a safer anesthetic for most purposes 
than chloroform. The latter is preferable, however, in a few conditions, 
e. g., in infants and the very old; in serious lung and kidney trouble 
chloroform, because of the less quantity required, is less irritating. In 
certain operations about the face the patient can better be kept anesthet- 
ized by chloroform, and it rs often better suited for employment in labor, 
because more quick in action and more relaxing. 

Giving Ether — The general principles for giving ether apply to the 
52 



818 ANESTHETICS AND SOPORIFICS. 

giving of chloroform. However, because chloroform is quicker in action, 
it should be given with greater care. Ether, like alcohol, is a stimulant 
to the heart, and is therefore generally preferred in heart disease. Chloro- 
form has clinically a distinct depressant action upon that organ. 

How to Give Chloroform. — Chloroform may be well given upon a 
folded towel or napkin, or piece of cheese-cloth. The object from which 
the chloroform is inhaled must not be held in contact with the face but an 
inch or more above the nose so that the vapor may be freely mingled with 
air. Chloroform should be given drop by drop, cautiously, and particular 
watch-care given for danger signals. If struggling occurs it is imperative 
that the drug be not "pushed" lest, at this time, when breathing deeply, 
the patient inhales at a few breaths an overwhelming quantity. Eternal 
vigilance is the price of safety in anesthesia and especially so in the giving 
of chloroform. 

Nitrous Oxide. — Nitrous oxide or laughing gas is perhaps the safest 
general anesthetic. Its action is rapid, anesthesia resulting in one minute. 
But its effect is fleeting, lasting less than one minute, thus rendering it 
unfit for major operations. It is much used by dentists for the extraction 
of teeth and has been used with advantage in minor surgery, such as open- 
ing an abscess. The gas (a liquid under pressure in steel cylinders) is 
bulky and not readily carried by the surgeon ; the apparatus necessary for 
its use together with other agents is complicated, so that this drug is not 
likely to become popular in surgery. 

Ethyl Bromide. — This, a colorless agreeable liquid, has not been 
widely used. In giving it to an adult it is well to pour from four to six 
teaspoonfuls, the whole amount to be given, upon a folded towel, and to 
apply the saturated surface directly to the nose of the patient, pressing the 
edges of the towel down upon the face to exclude the air. Unconsciousness 
is obtained in about half a minute. The anesthesia is rapidly recovered 
from, and after ill-effects are almost nil. This agent is adapted to cases 
needing anesthesia for examination, to the incision of abscesses, and for 
the relief of suffering in labor. It is considered comparatively safe by 
those who have used it. The favorite general anesthetics have been re- 
ferred to. 

Care of Patient After Anesthesia. — The patient must be carefully 
watched until he regains complete consciousness. He should, of course, 
remain recumbent. The erect attitude might result in heart failure. The 
head should be higher than the body. He should be warmly covered and 
perhaps be surrounded by hot-water bottles. The inhalation of oxygen is 



ANESTHETICS. 819 

best, but an inhalation of vinegar is an excellent procedure to prevent 
nausea and vomiting. If the latter occurs, the head should be turned 
well to one side, the vomitus caught in a towel or basin. Food should not 
be given for several hours and if water is allowed it should be given only 
in teaspoonful doses quite hot, frequently repeated. If vomiting con- 
tinues a mustard plaster should be put over the stomach, fresh air ad- 
mitted to the room and a little hot black coffee given. 

Local Anesthetics — The chief ones are ethyl chloride, ether and rhigo- 
lene sprays, ice and salt, carbolic acid, eucaine and cocaine. 

Freezing' Agents — These agencies are employed in the lesser opera- 
tions, and occasionally when there is some complication preventing a gen- 
eral anesthetic. 

Ice and Salt. — If one-quarter pound of ice be broken into small bits, 
and one-eighth pound of common salt added and the mixture be put in 
a thin bag and laid upon the skin surface, the area will become anesthetic 
in ten or fifteen minutes. 

Ether, Khigolene and Ethyl Chloride directed upon a part in a fine 
spray produce anesthesia by their cold effect. The latter is put up in a 
convenient glass tube with a metal cap. A part touched with pure carbolic 
acid becomes blanched and anesthetic. 

Cocaine Hydrochlorate in a watery solution is quite commonly used for 
injecting into the skin, for applying to the mucous membrane, the latter 
absorbing it. It is applied to the nose, mouth or throat by a spray or swab, 
or dropped into the eye. For injection a two per cent, solution is gen- 
erally sufficient. For application to the eye a four per cent, solution may 
be necessary, and for the nose and throat a ten or even twenty per cent, 
solution may be cautiously used. Da Costa says that never more than two- 
thirds of a grain should be painted upon a mucous surface and never more 
than one-third of a grain should be injected into the tissues. Examples of 
useful purposes to which cocaine may be put are, for instance, the removal 
of a wen, or a wart, the correction of a small deformity of the bones of the 
nasal cavity. A finger or toe can be comfortably amputated by its use, a 
constricting band meanwhile being placed about the root of the part to 
prevent the absorption of too great a quantity of the drug. The whole 
area supplied by a large nerve may be anesthetized by injecting cocaine 
about the nerve trunk. 

Eucaine Hydrochlorate. — Eucaine hydrochlorate has practically the 
same action and may be used in the same way as cocaine. 

Infiltration Anesthesia. — Infiltration anesthesia, commonly called 



820 ANESTHETICS AND SOPORIFICS. 

Schleich's method, is produced by injecting into a part several ounces of a 
weak table salt solution to which a minute quantity of cocaine, morphine 
and carbolic acid has been added. The method is very efficient and has 
been successfully used for major operations. The anesthesia is partly due 
to the pressure upon the tissues, especially the nerves, by the injected 
fluid. 

Spinal Anesthesia. — A method lately much talked about and one prac- 
ticed considerably in France, is one in which a small quantity of a one- 
half or one per cent, solution of cocaine is injected by a syringe through 
a hollow needle into the spinal canal. In about five minutes loss of sen- 
sibility occurs in the parts supplied by nerves given off below the point of 
injection. All of the body below the diaphragm can thus be rendered 
anesthetic. Anesthesia lasts about forty-five minutes. It has been em- 
ployed successfully in labor and in various grave operations. But it is 
not without its dangers, and, though relieving pain, it does not remove 
the horrors of an operation which consciousness must give. This method 
will probably never supplant general anesthesia. The ideal anesthetic is 
one without danger which abolishes both consciousness and sensation, thus 
giving the surgeon the absolute control of his patient — a condition es- 
sential to the accomplishment of the best result. May the twentieth cen- 
tury see the discovery of the ideal anesthetic. 

SOPORIFICS OR HYPNOTICS. 

The Sleep Producers. — The class of remedies so-called are sleep pro- 
ducers. They may be divided into those which not only cause sleep but 
also relieve pain and those which have no pain-relieving properties. Of 
the former opium is the best example, and should be given where sleep- 
lessness is due to pain, whereas, if due to other causes opium should never 
be given. 

Insomnia. — Insomnia is such a distressing experience that people will 
go to extremities to relieve it, sometimes being led to use carelessly the 
most powerful and harmful remedies. The warning cannot be too em- 
phatic to the laity against such a practice, for this class of drugs should 
rarely be taken except by the advice and under the direction of a skilled 
physician. The physician himself should be keenly alive to the especial 
danger of most direful drug habits. For the treatment of insomnia dili- 
gent search should be made for the cause and the latter removed. If due 
to coffee-drinking at night the habit should be abandoned. If to nervous- 



SOPORIFICS OR HYPNOTICS 821 

ness because of overwork or excessive social duties proper rest from such 
strain will probably relieve. If weariness or exhaustion be the cause, mod- 
erate stimulation with some hot drink, a little coffee or a small quantity of 
brandy, will help. A warm bath before retiring is sometimes efficacious. 
Some occupation before retiring, e. g., the perusal of some light but inter- 
esting book will often suffice. 

Insomnia from Pain — However, insomnia from pain must be relieved 
by opium or some of its derivatives, codeine, morphine or heroine. Long 
continued administration of opium, except in hopelessly incurable cases, is 
to be strongly condemned. The cause of pain should be removed, then the 
need of a hypnotic is gone. In emergency, for the relief of severe pain, 
there need be no hesitancy in giving to an adult one-fourth to three-fourths 
of a grain of opium, one-sixth of a grain of morphine, or ten drops of the 
tincture of opium (laudanum), repeating either dose in an hour if relief 
is not obtained. Meanwhile a physician should be summoned. When 
opium is given, it should be with the clear understanding of the probable 
ill-effects of mental depression, and of nausea and vomiting, and the 
danger of the habit ever in mind. 

Chloral. — Chloral is perhaps the purest soporific. It is poisonous, 
however, when taken in excessive dosage, causing weakness of the heart or 
even heart failure. When insomnia is due to nervousness Hare recom- 
mends the following : 

Chloral i or 2 drachms 

Bromide of potassium 2 drachms 

Syrup of wild cherry 1 ounce 

Water sufficient to make 3 fluid ounces 

Mix. Directions: Take a dessertspoonful in water at night. 

Sulphonal. — Sulphonal has sleep producing powers perhaps not equal 
to those of chloral. It finds its chief usefulness in nervous insomnia and 
especially in that occurring with those of unsound mind. It is commonly 
given in powder, ten grains to a dose. As it is insoluble in cold water it 
should be given in hot water or hot milk. The drug is slow in effect and 
therefore should be taken two or three hours before retiring. 

Trional and Tetronal. — These are closely related to sulphonal and are 
almost identical with that drug in their action. Their effect is felt in 
thirty minutes or less. The dose of each is ten to fifteen grains agreeably 
given in hot broth or tea. 

The Bromides. — The bromides of potassium, of sodium or of ammo- 



822 ANESTHETICS AND SOPORIFICS. 

nium 7 the three being practically identical in action, are drugs very com- 
monly used as quieters and sleep producers. The former is most fre- 
quently used. It is indicated where there is undue excitement of the 
nervous system, but never where the nervous symptoms are due to depres- 
sion. It is a useful remedy for hysterical women, for the disagreeable 
nervous symptoms often accompanying the climacteric, and is a soporific 
for the over-worked and nervous, provided it is not long continued. It is 
useful in neuralgias and nervous headaches and frequently quiets the 
excessive nervousness of drunkenness. The dose of either is ten to thirty 
grains taken dissolved in water. 



PART I OF BOOK V 

Treats of Accidents and Emergencies. The articles 
are alphabetically arranged, so as to be convenient 
for quick reference. This chapter should be studied 
carefully, especially the articles on Rescue from 
Drowning and on Hemorrhage. 



Accidents, Factory 838 

Mining 851 

Railroad 852 

Acid Burns 829, 830 

Apoplexy 826 

Arms, Broken 842 

Arterial Hemorrhage 845 

Artificial Respiration 852 

Asphyxia 826 

Asphyxiation 826, 844 

Bites 827 

Bleeding 847 

Brain, Compression of 832 

Concussion of 832 

Breathing, Restoration of 852 

Broken Arms 842 

Broken Bones 840 

Bruises 833 

Burning Clothing, How to Put Out ..831 

Burns 829, 830 

Children, Convulsions in 833 

Choking 831 

Circulation, Restoration of 832 

Cold, Exposure to 832, 837 

Collar Bone Fracture 843 

Coma, Uraemic 864 

Compound Fracture 841 

Concussion of Brain 832 

Contused Wounds 864, 867 

Contusions 833 

Convulsions 864 

Convulsions in Children 833 

Cramps, Muscular 834 

Crushed Feet 868 

Crushed Hands 868 



Crushed Limbs '. .864 

Cupping 834 

Cuts 834 

Dislocations 835 

Dog Bite 828 

Drowning, Rescue from 852 

Drunken Stupor 850 

Ear, Foreign Bodies in 839 

Elbow Fracture 842 

Electricity, Accidents from 836 

Epileptic Fits 837 

Exhaustion, Heat 845 

Expiration 852 

Exposure to Cold G32, 837 

Eye, Foreign Bodies in 839 

Factory Accidents 838 

Fainting 838 

Finger Dislocation C^5, 864 

First Aid to the Injured 825 

Fish Hooks, Extraction of 838 

Fits, Epileptic 837 

Fits 837 

Forearm Fracture 842 

Foreign Bodies in Ear 839 

Foreign Bodies in Eye 839 

Foreign Bodies in Nose 839 

Fractures 840 

Frost Bites 843 

Frozen Limbs 843 

Gas Asphyxiation 844 

Gas Poisoning 844 

Gun-shot Wounds 868 

Hanging 844 

Healing of Wounds 867 

Heat Exhaustion 845 



823 



824 



I^DEX TO PART I OF BOOK V. 



Heatstroke 844 

Hemorrhage 845, 847 

Hernia, Strangulated 858 

Hydrophobia 828 

Hysteria 849 

Incised Wounds 834 

Infected Wounds 868 

Injured, Transportation of 858 

Insect Bite 827 

Insect Stings 857 

Insensibility 863 

Internal Bleeding 845 

Internal Organs 850 

Intoxication 850 

Ivy Poisoning 851 

Jaw Fracture 843 

Lacerated Wounds 867 

Leg Fracture 843 

Lightning Stroke 851 

Limbs, Crushed 864 

Limbs, Frozen 843 

Limbs, Torn Off 868 

Lower Jaw, Dislocation of 835 

Lungs, Bleeding from 845 

Lungs, Hemorrhage of the 847 

Lye Burns 830 

Mining Accidents 851 

Moving of the Injured 858 

Muscular Cramps 834 

Nose Bleed 847 

Nose, Foreign Bodies in 839 

Nose Fracture 843 

Organs, Internal 850 

Poisoned Wounds 868 

Poisoning, Gas 844 

Poisoning, Ivy 851 

Powder Burns 830 

Pulmotor, The 855 

Punctured Wounds 868 

Rabid Animals, Bites of 828 

Railroad Accidents 852 

Reptile Bite 828 



Rescue from Drowning 852 

Respiration, Artificial 852 

Restoration of Breathing 852 

Rib Fracture 842 

Scalds 829 

Shock 855 

Shoulder Dislocation 835 

Skull Fracture ..843 

Snake Bite 829 

Spine Fracture 842 

Splints 840 

Sprains 857 

Stings of Insects 857 

Stomach, Bleeding from 858 

Stomach, Hemorrhage of 847 

Strains 857 

Strangulated Hernia 858 

Stroke, Lightning 851 

Stunning 832 

Suffocation 826, 852 

Sunstroke 844 

Thigh Fracture 842 

Tourniquet 846 

Torn Off Limbs 864 

Transportation of Injured . j 858 

Unconsciousness 863 

Uraemic Coma . . . . : 864 

Vapor, Apparent Death from 844 

Varicose Veins, Hemorrhage of ....847 

Wounds 864 

Wounds, Bleeding from 845 

Wounds, Contused 864, 867 

Crushed Feet 868 

Gun-shot 868 

Healing of 867 

Incised 834 

Infected 869 

Lacerated 867 

Poisoned 868 

Protrusion of Internal Organs ..869 

Punctured 868 

Torn Off Limbs 868 



The Dracger Pulmotor 856 

Drowning — Fig. 1 853 

Drowning — Fig. 2 853 

How to Stop Bleeding — opp. page.. 848 



ILLUSTRATIONS 

Transportation of the Injured — opp. 



page 856 

What to do if bitten by Mad Dog or 

Poisonous Reptile — opp. page.. 828 



Book V 



ACCIDENTS AND EMERGENCIES 

PART I. 



FIRST AID TO THE INJURED. 

The fate of an injured person frequently depends largely upon tke 
acts of the one into whose hands he first falls. If proper immediate 
assistance be given, serious consequences may be avoided. Everyone is 
liable to be called upon at some time to administer first aid, and there- 
fore, it is a duty with all to be so prepared that whatever and whenever the 
emergency, further harm may at the time be prevented, suffering relieved 
and perhaps life saved by quick and proper action. 

In this present chapter, in conjunction with that on poisons and their 
antidotes and that on the diagnosing of disease by symptoms (see general 
index at back of book), will be found a fund of information so arranged 
as to be especially available for quick reference in times of accident and 
emergency. It will also be found of great advantage if the chapter on 
Anatomy and Physiology (see Index) has been previously studied, as it 
will give a knowledge of the body that may prove invaluable in case of 
accident. 

In cases of severe injury no time should be lost in sending for a phy- 
sician, and it is to be borne in mind that it sometimes happens that an 
injury which to the non-professional seems trivial, may be recognized by 
the physician as extremely grave. But until the physician arrives there 
is need of doing many things which anyone can do, and the immediate 
doing of which often is the necessary preliminary in the saving of life, 
such as putting out burning clothing, stopping bleeding, rescuing people 
from drowning, extricating them from machinery, removing them from 
contact with electric wires, etc., and then attending to the immediate relief 
of their sufferings. Then, too, it frequently happens that no professional 

825 



826 FIBST AID TO THE INJURED. 

aid can be obtained, and the care of the injured and the ill devolves upon 
those who happen to be at hand. 

Whether physician is expected or not, make the sufferer comfort- 
able to start with, by laying him down gently, straightening his limbs, 
raising or lowering his head and such like things, as the case may require. 
If the injured part is covered with clothing, remove it by cutting or care- 
fully tearing, but do not remove more clothing than necessary, as one of 
the results of injury is to make the injured person feel cold. Shoes or 
boots should be cut away in severe injuries about the feet. Do not try to 
do too much. Do nothing for the sake of doing something. Yet, remem- 
ber, that the right thing done at the right time relieves suffering and may 
save life. The great thing is to know the right thing to do and when to 
do it. Be cool. Act quickly but not hurriedly. Make everything you do 
count for something in relief. 

The following advice as to what to do in certain specific cases should 
be known by everyone and is here arranged in alphabetical order for 
ready reference. 

ALPHABETICAL REFERENCE LIST WITH EXPLANATIONS AND 

TREATMENTS. 

Acid Burns. — See Burns. 

Asphyxia or Suffocation — Proceed to restore breathing by artificial 
respiration, as in drowning. See Rescue from Drowning and Gas Poi- 
soning. 

Arms, Broken. — See Fractures. 

Arterial Hemorrhage. — See Hemorrhage. 

Artificial Respiration. — See treatment in Rescue from Drowning. 

Apoplexy. — This state is caused by the rupture of a blood vessel 
within the skull and consequent escape of blood and pressure on the brain, 
or by the clogging of a blood vessel, thus cutting off the blood supply to 
some part of the brain. The result is the same in either case : a part of 
the brain ceases to perform its functions owing to pressure of the clot. 
If the clot be small the effect will be slight; if it be large the effect will be 
grave if not fatal. The sufferer loses consciousness, sometimes falling as 
i 1" felled by a heavy blow, sometimes becoming insensible more slowly. In 
well-marked cases, no effort will arouse the' patient from insensibility. 
The face is flushed and the pupils of the eyes generally dilated, or one 
may be dilated and one contracted. Breathing is slow and labored ; snor- 



SNAKE AND INSECT BITES. 827 

ing may occur; cheeks are often puffed out with each respiration, the 
air being blown through the lips. Pulse is slow, full and hard. Paralysis 
is an important symptom and must be looked for. Paralysis generally is 
only on one side — the face, arm and leg on the same side being commonly 
affected. The mouth is usually drawn away from the affected side of the 
face. 

Treatment. — Lay patient down, head and shoulders slightly raised ; 
loosen clothing about neck and body ; wrap cracked ice in a towel and place 
it on the head, or wrap head in cold wet cloths and keep them cold until 
arrival of the doctor. If without medical advice for long period, empty 
the bowels by giving an injection of soap and warm water, at the same 
time giving a cathartic, castor oil or salts, if the patient can swallow. 
Keep the patient quiet. Do not give any stimulant. 

Bandaging. — See special article on bandaging. 

Bleeding of all Kinds — See Hemorrhage. 

Brain, Concussion of. — See Concussion of the Brain. 

Brain, Compression of. — See Compression of Brain. 

Bites of Dogs. — Dog bites may be of trifling import or of serious con- 
sequence. Usually the fright they cause is unwarranted. If the dog is 
not diseased all that is requisite is such treatment as would be given any 
lacerated wound. In view, however, of possible seriousness it is well in 
all cases to immediately consult a physician, and if there is the slightest 
suspicion that the dog has rabies or is "mad" or even if it is sick in any 
way, this should be done at any cost or trouble, and if for the moment im- 
possible, then in the meantime, the wound should be cauterized at once. 
If there is evidence that the dog had rabies the Pasteur treatment should 
be taken without delay. If commenced within a few days after the bite 
(the sooner the better), the Pasteur treatment is an almost certain pre- 
ventive of the development of hydrophobia. Other animals as well as 
dogs suffer with rabies and may communicate it to human beings. (See 
general index at back of book for special article on Hydrophobia.) 

Bites of Venomous Insects, Snakes and other Reptiles. — In all such 
bites the prime object is to prevent the spreading of the poison through 
the system, and after that to get it out of the wound. Bind a stout cord, 
string or anything at hand very tightly around the limb, a few inches 
above the wound, remembering, however, that there is danger in making 
it too tight and also in keeping it tight too long. Then suck out the 
poison — it is harmless in the mouth. If physician near at hand, hasten to 
him ; if one cannot be secured without delay, the poison may be removed 



828 FIRST AID TO THE INJURED. 

or neutralized by prompt incision and application of some caustic. Dip 
a bit of soft stick in strong carbolic acid and rub every part of the inside 
of the wound with it, or with any caustic at hand. If a caustic cannot be 
obtained, heat a piece of iron or steel to white heat and thrust the white- 
heat end into the wound. A knitting needle or small knife blade will 
answer the purpose. After cauterization, treat as an infected wound. 
This done relax the cord or ligature above the wound and again tighten 
it and watch for a few minutes for symptoms of general poisoning. Re- 
peat this until sure that the patient is out of danger. If symptoms of 
general poisoning do come on similar to those of shock, keep the ligature 
tight and treat the patient as for Shock, giving whiskey or other alcoholic 
liquors in sufficient quantity to sustain the system; but there is no ad- 
vantage in absolute intoxication. 

MAD DOG OR POISONOUS REPTILE BITES. 

What to Do. — This class of common and dangerous emergencies may 
be successfully met on the moment by the simple means shown in the 
adjoining plate. By preventing the poison from entering the system, 
time is gained for the use of the proper remedies. 

The Band. — The band, fillet or ligature used may be a strap, cord, 
rope or handkerchief — anything, in fact, which can be drawn and tied 
tightly ; or which, if tied loosely, will permit of a stick being placed within 
it, and a tight twisting of the same, after the manner of a tourniquet, in 
order to stop the blood circulation more effectively. 

How to Do. — 1. If the bite be on the arm, bind the cord, or ligature, 
tightly around the limb at the point indicated by the head of the "arm" 
arrow. 

2. If the bite be on the hand, bind the cord tightly around the wrist 
at the point indicated by the head of the "hand" arrow. 

3. If the bite be on the upper part of the leg, bind the cord tightly 
around the limb at the point indicated by the head of the "upper limb" 
arrow. 

4. If the bite be below the knee, bind the cord tightly around the 
limb at the point indicated by the head of the "lower limb" arrow. 

5. Further Precautions. — It is perhaps unnecessary to add that in 
the emergency of a mad dog bite the band for preventing the virus from 
entering the system should be applied as quickly and tightly as possible. If 
the material is at hand, several of such bands, tied one above the other, 



IF BITTEN ON 
THE WANO 




ACCIDENTS AND EMERGENCIES-What to do if Bitten by a Mad Dog 



or Poisonous Reptile 

copy«h:nt 1916 Sf e. j TO 



BURNS AND SCALDS. 829 

will prove more effective than a single one. An additional emergency 
measure, and a very proper one, is to quickly cut the wound out with a 
sharp knife, and then to cauterize it with a hot iron, or such other means 
as may prove to be at hand. Make all haste to get the victim within reach 
of the proper remedies. (See Index.) 

The Snake Bite. — The snake bites that are dangerously poisonous 
are those of the copperhead, water-moccasin, rattlesnake and viper. As in 
the case of the mad dog bite, several bands, tied one above the other, are 
better than one. The Wound should be cut out, and then sucked. jSTo 
harm can come from this if the mouth be free from sores, or the poison 
is not swallowed. In the absence of other means of cauterizing a snake 
bite wound, hunters pour powder upon it and explode it with a spark. 
The band or bands used should not be removed for some time, and in 
case of more than one, the uppermost one should be removed first. 

Breathing, Restoration of. — Proceed as in Drowning. 

Bruises — See Contusions. 

Broken Bones. — See Fractures. 

Burns and Scalds. — These may be caused by contact with flames, hot 
metals, hot liquids, steam, electricity or chemicals. They are dangerous ac- 
cording to depth and extent. The skin may be but slightly inflamed or it 
may be blistered or charred. If the extent be large and the burn deep, it is 
apt to be fatal, especially in children. Shock is common after severe burns. 
If a person's clothes be on fire, throw him down and smother the fire with 
coat, blanket or rug (see Burning Clothing). The clothing should be cut 
away with sharp scissors. If any part of the clothing adheres to the 
flesh, do not attempt to remove it. In severe burns the patient may be 
put into a warm bath with the clothes on and then the clothing removed 
while he is in the bath. 

Treatment. — In slight burns a piece of antiseptic gauze moistened 
with salt solution (1 teaspoonful of salt to a pint of warm water) will re- 
lieve pain, or it may be alleviated by covering with clean cloths wet with 
a warm solution of washing or baking soda, putting in as much soda as 
will dissolve. When pain is relieved, dress with boric acid ointment or 
vaseline. Kerosene oil or two parts of kerosene to one part of sweet oil also 
relieve pain. Other applications are carron oil, made by shaking together 
equal parts of linseed oil and lime water. This is a good household 
remedy to have ready made and always on hand for emergencies, but the 
bottle containing same must always be kept tightly corked or flies will 



830 FIRST AID TO THE INJURED. 

deposit their eggs and make it dangerous for use. Castor oil, fresh lard, 
cold cream or any fat that is not rancid are good applications. 

Severe burns or scalds must be kept warm and the air excluded. 
They may be dressed with salt solution or with soda solution as described, 
if possible sterilized dressings, and then covered warmly with cotton and 
lightly bandaged. 

Burns by sulphuric or other strong acids should be washed imme- 
diately and plentifully with an alkali such as the soda solution, lime water 
or milk of magnesia or covered with baking soda or powdered magnesia. 
Afterward follow the general treatment for burns. 

Burns made by lye, caustic lime, soda or potash should be at once 
washed with a weak acid, such as vinegar or lemon juice in water, and 
then followed by general treatment. 

External burns made by carbolic acid should be washed at once with 
alcohol, whiskey or brandy, or better still, quickly apply baking soda. If 
the acid has been taken internally, administer whiskey or brandy. 

Burns by Powder. — Characteristics. — When it has been sufficient to 
produce rupture of the small vessels in the skin and subcutaneous tissue, an 
"ecchymosis" or bruise is present. The skin is darkened and discolored, 
and grains of powder are plainly discernible in the skin. When it so in- 
jures the deeper tissues as to cause effusion of blood from rupture of some 
of the larger vessels "extravasation of blood" is said to be present. 

Symptoms. — Burns from powder produce an effusion of blood into 
the skin according to the force and distance employed, first as a livid red, 
deep blue or black patch, which in the course of twelve or eighteen hours 
becomes larger and lighter at its margins. About the third day it as- 
sumes a violet tint, on the fifth an olive brown, on the sixth a green, on 
the seventh or eighth it has a yellow aspect. 

Consequences. — A severe burn may cause a rupture of a large artery 
or vein, under which circumstances a fatal extravasation may ensue. The 
effects also vary as regards locality. For instance, in an adult a burn of 
this character over the scalp may be followed by a local effusion of blood, 
and in a child this effusion may go on so as to form a swelling which in 
some portions of the body may give rise to enormous enlargement. In 
some cases the blood thus extravasated breaks down, as it were, and con- 
siderable suppuration takes place. 

Treatment. — 1. In the treatment a slight burn requires but mild 
treatment, cooling applications, and if advisable the grains of powder 
carefully removed. If extravasation of blood has taken place, it is to be 



CHOKING. 831 

checked by a mixture of two parts common salt to three parts saltpetre 
applied to the surface, or the iced poultice made as follows: — Take of 
flaxseed meal a sufficient quantity to form a layer from three-quarters to 
an inch thick. Spread a cloth of proper size. Upon this at intervals of 
an inch or more place lumps of ice, the size of a marble. Then sprinkle 
them lightly over with the meal. Cover with another cloth, folding in 
the edges to prevent the escape of the mass, and apply the thick side to 
the surface of the wound. 

2. A lotion of tincture of arnica, one ounce to a pint of water, 
appears to be beneficial in hastening the absorption of blood, removing 
pain, and so forth. Some of the stimulating liniments, such as the soap 
of opium, may likewise be employed. In more severe cases cotton, wool 
or lint soaked in oil and covered with oiled silk are the best dressings. 
Moist applications here rather do harm and should be avoided. 

In all cases of severe burns a physician should be secured with least 
possible delay. If away from medical help and there is great suffering, 
one-quarter grain of morphine, twenty drops of laudanum or a tablespoon- 
ful of paregoric may be given an adult and repeated once or twice at half 
hour intervals if necessary. For children, the dose must be properly re- 
duced. See general index for table of children's doses. An important 
matter in case of burns is treatment of the accompanying shock. See 
Shock. 

Burning Clothing, How to Put Out — If your own clothing catches 
fire do not run for help, as this will fan the flame. Lie down and roll up 
tightly in an overcoat, blanket, rug or anything of a woollen or cloth 
nature you can lay your hands on. If nothing obtainable to wrap in, lie 
down and roll over, slowly beating out the fire with the hands. If another 
person's clothing is on fire throw him to the ground and smother the fire 
with coat, blanket, rug, table cover or whatever of the kind at hand. 
When flames are extinguished, pour water on burning parts until last 
spark has disappeared. 

Carrying the Wounded or Injured. — See Transportation of the Injured. 

Choking. — It is a common experience to have something stick in the 
throat, especially with children. All sorts of things get in that are liable 
to cause suffocation. The sufferer turns purple in the face, the eyes pro- 
trude, he throws his arms about and sometimes falls unconscious. In 
other cases the obstruction lodges in the larynx or the windpipe, caus- 
ing great distress and violent coughing. 

Treatment. — Slap the sufferer forcefully on the back, or stand him 



832 * FIRST AID TO THE INJURED. 

up face to the wall, his chest resting against it, and give him a severe blow 
between the shoulders. If a child, place one hand on each side of the chest 
and squeeze it vigorously and suddenly; or hold it with the head hang- 
ing down and slap the back while in this position. If something is sup- 
posed to be in the throat, perhaps a piece of meat, try to grasp by thrust- 
ing the thumb and forefinger down as far as possible, or try to hook it 
out with the forefinger. When the breathing is not seriously affected it 
is best to wait for medical aid, for unskilful handling may increase the 
difficulty, and it not unfrequently happens that the obstruction has passed 
down, leaving only an irritation that is mistaken for its actual presence. 

When a button, coin or other such article has been swallowed by a 
child, do not give oil or other purgatives. If the object swallowed is sharp 
or angular it is a good method to give the victim rye bread, potatoes 
and cheese to eat, the idea being that the edges which might wound may 
become coated or enmeshed with these substances in such manner as to 
protect the stomach and intestines. 

Circulation, Restoration of. — Get the patient into warm place. Ee- 
move clothing. Rub with hands or hot flannels and give alcoholic stimu- 
lants in small doses, or half a teaspoonful of aromatic spirits of ammonia 
in one or two tablespoonfuls of water, repeating dose if necessary; also 
hot tea, coffee, broth or hot water. A very efficacious remedy is a glass 
of hot milk in which half a teaspoonful up to one teaspoonful of cayenne 
pepper or paprika has been thoroughly stirred. Apply hot water bottle 
or other dry heat to the feet. 

Cold, Exposure to. — See Exposure to Cold ; also Circulation, Restora- 
tion of ; also Frost Bites. 

Compound Fracture. — See Fracture, Compound. 

Compression of the Brain. — When by a blow or fall a fracture of the 
skull has occurred and there is a piece of bone pressing on the brain 
substance or an escape of blood within the skull, causing pressure on the 
brain, it is called compression of the brain, and the symptoms are the 
same as those of Apoplexy. In some cases the fracture is not apparent by 
any examination. It may be situated at the base of the skull. Bleeding 
from the nose or ears, or blood in the whites of the eyes may indicate such 
fractures. Emergency treatment is the same as for Fracture of the Skull, 
which see; also see Apoplexy. Do not give stimulants. 

Concussion of the Brain. — This may be result of a severe blow upon 
the head or by falling on the head. The sufferer is stunned, is stupid, 
confused, sick at stomach, often vomits, lies pale and shivering, sometimes 



CONVULSIONS IN CHILDREN. 838 

faints and is more or less insensible, sometimes completely so, depending 
on severity of injury. Recovery is usually rapid, but after effects may 
last a long time. 

Treatment. — Place patient in cool, quiet, dark room on his back, 
with head slightly raised. Unfasten any clothing that is tight about neck 
or waist. If patient shivers or seems faint and cold, apply heat as de- 
scribed under Shock. Do not give stimulants in any head injuries. After 
first shock has passed away apply ice to the head. 

Contusions. — Ordinary bruises or contusions caused by falls or blows, 
consist of the rupture of small blood vessels under the unbroken skin and 
are indicated by the familiar black and blue marks. 

Treatment. — Lay over the bruise a cloth saturated with hot water, or 
with half hot water and half alcohol, or either with witch hazel or tincture 
of arnica. Hot poultices lessen pain and aid in absorption of the blood. 
Frequently no treatment is needed. 

Contusions with Injury to Internal Organs These may be serious and 

manifest various symptoms. If contusion of chest or abdomen there may 
be spitting or vomiting of blood or blood may be passed from bowels or 
bladder. There may be violent pain, paleness, fainting, depression and all 
signs of shock. 

Treatment. — Treat the shock and hemorrhage as described under 
those headings. 

Contused Wounds — See Wounds. 

Convulsions in Children. — Inject five grains chloral into rectum. 
Place child in warm mustard bath and then apply ice bag to spine. An- 
other treatment is to dip a blanket in hot water and wrap child's naked 
body in it, taking great care not to burn. Cover this with a dry blanket. 
Next lay cloth in cold water on the head. If spasms continue, give tea- 
spoonful of syrup of ipecac if it can swallow and follow with a tumbler 
of warm water. Then thrust finger down throat to hasten vomiting. 
Repeat ipecac every fifteen minutes if necessary for three or four doses. 
If spasms continue after child is in blanket fifteen minutes, give injection 
of soap and warm water and tablespoonful of castor oil as soon as he 
can swallow. Also see Index for other treatments. Remember that while 
one of these treatments should be commenced without a moment's delay, 
yet a physician should at the same time be immediately sent for, as 
although convulsions in children are most frequently due to some undi- 
gested substance, nevertheless, they are sometimes forerunners of serious 
diseases. 

53 



834' FIRST AID TO THE INJURED. 

Cramps, Muscular — When these occur in one of the legs (which is 
most frequently the case) take a strong cord, wind it around the leg where 
it is cramped, and taking an end in each hand give a sharp pull, strong 
enough to produce some pain. This will not only afford relief, but will 
generally prevent repetition for some hours. Another method is to press 
the toes forcefully on the floor or against end of bed, if occurring in 
night. These methods are not available with those seized with muscular 
cramps while swimming. In such case the swimmer should turn on his 
back and use his arms to keep himself afloat until the spasm is over. 

Crushed Limbs. — See subheading under Wounds. 

Cupping. — Where possible, cuts, wounds, etc., should be immediately 
sucked to draw out poison and frequently the patient can do this himself, 
but in many instances the wound is so situated that he cannot do so, and 
because of disease or for other reasons it may be dangerous or undesirable 
for anyone else to do so. Like results, however, may sometimes be ob- 
tained by "cupping," which in effect is a drawing of blood from a wound 
by vacuum, and thereby the poison fully or partially taken from the 
system before it has had opportunity to circulate. The inside of an or- 
dinary tumbler is swabbed with alcohol just sufficiently to blaze when 
ignited and just before the flame dies away the tumbler is inverted and 
placed over and surrounding the wound, where it is firmly pressed. A 
partial vacuum forms within the cup (glass) as the air cools, and the 
poisonous blood from the wound and its adjacent parts is more or less 
thoroughly drawn up into the cup, either through the already open wound 
or through small cuts specially made for the purpose. Great care must 
be exercised in swabbing the glass that there is not sufficient alcohol to 
run to the edge of the glass or bad burning may result. 

Cuts. — Simple cuts should be washed in clear water and allowed to 
bleed for a brief time that any poison may be expelled with the flowing 
blood. If cut caused by rusty or dirty instrument, wash with peroxide of 
hydrogen or other antiseptic, and dust with borated talcum or boric acid 
powder. Even the smallest cut, prick or scrape should be carefully treated, 
for blood poisoning may result from the most trifling wound. One of the 
most efficient means of extracting poison from small wounds is to suck 
them vigorously. If a little cut gapes open it may be brought together 
with a piece of sticking plaster through the middle, but never cover any 
wound entirely with plaster, though to protect it, a small, sterilized 
bandage or pad should be utilized. 



DISLOCATIONS. 835 

If the wound is deep or an artery has been cut so that blood spurts 
out, follow directions given under Hemorrhage. 

Dislocations — If one bone is displaced from another at a joint the 
injury is called a dislocation. The ligaments that hold the joint in place 
have been torn, and there is pain, deformity and stiffness. It is sometimes 
difficult to distinguish dislocations from fractures near the joint, and 
for this and other reasons it is very unwise for any unskilled person to 
undertake treatment of any dislocation unless doctor cannot possibly be 
obtained. Pending arrival of physician, simply make the sufferer as com- 
fortable as possible and lay a wet cloth over the affected joint. If it hap- 
pens that professional aid cannot be secured, then be guided by the instruc- 
tions given under respective subheadings as hereafter following, being 
very careful not to confuse fracture with dislocation. 

1. Dislocation of the Shoulder — Sometimes this is easily replaced, 
especially if dislocation has occurred previously. Lay patient on back and 
sit down on the injured side, facing /his head. Draw down his arm, 
and while drawing down draw it over in front of his body to the other side. 
This will often pry the head of the bone into its place. As a fulcrum, 
you may take off your shoe and place your stockinged foot in the arm 
pit. Or, standing beside the patient as he lies on his back, draw the arm 
vertically upward. These manipulations should be executed with the 
greatest gentleness, yet with absolute firmness. If any difficulty be ex- 
perienced, the attempt should be given up unless you can find out the 
cause of the difficulty beyond question. Follow with cold applications. 

2. Dislocation of the Fingers — This may be treated by pulling bones 
into place and following with cold applications. 

3. Dislocation of the Lower Jaw — The mouth is wide open and the 
lower jaw immovable and projecting. Place your two thumbs in the suf- 
ferer's mouth, one on each side and both resting on the lower back teeth. 
Press steadily but firmly downward, then a little backward, and the jaw 
should go into place with a snap. But before putting your thumbs in the 
mouth, protect them by wrapping them in handkerchiefs as otherwise, 
when the jaw goes into place, the thumbs are apt to be caught between the 
teeth and be more or less seriously injured, and there will be two patients 
instead of one. 

4. Other Dislocations. — Excepting under most exceptional cases, dis- 
locations other than those of shoulders, fingers and lower jaw had much 
better be left alone until surgeon arrives, even if much delayed, as more 



836 FIRST AID TO THE INJURED. 

harm is apt to be done by unskilled handling than by waiting. If situated 
where impossible to obtain medical aid, consult chapter on surgery. 

Dog Bites — See Bites of Dogs. 

Drunken Stupor. — See Intoxication. 

Delirium Tremens. — See special article as per general index at end of 
book. 

Drowning. — See Eescue from Drowning. 

Electricity, Accidents from.-^-First remove sufferer from influence of 
current; but for his own safety and that of others present, the rescuer 
must use the greatest precautions, as it often entails great danger. Be- 
ware of third rails, swinging wires and wires of all kinds. Unless proper 
precautions are exercised a person in contact with a wire or rail will 
transfer the current to the rescuer. He must not touch the unfortunate 
victim unless his (the rescuer's) own body is thoroughly insulated. The 
rescuer must act very promptly, for the danger to the victim is much in- 
creased the longer the electric current is allowed to pass through his 
body. If possible, the rescuer should insulate himself by covering his 
hands with a mackintosh, rubber sheeting, several thicknesses of silk or 
even a dry cloth. In addition, he should complete his insulation by stand- 
ing on a dry board, a thick piece of paper or even on a dry coat. Rubber 
gloves and rubber shoes or boots are still safer, but cannot usually be pro- 
cured quickly. If a live wire is under the victim and the ground is dry, 
it will be safe to pull him off the wire with the bare hands if care be taken 
to touch only his clothing, but this must not be attempted if the clothing 
be wet or damp. A live wire lying on a patient may be flipped off with a 
dry board or stick. Do this with one motion, as rocking the wire to and 
fro will increase shock and burn. A live wire may be cut by an axe or 
hatchet with dry, wooden handle. The electric current may be short- 
circuited by dropping a crow-bar or poker on the wire. These must be 
dropped on the side from which the current is coming and not on the 
farther side, as the latter will not short-circuit the current until after it 
passes through the body of the victim. Drop the metal bar ; do not place it 
on the wire or you will then be made a part of the short circuit and receive 
the current of electricity through your own body. 

Always send for a doctor, but do not wait for him. Treatment should 
be given even if the victim appears to be dead. Loosen the clothing 
around neck and body and then proceed to restore breathing by artificial 
respiration as in Drowning. 

Ear. — See Foreign Bodies in Ear. 



EXPOSURE TO COLD. 837 

Eye. — See Foreign Bodies in Eye. 

Epileptic Fits. — Those who are subject to epilepsy usually know by 
a peculiar feeling that an attack is about to come on. Following this the 
face becomes pale, and sometimes uttering a peculiar cry, the victim falls 
unconscious. The face now becomes congested and violent convulsions 
follow. The tongue is sometimes bitten and bleeds, there may be frothing 
at the mouth, the eyes roll and are turned upward. A single attack lasts 
from a second to several minutes, but there may be a series of attacks, one 
succeeding another with scarcely appreciable intervals for an hour or 
more. After an attack the victim usually has a headache and a great desire 
to sleep. Sometimes, however, he becomes violent and dangerous. 

Treatment. — See that the victim lies flat, and guard him against in- 
juring himself. If possible place a cork or piece of folded cloth between 
his teeth to prevent him from biting his tongue. Do not endeavor to 
break his "grip" as it is called. Oftentimes people think this necessary, 
and a strong man will sometimes force open a delicate hand with a violence 
that may lame it for weeks. When the fit is over permit the patient to 
sleep in a cool room as long as he will. Be on your guard for periods of 
violence. 

Expiration. — See Bespiration. 

Exposure to Cold.— During intense cold frost bites and the freezing 
of nose, ears and other extremities quite commonly occur. Usually they 
do not affect the system generally and require but simple local treatment. 
(See Frost Bites.) But exposure to cold weather, accompanied by 
actual freezing of any part of the body or not, may affect the whole 
system and require special treatment. Even when the temperature is 
not excessively low, long exposure may cause a general chilling of the 
whole body, resulting in depression and sometimes in insensibility or 
even death, although no part may be frozen. Especially is this apt to 
occur during exhaustion from overwork, long exposure in an open boat, 
long marches, and in those whose vitality is lowered by lack of food or any 
other cause. Chilling may take place insidiously and without the person 
being aware. The blood becomes chilled, circulation is impeded, and there 
is grave danger of general collapse. 

Treatment. — If there are no frozen parts, treat as for restora- 
tion of circulation — that is, get the patient into a warm place, remove 
clothing, rub with hands or hot flannels and give alcoholic stimulants 
in small doses, also hot tea, coffee, broth or hot water. A glass of hot 
milk in which half a teaspoonful up to a teaspoonful of cayenne pepper 



838 FIRST AID TO THE INJURED. 

or paprika has been thoroughly stirred usually gives excellent results. 
Apply hot water bottle or other dry heat to the feet. If the person is in- 
sensible, artificial respiration may be necessary (see artificial respiration 
in drowning accidents). 

If any part of the body be frozen, this must be given first attention. 
It has been taught almost universally that a frozen limb should be put into 
cold water or rubbed with snow, and while this method may be safely 
adopted in the case of frost bites to nose and ears, it may prove dangerous 
to a person who is seriously frozen, and especially if exhausted, and it is 
now recommended that the patient be immediately immersed in a warm 
bath, which should be made gradually warmer until it is as hot as can be 
borne. This method has been endorsed by surgeons accompanying arctic 
expeditions, and has been adopted by some of the world's best life-saving 
societies, such, for instance, as the New York Society for First Aid to the 
Injured. But it is to be borne in mind that under no circumstances 
should dry heat be applied to frozen parts. See Frost Bites. 

Factory Accidents — -See Wounds. 

Fainting. — The pale, bloodless face in fainting is well known. It 
indicates a like bloodless state within the brain. The action of the heart 
has been weakened for the time and there follows a lessening of the 
blood supply to the brain. This causes a loss of consciousness. The 
pulse is slow, feeble and sometimes absent. 

Treatment. — Lay the fainting person down at once. If on a sofa or 
bed let the head hang over so that it will be lower than the body, and 
raise the feet on a couple of cushions or pillows. This position enables the 
heart to more easily send blood to the brain. Expose the face to cold air, 
sprinkle it with cold water and hold ammonia or smelling salts to the 
nose, and also administer internally half a teaspoonful of aromatic spirits 
of ammonia in one or two tablespoonfuls of water. If the fainting spell 
continues, treat it like a case of shock. Remember as of vital impor- 
tance that the person who has fainted must be laid down flat and the 
feet raised higher than the head, in order to increase the flow of blood to 
the brain. 

Fish-Hooks, Extraction of. — When a fish-hook becomes imbedded in 
the flesh beyond its barb, it is a very painful matter to extract it without 
proper instruments and knowledge of their use, and so if a physician can 
be seen within a reasonably short time, it is better to leave the hook in the 
flesh until he can give it attention, as by a very simple incision with 
proper and aseptic instruments he can remove it with little pain and no 



FOREIGN BODIES IN THE EAR. 839 

danger of after poisoning. However, where resort cannot be had to a doc- 
tor the hook must be taken out. To pull it out in the ordinary way tears 
the flesh, is very painful and leaves a nasty wound. The following is 
therefore recommended as a more satisfactory method: Turn the hook in 
the flesh until the barbed point is directed outward to a different part 
from that at which it entered and push it through the skin at this new 
point until the barb is clear. Then with a pair of wire clippers, snip off 
the barbed end, when the hook may be drawn through its original entry 
point without difficulty. (If no clipper is at hand, the barb may be filed 
away with same results.) Then thoroughly suck the wound to withdraw 
any poison. Bandage and treat as an ordinary wound. 

Foreign Bodies in the Eye — In case of a foreign body in the eye at- 
tempts may be made to remove it as follows: Wink rapidly a few times, 
at the same time blowing the nose, and it may be carried to the corner of 
the eye, where it may be removed with the corner of a handkerchief or a 
bit of cotton twisted about the end of a match. Draw down the lower lid 
and if the body is seen remove it in the same way. Drawing the upper 
lid over the lower by means of the eyelashes will sometimes remove the 
body. If this fails, the eyelid may be rolled over a pencil or match by 
pulling the lid away from the eye and, having the patient look at his feet, 
you press the back part of the lid down with the pencil laid across it 
above the eye. The particle will often be found adhering to the inner 
surface of the lid, and when detected can generally be wiped off with a bit 
of absorbent cotton or soft cloth, care being taken not to touch the ball 
of the eye. A drop of castor oil may be put in the eye to relieve irritation 
and a grain of linseed placed in the corner of the eye and the lid gently 
worked with an inward rotary motion often proves successful when other 
methods have failed. If these simple methods are not availing, see a 
doctor at once. 

Foreign Bodies in the Nose. — These are frequently in the form of 
beads, buttons and so forth pushed up by children with desire to see what 
they may do. They may sometimes be driven out by violent sneezing 
produced by snuff or by tickling the inside of the nostril with a feather. 
If such means are ineffective, call a physician at once. He can generally 
readily remove such objects with suitable instruments. 

Foreign Bodies in the Ear — Insects and certain other foreign bodies 
in the ear may generally be removed by syringing with warm water (be 
very careful it is not hot). If no syringe at hand, let the patient lie down 
on the opposite side and fill the auditory canal with warm water, but while 



840 FIRST AID TO THE INJURED. 

this is perfectly safe in case of an insect or any foreign body that will not 
swell, it must be remembered that if the foreign body be of such nature 
that water will make it swell, then this method must not be used. Eo 
further attempts should be made except by physician, whom see at once. 

Fingers, Dislocation of — See Dislocations and Wounds. 

Fits. — See Epileptic Fits. 

Fits in Children — See Convulsions. 

Fractures — A fracture is a broken bone. There are different kinds 
of fractures, but in general classification they are either simple or com- 
pound. A simple fracture is one in which the skin is not injured, so that 
no matter how much the bone is broken up, there is no communication of 
the fragments with the open air. A compound fracture is one in which 
the breaking of the bone is accompanied by a wound, caused either by the 
same force which produced the break, as, for instance, a bullet, or by the 
ends of the broken bones protruding through the skin. Compound frac- 
tures are much more dangerous than simple ones, chiefly because when- 
ever the skin is broken disease-producing germs are apt to gain entrance 
to the tissues and set up the process of suppuration, or forming of pus. 

It is sometimes very difficult to tell whether or not there is a fracture, 
but it may usually be recognized by the following indications : First, that 
the limb is altered in shape, bent or shortened at a point where there is 
no joint, inequality often being felt on running the finger along the broken 
bone; second, by there being an unnatural degree of movement at the 
seat of injury; third, by the inability of the patient to use the part; 
fourth, by the patient feeling severe pain at a particular point, and this 
point being painful to the touch; fifth, by the grating of the broken 
ends of the bone, which may be felt and sometimes even heard when the 
limb is moved ; sixth, by a careful comparison of the injured limb with the 
sound one. The person who extends first aid, however, should never try 
to diagnose by trying for false or unnatural movement nor by causing 
the grating of the bones just described, as so doing may result in getting 
the bones still more out of place. 

Treatment. — Where fracture is suspected have the patient lie down 
in as comfortable position as possible. Then very gently and slowly re- 
move enough clothing to expose the injured part, cutting or ripping if 
necessary with knife or scissors. If the limb is very visibly deformed, try 
to straighten it by grasping the limb below the deformity and pulling 
gently and steadily in a straight line with the limb. Support the limb 
in its corrected position by slipping a pillow or cushion under the injured 



COMPOUND FRACTURES. 841 

part, and tie it around the limb with two or three handkerchiefs, suspender 
straps or strong cords. A folded coat or two may be made to answer the 
same purpose. One should have an assistant in this. Then await the 
arrival of the doctor. There is no need for hurry in further setting the 
fracture, but if a physician cannot be obtained, or the patient must be 
moved, improvise a splint suitable for the fracture. Splints may be made 
of anything that is stiff and rigid. Something flat like a board is better 
than a pole or staff, yet limbs broken off a tree will do if nothing else 
can be found. Shingles make excellent splints. In applying splints, re- 
member that they should extend beyond the next joint above and the next 
joint below, otherwise movements of the joints will cause movement of 
the broken point. If possible secure two pieces of thin board as wide 
as the limb is thick and long enough to extend beyond the joints above and 
below the fracture. Cover one side of each splint with a pad made by 
folding up pieces of cotton batting or a number of thicknesses of the 
softest cloth at hand. Now tie the splints firmly one on each side of the 
injured limb, with several strips of cloth, handkerchiefs, bicycle tape or 
other like binders, in such manner as to keep the broken ends of the 
bone immovable. If single pieces of board of proper length are not 
available, a number of smaller pieces of even thickness may be laid side 
by side (such as shingles) and the whole held firm by canes or poles of 
sufficient length being bound on the outside. In emergency, almost 
anything may be used, barrel staves, pasteboard boxes, cigar boxes, pieces 
of sole leather from nearest shoemaker, stockings stuffed with bran, sand 
or other material. For padding inside the splints and against the injured 
limb, use cotton batting, cloth, hay, straw, leaves folded up in handker- 
chiefs, a piece of a shirt, or leaves or grass stuffed into a shirt sleeve or 
coat sleeve. In railway accidents stuffing out of the seats is often used. 
Never bandage a fractured limb before applying splints unless to hold 
a necessary dressing in place, and in such case the dressing should be large 
and thick and the bandage only applied over the dressing, the reason 
being that otherwise, after swelling of the limb may cause the bandage to 
become too tight. Never move an injured patient until careful examina- 
tion for fracture has been made and splints applied, if necessary. The 
best way to move a patient is on a stretcher, which may be improvised 
from shutters, doors, etc. See instructions in Transportation of the 
Injured in this same chapter. Eead also article on Bandaging; also 
examine following particulars as to specific fractures. 

Fractures, Compound. — Should there be a wound in connection with 



842 FIRST AID TO THE INJURED. 

any fracture, place a large pad or compress of sterilized gauze, or other 
sterilized material, over the wound and bandage in place. This is of 
great importance. It is wiser to leave the wound untouched until ster- 
ilized material can be secured, or prepared by boiling, than to dress with 
unsterilized material. Then proceed in same manner as with simple 
fractures. (See preceding item.) 

Fracture of the Arm. — A padded splint should be placed on the arm 
from the highest part of the shoulder to the point of the elbow, then place 
a shorter one on the inside of the arm, taking care that it does not cut 
into the arm pit or the bend of the elbow. Then put the hand in a sling. 
Read carefully the general instructions regarding fractures in this emer- 
gency chapter. 

Fracture of the Forearm. — Mrst bend the elbow at a right angle and 
place a broad, well-padded splint, reaching to the ends of the fingers along 
the back of the forearm and hand. Now, place another splint on the front 
of the arm and bind them on firmly. Be careful that the splint does not 
cut into the bend of the elbow. Head carefully the general instructions 
regarding fractures in this chapter. 

Fracture of the Elbow. — Put the arm in as comfortable a, position as 
possible, apply cold cloths and await arrival of physician. This fracture 
requires the most skilled work and only under extraordinary circum- 
stances should a non-professional person attempt any treatment. 

Fracture of the Ribs. — See general article on Fractures in this emer- 
gency chapter. In addition to some of the usual signs of fracture there 
is commonly difiiculty in breathing and sometimes spitting of blood. 

Treatment. — The whole chest should be firmly bandaged with a 
roller bandage. If there be spitting of blood, keep the patient quiet. 
Secure aid of physician as soon as possible. 

Fracture of the Spine. — If the neck or back has been injured and the 
patient cannot move the lower limbs, fracture of the spine may be sus- 
pected. In this case if the patient be in a safe and sheltered place do 
not move him at all, but await physician. If environment makes it neces- 
sary to move him, then endeavor to place him on stretcher with the least 
possible movement of the head and body. 

Fracture of the Thigh. — A long splint should be applied frbm the 
arm-pit to the foot and another on the inner side of the thigh from the 
crotch to the foot. Place bandages around body, thigh and leg. In women 
the other leg may be used for an inner splint and the bandages placed 



FROST BITES. 843 

around both legs and the outside splint. Read carefully the general in- 
structions regarding fractures in this emergency chapter. 

Fracture of the Jaw. — Close the jaw so as to bring the teeth against 
each other and bandage with four-tailed bandage described in article on 
bandaging (see general index). 

Fracture of the Collar Bone. — The patient should be placed on his 
back on the floor with a blanket beneath him and have him remain there 
until physician arrives. If necessary to move him, bind the elbow to the 
side and support the hand and forearm in a sling. See instructions re- 
garding Fractures. 

Fracture of the Leg. — Follow instructions as to splints, etc., as de- 
scribed in general instructions regarding fracture in this emergency 
article. 

Fracture of the Nose. — Apply cold compresses and see physician. 

Fracture of Skull. — This may be caused by a fall or a blow on the 
head, and there may or may not be a wound. Symptoms of concussion or 
compression of the brain may appear. (See Compression and Concussion 
of the Brain.) 

Treatment. — If fracture is suspected, carefully dress any wound on 
the head and place the patient in a cool, dark, quiet room. He should lie 
on the back, the head slightly raised. Apply wet, cold cloth to the head. 
Do not give any stimulants. Secure physician at once. 

Frost Bites, Frozen Limbs, etc. — In severe winter weather any ex- 
posed or insufficiently clad part of the body is liable to become frozen, 
and this is especially likely with the extremities such as nose, ears, fingers, 
toes, etc. The parts first become blue, then purple and then white and 
stiff. When solidly frozen the part becomes as hard as stone and at the 
same time is very brittle so that, for instance, were you to strike a solidly 
frozen ear, it would break off. Freezing is apt to occur without the victim 
being aware of the fact. It may usually be prevented by rubbing any part 
which feels very cold, as this brings warm blood to the surface. The 
danger is when after being cold the part suddenly has no feeling. The 
object of treatment is to gradually restore circulation to the congealed part. 
Application of snow or cold water to the frozen part, gently rubbing and 
pinching it, is the most common method of restoration, but care must be 
taken in severe cases to do this so gently as not to break off any brittle 
part. Under no circumstances should dry heat be applied nor hot water, 
as either of these methods is apt to cause mortification of the frozen part ; 
but it is now recognized that the most efficacious treatment is that of 



844 FIRST AID TO THE INJURED. 

commencing the thawing process with water that is merely warm and 
then gradually as the thawing takes place making the water warmer nntil 
it is as hot as may be borne. See full dissertation on this point under 
Exposure to Cold. 

Frozen Limbs, etc. — See Frost Bites and Exposure to Cold. 

Gas Poisoning or Asphyxiation from Gas — This may occur from escape 
of illuminating gas from incompletely turned off jet, leak in gas pipe, etc., 
or from escape of coal gas from stoves, from the burning of charcoal and 
in other ways. If gas is in evidence be very careful not to take a lamp 
into the room nor to strike a match, as explosion may occur. The first 
thing is to get air to the victim or else the victim into the air — raise or 
smash windows or do anything necessary to let in the air. On entering 
gas filled room for purpose of rescue, beware of being overcome yourself. 
Generally less gas will be found near the floor of a room, and so one may 
be able to creep where it would be dangerous to walk. Eresh air having 
been gained and the victim being unconscious, proceed at once to restore 
breathing as described in respect of drowning. Use stimulants moderately 
and work to restore perfect circulation. Keep patient awake. 

Hanging. — Cut patient down, then use treatment for Drowning and 
Gas Poisoning. 

Heatstroke or Sunstroke. — This is induced by exposure to excessive 
heat, either with or without direct rays of the sun. There are certain 
general symptoms of its oncoming which should serve as a warning — head- 
ache, a sense of weakness at the pit of the stomach, a weakness of the 
knees, dizziness and sometimes vomiting and disturbed vision. These 
symptoms may gradually merge into unconsciousness or without warning 
the stricken one may suddenly collapse and lie insensible. A character- 
istic condition is the intense, burning dry heat of the face, head and body. 
The face itself becomes red and flushed ; the pulse is full and rapid ; con- 
vulsive twitchings of various parts of the body are frequently observed. 

Treatment. — Endeavor at once to reduce the heat of the body. Un- 
dress the patient, wrap the body in a sheet and keep the sheet wet with 
cold water by frequent sprinkling. Continue this until consciousness re- 
turns and the body feels cool. If after becoming conscious the patient 
relapses into unconsciousness, the cold water process must be repeated. 
If impossible to immediately follow the above treatment, then wring out 
cloths in ice water, or coldest to be had, and place them on the head, back 
of the neck and around the wrists. 



HEMORRHAGE. 845 

Note. — Sunstroke or Heatstroke is quite different from Heat Ex- 
haustion, for which see next following item. 

Heat Exhaustion. — This is due to similar cause, but is character- 
istically different from Heatstroke. The face instead of being greatly 
flushed will at most be but slightly so, and is more apt to be pallid, while 
the skin instead of dry and burning will be found moist and even cool — 
the pulse is frequent and feeble. 

Treatment. — Do not apply cold, as temperature is not to be reduced. 
Place sufferer in a cool, quiet room and give stimulants gradually. Keep 
patient warm by use of hot water bottles or other dry heat, but do not 
bring on perspiration. Build up with broths and light, nourishing food. 

Note. — Heat exhaustion is far more common than heatstroke. 
Usually cases only occur after several days of continued heat. Debility 
and alcoholism strongly predispose attacks. (See Heatstroke.) 

Hemorrhage, or Bleeding from Wounds — All wounds, even a pin prick, 
will bleed, but unless an important vein or an artery is penetrated, the 
bleeding will usually stop of itself if the blood be allowed to clot and so 
close the aperture o'f escape. It follows that to keep wiping and bathing 
a simple wound, as so frequently is done, hinders nature in its method of 
stopping the flow by clotting or coagulation of the blood. Bleeding to 
death even from the slightest of wounds would be a common occurrence 
were it not for the clotting of blood. While on general principles this 
shows the vital importance of leaving it to nature to stop the bleeding by 
coagulating the blood in the wound, yet it must always be borne in mind 
that there are rare cases where the blood has no power to coagulate, and 
with individuals so affected there is danger of bleeding to death even from 
slight wounds if extraordinary precautions are not taken. But remember 
that a very little blood makes great showing and people are often unneces- 
sarily frightened by a flowing of blood that will soon stop of itself if left 
alone or if the part be elevated as by holding a cut finger above the head, 
or if a small compress and bandage are applied, or light but steady pres- 
sure made in any way on the part which bleeds. 

To stop bleeding from any external wound, the patient should first 
lie down, the bleeding part raised as high above the rest of the body as 
possible. This of itself will sometimes check the bleeding if the blood 
vessel wounded is but a small one or a vein. Cut away or otherwise remove 
any clothing necessary to fully expose the wound. If the bleeding con- 
tinues after lying down, make a compress with a sufficient quantity of 
Sterilized gauze or absorbent cotton or if these are not obtainable, then by 



846 FIRST AID TO THE INJURED. 

folding any clean cloth, as a couple of clean handkerchiefs or a piece of a 
clean shirt or skirt. Make a rather thick pad somewhat larger than the 
wound and place it over the wound, binding it on tightly with a hand- 
kerchief, strip of cloth, pair of suspenders or anything of sufficient length 
that may be used as a bandage. Watch closely for a few minutes and 
if blood continues to now freely through or around the compress, apply 
another on top of the first one, binding it on more tightly, and with the 
fingers make steady and continuous pressure on the compress. If the 
wound in a limb still continues to bleed freely, apply a tourniquet (see 
description regarding "tourniquet"), still keeping the limb elevated. A 
tourniquet may be very painful and moreover may do harm. It is fre- 
quently needlessly used to stop bleeding that a compress and bandage 
with finger pressure would easily control, and so the tourniquet should 
only be resorted to when these . methods have failed. In the case of 
hemorrhage from a wound on any part of the body where a tourniquet 
cannot be readily applied, such as head, neck, trunk, or limb wounded 
too high up, the compress and finger pressure are the only practical 
methods for other than a doctor to attempt. In cases where use of the 
tourniquet seems necessary, the following instructions may aid: 

1. The Tourniquet — Take a strip of strong cloth, handkerchief, towel, 
pair of suspenders or other material immediately at hand, wind it loosely 
one or more times about the limb between the wound and the body and tie 
the ends together. Take a smooth, round stone, apple, potato or any hard, 
smooth object (or lacking such a tight wad of cloth) and place it under 
the bandage between it and the skin and over the seat of the main artery. 
Then pass a cane, umbrella, ruler, stick, or rod of any kind, under the 
bandage on the other side of the limb and twist the bandage with the rod 
until the stone or wad is pressed firmly into the limb and the bleeding 
stops. The tourniquet may be left in place until the physician comes, or, 
if very painful, or after half an hour has elapsed, may be very slowly 
relaxed, tightening it again if the bleeding recommences. 2/ the position 
of the main artery is not known or cannot be remembered, apply the tour- 
niquet without the stone or wad. 

2. To Locate Main Arteries — a. Hand or Arm. — Apply tourniquet to 
upper arm above wound, with the stone or wad on the inner side of the 
arm. 

b. Foot, Leg or Thigh. Apply tourniquet at upper end of the thigh 
with the stone or wad placed one inch below the centre of the crease of 
the groin. 




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HEMORRHAGE. 847 

3. While the tourniquet is being prepared and applied, pressure must 
be made by another person, or even by the injured person himself if no 
one else available, the thumbs or fingers being pressed tightly against the 
place which the stone or wad of the tourniquet is to occupy. 

4. A careful previous study of the colored plates 1 and 2 in this 
chapter in conjunction with the descriptive matter on the opposite pages 
will give a knowledge of the location of veins and arteries that may 
prove invaluable. 

Hemorrhage of the Lungs. — This is generally shown by the coughing 
up of bright, frothy blood. It often gives much alarm, but is not usually 
dangerous. 

Treatment. — Perfect rest in bed in a cool room, with head and 
shoulders raised. Give patient small piece of ice to swallow and small 
doses of dry table salt and reassure him by telling him there is no 
danger. See special medicinal treatment per general index. 

Hemorrhage of Varicose Veins. — Swollen or varicose veins in the legs, 
when ulcerated, sometimes burst and even fatal hemorrhage may result 
if the accident is not properly treated. The bleeding, however, may be 
stopped immediately by placing the tip of one finger on the bleeding point. 
The patient should be lain down and the leg raised perpendicularly and a 
compress and firm bandage applied over the ruptured vein. Ordinary 
position may then be resumed. The simple elevation of the leg will 
usually stop this hemorrhage. 

Hemorrhage of the Stomach. — Dark blood in clots is vomited, usually 
resembling coffee grounds, but sometimes mixed with bright blood. 

Treatment. — Same as for Hemorrhage of the Lungs. 

Hemorrhage of other Internal Organs — Bleeding from other internal 
organs should be treated much as in case of stomach and lungs. Get the 
patient to bed and insure perfect rest in a cool room. 

Special Note. — In all internal hemorrhages summon a physician, 
informing him of the exact nature of the trouble at the time of calling him. 

HemoTrhage Through the Nose, or Nose-Bleed. — Frequently this is na- 
ture's way of relieving some internal condition, and within reasonable 
limit is often of considerable benefit. Usually it will stop of itself in a 
few minutes. It is seldom serious, yet with weak or anaemic patients or 
where the blood continues to flow copiously for a considerable time it 
may prove so. 

Treatment. — In ordinary cases of bleeding of the nose a well-recom- 
mended remedy is the following, in respect of which for clearness of de- 



848 FIRST AID TO THE INJURED. 

HOW TO STOP BLEEDING FROM WOUNDS- 

The Emergency. — In case of severely bleeding wounds, quick work 
is required to save life. One must know not only what to do, but bow to 
do it. 

The Arrows. — The arrows in the adjoining plate show the places on 
the body where pressure is to be made in order to stop the flow of blood. 

Kinds of Pressure. — In ordinary wounds the pressure may be found 
sufficient when made with the index finger or the thumb. In severe 
wounds, and where the arteries or veins lie deep, the firm pressure of both 
thumbs may be required. In still more severe wounds or where the thumbs 
becomes tired resort may be had to the tourniquet. The following illus- 
trations are from actual photographs showing exactly where pressure 
should be brought to bear and giving explanation under each illustration. 

Places of Pressure. — 1. If the wound is upon the forehead, place the 
index finger or thumb upon the spot indicated by the head of the "fore- 
head" arrow, and exert firm pressure. 

2. If the wound is upon the scalp, place the index finger or thumb 
upon the spot indicated by the head of the "scalp" arrow, and' press firmly. 

3. If the wound be upon the face, press the index finger or thumb 
upon the spot indicated by the head of the "face" arrow. 

4. If the wound be upon the head or upper part of the neck, in other 
words, above the shoulders, the pressure must be made on the spot indi- 
cated by the head of the "neck and head" arrow. Press hard. 

5. If the wound be on the arm, make the pressure on the inside of 
the arm, at the spot indicated by the head of the "arm" arrow. This 
pressure will stop the bleeding of a wound anywhere below the neck and 
above the heart. It must be made on the inside of the arm nearest wound. 

6. If the wound be on the hand, make the pressure on the places in- 
dicated by the heads of the "hand" arrows. 

7. If the wound be on the body anywhere below the region of the 
heart, the pressure must be exerted very firmly on the inside of the thigh, 
at the point indicated by the head of the "thigh" arrow. 

8. If the wound be on the lower leg or foot, the pressure must be 
made on the spot indicated by the head of the "leg and foot" arrow. 

9. If the wound be on the top of the foot, make the pressure at the 
spot indicated by the head of the "top of foot" arrow. 

10. If the wound be on the sole of the foot, make the pressure on 
the spot indicated by the head of the "sole of foot" arrow. 



FOR FOREHEAD 



FOR SCALP 



FOR FACE 



FOR ARM 




FOR HAND — -J^// FOR THIGH 

\ 

VOR HAND 



FOR TOP OF FOOT 



ACCIDENTS AND EMERGENCIE5~How TO Stop Bleeding 



COPYRIGHT >3I6 BYE.J.SWU.E.r 



HYSTERIA. 349 

scription we will assume blood to be flowing from the right nostril : The 
sufferer stands and in first place cleans the nostrils by a good blowing 
into handkerchief , then with head erect he places the forefinger of the right 
hand against the right or bleeding nostril and presses tightly, while at the 
same time he raises his left arm upward as if he were reaching strenuously 
for something above him, the palm open and fingers extended. Continue 
fixed in this position for one full minute, then release the nostril, when 
the flow will usually have stopped. If not, continue for another minute. 
Three minutes is an outside limit for results. If it be the left nostril that 
bleeds the position of the hands would simply be reversed. This method 
has the great advantage that when the bleeding has stopped there is no 
clotted blood or bloody mucous in the nostril, the air passage being left 
as clear and free as if there had been no bleeding. 

The following are usual methods, but all have the disadvantage of 
leaving more or less clotted bloody mucous in the nostril : 

1. Do not blow the nose. See that there is nothing tight about the 
neck. Keep quiet, either sitting or standing, with head bent slightly for- 
ward. Apply something cold to bridge of nose and back of neck. Breathe 
in cool air through the nose and breathe out through the mouth. 

2. Put hands in a basin of water as hot as can be borne. 

3. Sniff ice water up the nose a few times and then hold the nostrils 
closed with the fingers for five minutes. 

4. Place a piece of blotting paper between the upper lip and the gums 
and leave it there for a considerable period. If no blotting paper at hand, 
coarse brown or any paper of absorbent nature may suffice. 

If none of the foregoing measures are successful in stopping the flow 
of blood then summon a physician without delay, informing him of the 
nature of the trouble when doing so. 

Hydrophobia. — See Bites of Dogs. 

Hysteria. — See special article in chapter on Nervous Diseases ; also 
index for other references, treatments, etc. 

Hysterical Unconsciousness — The patient, usually a woman, may ap- 
pear to be insensible or to wish to be thought so ; the body being limp and 
the eyes closed. However, if any attempt be made to open the eyelids to 
examine the eyes, it is resisted and the eyeballs are kept rolled up in the 
head, a characteristic sign of hysteria which is not in evidence in uncon- 
sciousness from other causes. The usual pallor of fainting is not present, 
the pulse is apt to be natural, certainly not absent nor very feeble or slow, 
54 



850 FIRST AID TO THE INJURED. 

and inquiry will generally elucidate the fact that the patient is subject to 
hysterical attacks. 

Treatment. — The best treatment is to leave the patient in charge of 
a quiet, kindly, unexcitable attendant, who should speak firmly and en- 
deavor to make patient gain self control. (See Unconsciousness.) 

Insensibility. — See Unconsciousness. 

Internal Bleeding. — See Hemorrhage. 

Internal Organs, Injury to, Protusion of, etc. — See Wounds of Internal 
Organs, etc. 

Intoxication— Drunken Stupor, etc. — A person in a drunken stupor 
closely resembles one in a fit of apoplexy. When the breath does not smell 
of liquor it is not drunkenness. But the mere fact that the breath smells 
of liquor is not evidence that the patient is drunk. A man may have taken 
a drink without its making him drunk and without his being in any sense 
the worse of liquor, yet with the odor on his breath, he may have an 
apoplectic fit, or liquor may have been administered to him after the fit. 
These facts sometimes make it difficult to distinguish the true condition. 
In drunken stupor the face is not drawn to one side and the cheeks do not 
puff out in breathing as occur in apoplexy. Snoring ceases for the mo- 
ment in drunkennness if effort be made to arouse ; in apoplexy it does not. 
In drunken stupor, there is no one-sided paralysis as in apoplexy. The 
pupils of the eyes are of equal size and when the ball of the eye is touched 
the eyes close quickly ; they do not in apoplexy. In apoplexy the pulse is 
slow, full and hard ; in drunken stupor it is feeble and soft and increased 
in frequency. As a rule, the patient can be roused to speak in the man- 
ner peculiar to a drunken man ; in apoplexy he cannot. If the least doubt 
exists as to whether a person is intoxicated or has had an apoplectic attack, 
he should invariably be treated as if it were the latter. It is to be borne 
in mind also that death may result from an overdose of alcohol. 

Treatment. — If the case is one of intoxication, give an emetic of a 
tablespoonful of mustard in a tumbler of warm water. If there are in- 
dications of shock — that is, cold, clammy skin and feeble pulse, the pa- 
tient must be treated as for Shock, eliminating, however, the doses of 
alcoholic stimulants and substituting therefor hot broths and the like. 
Yet, as the stupor wears off, it may be necessary to administer small 
doses of liquor for a time, because if a man who has been accustomed 
to drinking heavily be suddenly completely deprived of liquor, there is 
the possibility of the onset of delirium tremens. The procedure as to 
giving or not giving a certain amount of alcoholic stimulant must there- 



THE PULSE. 851 

fore be governed by the circumstances of each individual case. An article 
on Delirium Tremens will be found by reference to general index. 

Ivy Poisoning. — This is a condition caused commonly by the poison 
oak or poison-ivy. It is characterized by redness, burning, itching and 
generally by swelling with a vesicular eruption. 

Valuable applications are those of cloths wet with lead-water and 
laudanum, black wash or phenol-sodique one part, water eight parts. 
Mild ointments give relief, especially oxide of zinc ointment containing 
ten grains of carbolic acid to the ounce. 

Jaw, Dislocation of — See Dislocation of Jaw. 

Jaw, Fracture of — See Fracture of Jaw. 

Lightning Stroke — Place the victim in a current of fresh air, dash 
cold water on face and chest ; if body be cold use lively friction with hands 
or flannel. Manipulate arms and use artificial respiration as in drowning 
cases. ( See Drowning. ) If revival ensue give stimulants — whiskey, spirits 
of ammonia, a teaspoonful of the former every few minutes, or twenty 
drops of the ammonia in a tablespoonful of water. An electric current 
from a home battery applied to spine and back part of the head is useful, 
before signs of life appear. Means for the recovery of one stricken with 
lightning should not be discontinued till at least an hour has elapsed 
after the visitation, as many supposedly fatal cases have been returned to 
life. 

Lungs, Bleeding from. — See Hemorrhage of the Lungs. 

Mining Accidents. — The Bureau of Mines at Washington, D. C, 
recommends a first aid organization in connection with all mines, such or- 
ganization being composed of operatives and officials who shall study First 
Aid and carry on regular practice drills. The organization should be 
divided into squads or teams of six men each, including one captain, one 
patient and four stretcher bearers. Each squad should have the following 
equipment for use in practice drills and in cases of actual emergency : 12 
triangular bandages, 12 medium size safety pins, 6 packages of gauze 
(plain or picric), 6 first aid outfits, 6 light wood or yucca splints 3^ inches 
wide by 18 inches long, 12 roller bandages, assorted sizes, 2 tourniquets, 
2 rolls of cotton (plain or absorbent), 2 blankets, 1 stretcher, 6 wooden 
splints for legs and back fractures, 1 or 2 sets of first aid charts. 

Moving of the Injured — See Transportation of the Injured. 

Poisons and their Antidotes. — See special alphabetically arranged 
article on this subject as per general index. 

Pulse, the. — See "Sick Koom Emergencies'' (general index). 



852 FIKST AID TO THE INJURED. 

Powder Burns — See Burns and Scalds. 

Rabid Animals, Bites of — See Dog Bites. 

Railroad Accidents — See Wounds. 

Respiration, Artificial. — See Rescue from Drowning. 

Rescue from Drowning. — Death from drowning is the result of as- 
phyxia, due to the stoppage of a supply of fresh air to the lungs. No 
time should be lost in going to assistance of a drowning person, but none 
should attempt to go into the water themselves to rescue others unless 
they are capable swimmers and have understanding of proper methods of 
rescue. Before diving, boots and heavy clothing should be discarded if 
possible, and when a leap must be made from a height into waters whose 
depth is unknown, it is safer to drop in feet first. Where weeds are about, 
there is always danger of entanglement and great care is requisite. When 
approaching a drowning man, there is always danger of being clutched, 
but a swimmer who knows the right way can avoid this. It is a subject 
with which all swimmers should become thoroughly informed. When the 
apparently drowned person has been rescued from the water, no time 
should be lost in the commencement of endeavor to bring back respiration. 

Treatment. — We shall first consider what we may call manual treat- 
ment, as differentiated from that of mechanical device, and afterwards 
refer to the latter. There are various methods of manual treatment, 
most of them requiring two persons, but the method which has now been 
recognized by the great life-saving bodies of the world as not only the 
easiest but the most efficient is that known as the Schafer or prone system, 
being the outcome of exhaustive investigations made by Prof. E. A. 
Schafer, Chairman of a Committee appointed by the Royal Medical and 
Chirurgical Society of England, and finally adopted by that Society in 
1904. Professor Schafer describes the method as follows: Lay the 
subject face downwards on the ground, then, without stopping to remove 
clothing, the operator should at once place himself in position astride or 
at one side of the subject, facing his head and kneeling on one or both 
knees. He then places his hands flat over the lower part of the back (on 
the lower fibs), one on each side (Fig. 1), and then gradually throws the 
weight of his body forward on to them so as to produce firm pressure 
(Fig. 2), which must not be violent nor upon the patient's chest. By 
this means the air and water, if any, are driven out of the patient's lungs. 
Immediately thereafter the operator raises his body slowly so as to re- 
move the pressure, but the hands are left in position and the movement of 
body again repeated. This forward and backward movement is repeated 



RESCUE FROM DROWNING. 



853 



every four or five seconds ; in other words, the body of the operator is sway- 
ed slowly forward and backward upon the arms from twelve to fifteen times 




a minute, and should be continued at least an hour, or until respirations are 
produced. Whilst one person is carrying on artificial respiration in this 
way, others may, if there be opportunity, busy themselves with applying 
hot flannels to the body and limbs, and hot bottles to the feet, but no attempt 




Schafer Method. — Fig. 



should be made to remove the wet clothing or to give any restoratives by 
the mouth until natural breathing has recommenced. 

It will be well to always bear in mind that an essential condition to 



854 FIRST AID TO IXJUEED. 

the success of artificial respiration is the keeping of the windpipe open 
so as to afford free access to the lungs. In asphyxiated persons the wind- 
pipe is obstructed by the contracted and retracted tongue and by the 
epiglottis. It is therefore essential that the tongue should always be drawn 
forward in the proper manner, and this must be done even if the mouth 
be closed and it be necessary to force it open in order to draw out the 
tongue. 

When natural respiration is once established, the operator should 
cease to imitate the movements of breathing, and proceed with treatment 
for the promotion of warmth and circulation. Friction over the surface of 
the body must be at once resorted to, using handkerchiefs, flannels, etc., 
so as to propel the blood along the veins toward the heart, while the 
operator attends to the mouth, nose and throat. The friction along the 
legs, arms and body should all be toward the heart and should be con- 
tinued after the patient has been wrapped in blankets or put into dry 
clothing. As soon as possible, the patient should be removed to the near- 
est house and further efforts made to promote warmth and proper cir- 
culation by the application of hot flannels to the pit of the stomach and hot 
water bottles, heated bricks, etc.. to the armpits, between the thighs and 
to the soles of the feet. If there be pain or difficulty in breathing, apply 
a hot linseed meal poultice to the chest. On restoration to life, a teaspoon- 
ful of warm water should be given, and then if the power of swallowing 
has returned, very small quantities of warm brandy and water, beef tea 
or coffee should be administered, the patient kept in bed, and a disposi- 
tion to sleep encouraged. The patient should be carefully watched for 
some time to see that breathing does not fail, and should any signs of 
failure appear, artificial respiration should be resumed. While the pa- 
tient is in the house, care should be taken to have air circulate freely 
through the room and all overcrowding must be avoided. In all cases of 
apparent drowning physician should be sent for at once, but do not wait 
his coming to commence restoration, for each moment may count. There 
are eases on record where respiration has only been re-established after 
several hours of continuous effort. 

Mechanical Device. — Resuscitation must usually depend upon 
manual effort, and everyone therefore should become thoroughly conver- 
sant with the instructions contained in the foregoing paragraphs. Yet it is 
evident that the work of resuscitation is mechanical, being simply a move- 
ment of the patient's body in such manner as to cause expansion and con- 
traction of the lungs or in other words produce artificial respiration. This 



shock. 855 

being so it follows that if a mechanical device be truly adapted the require- 
ments of the work will be done with greater regularity and more efficiency 
than is possible by manual effort. A machine of this nature has been de- 
vised. It is known as the Pulmotor and may be purchased from any dealer 
in surgical instruments. It is expensive and therefore cannot be an article 
of general household possession, but its value is so great when times of 
necessity come that every municipality should possess one and they should 
be found at all summer resorts, at all boathouses, and where financial 
conditions permit at all waterfront residences. Manual work, if properly 
done, is exhaustive and tiresome and there are very few who can continue 
it for any great length of time without cessation, yet the life of the patient 
depends upon the operation being carried on continuously and incessantly 
until natural breathing comes. The pulmotor is automatic and once 
started will keep up its work with continuity and may be superintended 
by a layman with as much capability as by a physician. It is simple of 
adjustment and automatically accommodates itself to the size and capacity 
of the patient's lungs, whether man, woman or child. Not only this, but 
the air administered is oxygenized some ^.Ye per cent, above normal air, 
thus producing an especially vitalizing effect. In cases where limbs 
or ribs of the patient have been broken manual resuscitation is extremely 
difficult, sometimes impossible. With the pulmotor it may be carried 
on without danger to the patient. It may be used to advantage in all 
cases of asphyxiation, whether in the way of apparent drowning, electrical 
shock or gas, and may be used with infants who have not grasped the 
breath of life at birth yet who have animation within them. We have 
no brief for the manufacturers of the pulmotor nor for the surgical 
instrument dealers who sell them, but we consider it our duty to call the 
attention of the public to its undoubted worth that united action may 
ensue and one of the machines be secured for every municipality and kept 
on hand at all places where drowning accidents or asphyxiation from 
other causes are likely to occur. 

Restoration of Circulation. — See Circulation, Eestoration of. 

Ribs, Fractures of — See Fractures. 

Scalds — See Burns and Scalds. 

Shock. — Accident, surgical operations, exposure to cold, sunstrokes, 
apoplectic attacks, asphyxia, poisoning and innumerable other ills are fre- 
quently followed by what is known as Shock. It is a more or less pro- 
found depression of the nervous system, and its onset is likely to be un- 
noticed unless looked for. Its detection and treatment are of great im- 



856 FIRST AID TO THE INJURED. 

portance and the subject well comes under consideration in dealing with 
Emergencies. 

The patient either becomes stupid, showing no interest in what is 
taking place about him, or partial, in some cases complete, unconscious- 
ness occurs. The breathing is feeble, the face pale, pinched and anxious, 
the eyes are dull and the pupils dilated, the pulse feeble, usually rapid and 
sometimes absent at the wrist, the skin is cold and there may be shivering ; 
sometimes the mind wanders. These symptoms may follow a slight injury 
like a crushed finger, while on the other hand they may be absent, or only 
present in a slight degree, after the severest accident. The severity of the 
shock does not depend so much upon the nature or gravity of the injury or 
condition as upon the character and vitality of the individual. Usually, 
reaction takes place in a few hours, but in some cases there is no reaction, 
and the patient dies of heart failure. 

Treatment. — Much can be done to relieve a person suffering from 
shock. Should shock occur while there is severe bleeding, such bleeding 
must be stopped, and any wound or fracture may receive a quick dress- 
ing, but no attempt to do more than this to the injury should be made until 
after attending to the shock. When shock comes after asphyxia, poison- 
ing, or the like, the treatment for the shock may be given at the same 
time as the treatment for the primary condition. 

The patient should lie in a horizontal position with the head slightly 
lowered. Give from a teaspoonful to a tablespoonful of whiskey or other 
alcoholic liquor in a tablespoonful of hot water. Administer this every 
ten minutes until five or six doses have been taken. 

Cloths wrung out in hot water should be laid on the bared chest and 
abdomen and the patient covered with a blanket to keep in the heat. Hot 
water bottles, bricks, or the like should be placed along both sides of the 
body and legs, inside the thighs and under the armpits. In doing this, 
care must be exercised not to burn the patient. This danger may be 
obviated by wrapping hot water bottles, etc., in cloth sufficiently to give 
just the heat required. 

Rub the body and limbs vigorously with the hand, or with hot, dry 
cloths. 

One-half pint of equal parts of water and whiskey, heated to 110° F., 
should be given in form of a rectal injection. 

Concentration throughout should be upon warming and stimulating 
the patient in every possible way. 




Transportation of the Injured. 




Artificial Respiration. — The Pulmotor. 
©E.J. S. 



STRAINS. 857 

Snake Bites, — See Bites of Venomous Insects, Snakes, Reptiles, 
etc. 

Splints. — See article on Fractures; also see general index. 

Sprains. — Sprains are due to the violent twisting, stretching or partial 
tearing of the ligaments about a joint, and it sometimes happens, espe- 
cially in sprains of the ankle, that there is at the same time a fracture of 
the ends of the bones. Unlike dislocations and fractures, sprains do 
not cause any deformity until swelling, which takes place very rapidly. 
There is always severe pain and any movement of the joint greatly in- 
creases the suffering. The most common sprain is that of the ankle, and 
its effects are so speedily manifested that in very few minutes, the patient 
may be unable to walk or even put his foot to the ground without great 
suffering. 

Treatment. — Recovery from a sprain takes place slowly, and the 
serious mistake is often made of considering the injury trifling. Perfect 
rest is essential. The first thing is to reduce swelling and alleviate pain. 
The injured joint should be immediately placed in water as hot as can 
be borne, and this water should be kept continuously hot by constantly 
adding fresh hot water. Keep this up for an hour or longer. Or, instead 
of hot water, ice water cloths or an ice-bag may be held on the joint by a 
firm pressure bandage, which should be kept on for several hours. After 
the hot water or the ice treatment, cotton batting should be padded about 
the joint, and then bandaged with moderate firmness, using splints if 
desired. An affected ankle should be elevated above the hip. Cold ap- 
plications of water, lead-water and laudanum, or of alcohol and water 
should be used for a day or two, after which hot fomentations and hot 
water bag afford more relief. When the pain and other acute symptoms 
have subsided, gentle motion and rubbing with liniments help to prevent 
stiffness. Time is lost by attempting to use the affected limb before it 
is sufficiently restored and great precaution should be taken in such regard. 

Stings of Insects. — For the more common and less poisonous stings, 
such as those of the honey bee, wasp, etc., applications of washing or 
cooking soda, ammonia water, iodine or lead-water and laudanum, give 
relief. For stings of scorpions, large spiders and so forth, see Bites of 
Venomous Insects, Snakes, Reptiles, etc. 

Stretchers for Carrying the Wounded or Injured — See Transportation 
of the Injured. 

Strains. — A strain is the wrenching or tearing of a muscle or tendon 
and is usually caused by violent exertion or sudden unexpected move- 



858 FIRST AID TO THE INJURED. 

ments. A strain generally occurs in the muscles or tendons of the arms 
or legs. The symptom is sudden, sharp, excruciating pain. 

Treatment. — Let the injured person rest ; bandage the injured part 
tightly or apply adhesive plaster. It is sometimes necessary to prevent 
movement of the part by splinting. 

Stomach, Bleeding from — See Hemorrhage of the Stomach. 

Strangulated Hernia — An accident that may happen to anyone hav- 
ing a rupture in the abdominal wall forming a small pouch into which 
a little loop of intestine escapes. If this intestine loop becomes crowded 
into the pouch in such manner as to be tightly squeezed, the bowels can- 
not act, and there is danger of mortification. This is termed strangulated 
hernia and is a very dangerous condition. It is accompanied by fecal 
vomiting and great pain and prostration. No time should be lost in secur- 
ing the best medical skill that can be obtained.^If the hernia cannot 
be reduced an operation is imperative and is attended by small risk in 
hands of a skilful surgeon. Pending arrival of physician, the patient 
should be placed on his back with the foot of the bed elevated. The legs 
should be drawn up toward the abdomen and warm applications made to 
the rupture. 

Stunning — See Concussion of the Brain. 

Suffocation. — See treatment in Rescue of the Drowning. 

Sunstroke — See Heatstroke. 

Torn-off Limbs. — See Wounds. 

Tourniquet. — See as to making and using with Hemorrhages. 

Transportation of the Injured. — Never move a seriously injured per- 
son if avoidable. When necessary proceed in such manner as to cause 
least possible suffering and danger as to results. By unskilful handling 
sharp ends of a broken bone may be thrust through the flesh, or may cut 
into an artery, or bleeding of a wound may be started afresh. Every 
little bit of strength which the patient may lose through pain during 
transit, lessens the chance of recovery and may turn the scale on the side 
of death. The dangers to life from a broken leg, for example, when the 
skin is not cut through, are more than doubled, if, by ignorant handling, 
with the kindest intentions in the world, the affected limb is allowed to 
swing downward for a single instant so that some sharp splinter of bone 
penetrates the skin, and makes the injury a compound fracture. When 
moving is necessary, first examine for possible fractures and apply splints, 
etc. Then, if possible, place the injured person on a stretcher which may 
be improvised from boards, doors, shutters, etc., or if nothing of this 



TRANSPORTATION OF THE INJURED. 859 

kind at hand, may be made with two poles and a couple of coats. The 
sleeves of the coats are first turned inside out. The coats are then placed 
on the ground with their lower sides touching each other. The poles are 
passed through the sleeves on each side and the coats are buttoned up with 
the button sides down. A piece of carpet, a blanket, or sacking can be 
used in much the same way as the coats, rolling in a portion at each side 
and firmly fastening by cords or otherwise so that there can be no danger 
of giving away under the weight of the patient. In the woods, two poles 
about ten feet long, kept apart by forked sticks about a foot in length, tied 
in place with rope, twine or leather straps, or even some climbing plant, 
and covered with clothing, form a very good litter. 

In placing an injured person on a stretcher the work can be most 
safely done by three persons. There are two modes of operation, one in 
respect of patients who have a broken limb and the other as to cases where 
there is internal or bodily injury. In either case place the stretcher at the 
patient's head on a line with the body, the foot of the stretcher being 
nearest the patient's head. When it is a case of broken limb, one bearer 
kneels on each side of the patient and the two join hands underneath his 
hips and shoulders, the third man attending to the wounded limb or look- 
ing after any bandages or splints that may have been applied. The 
bearers then rise to their feet, raising the patient in a horizontal position, 
and by a series of side steps bring the patient over the stretcher, when he 
is lowered gently and made as comfortable as possible. In cases where 
there is internal injury or the body is affected, the three bearers should 
stand in a row on the injured side of and facing the patient. Each 
bearer then kneels on the knee nearest the patient's feet, with the knee 
towards the patient's head raised so as to form a kind of bench. They 
now put their hands under the patient and at the command "Lift" gently 
raise him to their knees. At the command "Rise" they rise to their feet 
and gently turn the patient so as to face against their breasts. They may 
walk either by stepping forward or by sidestepping, the patient then be- 
ing lowered upon the stretcher by bending again to the knee position just 
described. The tallest of the bearers places himself between the handles 
at the head of the patient and one of the others at the foot, the third mem- 
ber devoting himself to the patient by guarding any injured part. The 
bearer at the head starts out with the left foot and the other with the right 
— were they to keep step the stretcher would roll badly. The patient is 
carried feet first except in going upstairs or up a hill, when he is carried 
head first. 



860 FIRST AID TO THE INJURED. 

If there is plenty of assistance at hand, let the acting surgeon of the 
party take charge of the wounded limb, and devote himself, after giving 
the necessary instructions to an acting assistant surgeon chosen on the in- 
stant, to protecting that injured member in every way. Next, let four 
persons, under direction of the assistant surgeon, lift the sufferer by his 
hips and shoulders, two others supporting the head and feet, as may be 
necessary, and when raised to a sufficient height, let two others, still, slide 
the prepared litter under the patient as he is held up in the air by his 
seven bearers. He can then be gently deposited upon the litter, having 
undergone the least amount of disturbance possible under the circum- 
stances. 

If alone with an individual so severely wounded as to be helpless, 
the best way often is to make him as comfortable as possible, see that there 
is no danger of serious bleeding, leave him some weapon with which to 
defend himself, and hasten for the nearest assistance which can be pro- 
cured. 

Carrying the Litter. — The litter should be carried by two persons, 
whilst the acting surgeon walks by the side and keeps a constant watch 
over the patient. The following rules should be observed : First, the litter 
should be carried with the hands, or supported by straps passing over the 
bearers shoulders. The litter itself should never be placed upon the 
shoulders of the bearers, because the patient might then fall off, or even 
die from hemorrhage or other cause without his danger being observed. 
The patient is carried feet first except in going up stairs or up a hill, when 
he is carried head first. 

Bearers not to keep step. — Second, the bearers should not keep 
step. If they keep pace, as in marching, the litter shakes from side to side, 
and the patient is apt to roll about, or even to be thrown to the ground. 
To prevent this, the bearers must walk in broken step — that is, not putting 
the right foot, for example, forward at the same moment — and then 
the litter remains nearly even as it is borne along. 

Pace of the Bearers. — Third, the pace of the bearers should be 
short, not more than twenty inches, and the steps made without any spring 
on lifting the foot from the ground. All jolting, all hurried movements 
and lifting over fences, ditches, and so forth, are to be avoided. Send 
some one ahead, if practicable, to look out for gates, bridges, and similar 
advantages, which are very important in the transportation of the sick and 
wound cd, and let him come back and guide the bearers in the easiest path 
to the place of destination. 



TRANSPORTATION OF THE INJURED. 861 

Bearers of Same Height. — Fourth, if it can be done, choose bear- 
ers of the same height, and should it be impracticable to do this, arrange 
the shoulder-straps in such a way that the litter will hang as level as pos- 
sible. Fifth, in ascending an inclination, such as hill or staircase, the pa- 
tient's head must be in front, and in descending it should be behind. If, 
however, the invalid has a broken leg, this rule must be reversed ; other- 
wise the weight of the body would press upon the injured part, and, per- 
haps, aggravate the trouble. Sixth, the patient should usually be removed 
from the litter in the same manner as he was placed upon it. 

In Absence of a Litter. — Should neither a litter nor material out 
of which one can be made present itself on careful search, the wounded 
man must be supported in the arms-, which of course can only be done as a 
general thing for short distances. If there is only one person at hand to 
help, and if the injured man can walk, though weak and faint from loss 
of blood, he must put one arm around the neck of the individual aiding 
him so that his hand hangs down over the further shoulder. The person 
assisting places his arm from behind around the waist of the wounded 
man, and with his other hand grasps that of the patient as it hangs over 
his shoulder. In this mode he can support him very efficiently, and if 
necessary even raise him from the ground for a few steps over difficult 
places, and so help him along. Should the patient, however, be unable to 
walk, the only resource is for the person helping him either to take him 
on his back, or, if not too heavy, to carry him in his arms like a child. In 
either case the wounded person should clasp his arms around the neck of 
the bearer. 

Bed for Accident Patient. — The preparation of the bed for a pa- 
tient who is the subject of a severe accident is a matter of no little impor- 
tance. The couch intended for the reception of an accident case, wounded 
about the legs or hips, should be provided with a large sheet of water-proof 
material and an extra sheet folded and placed across the bed, so that it can 
be readily removed when soiled with blood or other discharges without 
disturbing the head and shoulders of the patient. If the mattress is likely 
to yield to any extent with the weight placed upon it, it should be sup- 
ported with extra slats. In case of wounds about the head, the pillow 
ought to be protected by a piece of extra sheeting. 

Undressing the Patient. — A patient who is not too much injured 
to endure the effort should always be undressed before being placed in 
the bed. All tight clothing about the neck should at once be loosened or 
altogether removed. Boots must be taken off with great care. 



862 FIRST AID TO THE INJURED. 

Case of Broken Leg. — If the leg is broken it is better to cut the 
boot down the side and nearly to the toe. Pantaloons need not be cut, un- 
less the patient's leg or thigh is injured, in which case the outside seam 
ought to be ripped up, so as to get them off without causing suffering to the 
invalid. In taking off the coat and waistcoat always remove them from 
the sound side first, and then they come away from that which is injured 
with comparatively little difficulty. 

Unloading the Litter. — When a patient who is unable to walk is 
brought in on a litter or stretcher of any kind, such as a window-shutter 
or door, the litter should be placed with its head at the foot of the bed 
which the invalid is to occupy, and lying in the same direction, this posi- 
tion being the most convenient one for transferring the sick man to his 
couch. To properly lift an adult patient four assistants are required, two 
standing on either side. One of these helpers should support the head and 
shoulders, and a second the hips on one side, whilst on the other side the 
third assistant lifts the back, and the fourth supports the legs. In some 
cases the size or arrangement of the room will not permit this. 

Placing the Patient Abed. — The litter must then be laid along- 
side of the bed, and three assistants lifting the patient into the air, a 
fourth rapidly withdraws the litter to allow the bearers to approach the 
side of the bed and deposit the invalid upon it. All the assistants should 
commence to lift together, and set down the patient at a given signal, 
special attention being devoted to the injured limb. The bed-clothes 
should be -folded back for the whole length of the bed on one side, leaving 
one-half of the bed laterally uncovered for the reception of the patient. 
By this little maneuver they are easily replaced over a frame of wire, or 
of two half hoops tied together in their centres, in such a way as to protect 
the wounded limb from the weight of the bed covering. 

There are a number of other ways of carrying an injured person. 
Wlhere the patient is in condition to permit, the "chair" method may 
be adopted. Two persons join hands thus: Each of the two grasps bis 
own right wrist with his left hand, back uppermost. Then each grasps 
his companion's left wrist with his right hand. This forms a chair. 
The patient sits on this support, at the same time putting his arms around 
the necks of the bearers to steady himself. When the patient is unable to 
sit in such a chair, one bearer standing behind the patient passes his arms 
under the patient's arms and clasps hands over his chest. The other bearer 
stands between the legs, his back turned toward the patient and passes 
his arms beneath the knees from the outside. The patient may now be 






UNCONSCIOUSNESS. 863 

lifted and carried. It is sometimes necessary for one person to carry an- 
other without aid, as from a burning building, etc. The method recom- 
mended by the Boy Scouts of America is to turn the one to be carried on 
his face, step astride his body, facing toward the patient's head, and with 
hands under his armpits lift him to his knees ; then clasping hands over 
the abdomen lift him to his feet, then with the left hand seize the patient 
by the left wrist and draw his left arm around your neck and hold it against 
your left chest, the patient's left side resting against your body and sup- 
port him with your right arm about his waist. Then with your left hand 
seize the right wrist of the patient and draw the arm over your head and 
down upon your shoulder, then shifting yourself in front stoop and clasp 
the right thigh with your right arm passed between the patient's legs, 
your right hand seizing the patient's right wrist; lastly with your left 
hand grasp the patient's left hand and steady if~against your side while 
you rise, and the patient will lie over your shoulder like a sack and so may 
be carried. 

A simpler way if there is a chair at hand is to hold the patient in the 
chair while you place your shoulder against his abdomen ; then throw the 
arm belonging to that shoulder around him and rise to your feet with his 
body hanging over your shoulder like a meal sack, his head and shoulders 
hanging down behind while his legs are in front. Only one hand is used 
and the other is therefore free for use in descending a ladder or for any 
other purpose. This latter 'method is recommended by the New York 
City Society for First Aid to the Injured. 

For other methods see general index. 

Unconsciousness — Insensibility or unconsciousness may result from 
so many different causes that even the most skilled physicians often find 
it difficult to determine its origin. The following general procedure is 
recommended. 

1. Send for medical assistance. 

2. Lay patient on his back. Loosen all tight clothing about neck, 
chest and waist which might interfere with flow of blood to and from the 
head. If face is then red or flushed raise head and shoulders. Lay cloths 
dipped in cold water on the head. Never give stimulants when the face is 
flushed. If the face is pale do not raise the head but see that it is on 
level with the body. In all cases the head should be turned a little to one 
side to prevent tongue falling back, vomit matter being drawn into lungs, 
etc., and to insure free breathing. 

3. Get all the information possible. The person may have had a fall 



864 FIRST AID TO THE INJURED. 

or a blow, may be wounded, suffocated, drunk, have had heatstroke, be 
suffering from uraemic coma or any one of many ills. Enquire as to 
whether patient fell suddenly, had convulsions, complained of illness, had 
been under conditions to cause heatstroke and make other pertinent 
queries. 

4. Compare the two sides of the body for evidence of paralysis or 
fracture. Open eyes and observe whether pupils contract when exposed 
to light and whether they are of same size, large or small. Count pulse, 
note respiration, whether slow, irregular, quiet or snoring. Notice the 
odor of the breath and whether the skin is hot or cold to the touch. 

Information such as outlined may help you to decide as to what 
the unconsciousness is due and enable you to act if the coming of phy- 
sician be delayed. In any event it will be valuable to the doctor when he 
arrives, as symptoms may have changed in the meantime, and it may be 
important to him to know what the earlier symptoms were. (See Hys- 
terical Unconsciousness and Ursemic Coma. 

Unconsciousness, Hysterical. — See Hysterical Unconsciousness. 
Ursemic Coma and Convulsions. — Unconsciousness may be due to pres- 
ence of impurity in the blood resulting from disordered action of the 
kidneys. In such cases there is usually a strong smell of urine about the 
person affected, and if there be convulsions aud there are signs of drop- 
sical swellings about the legs and eyes, this condition should be had well 
in mind. Treatment should be left to the* physician. In his absence 
give a cathartic, as castor oil or epsom salts if the patient can swallow — 
a hot water and soap enema if he cannot swallow — and surround him 
with hot blankets and bottles to induce sweating, being careful not to 
burn him. 

Varicose Veins. — See Hemorrhage of Varicose Veins. 
Vapors, Apparent Death from. — See Gas Poisoning. 
Wounds — It is of first importance in dealing with wounds to have 
a clear idea of the principle of Asepsis. 

Asepsis means the absence of living germs. Germs are bodies so 
small that of some kinds it would take 1,500 to stretch across the head of 
a pin. They procreate with marvelous rapidity. There are innumerable 
varieties. They are present on the surfaces of everything, even on those 
that appear cleanest and brightest, though more abundant where there 
is dirt. They are always present on the skin of the body, in the mouth, 
throat, stomach and intestines, in water, and are carried in the dust in 
the air. Most of these germs are harmless to man, in fact they are neces- 



WOUNDS. 



865 



sary to his existence. Comparatively few germs are what are known as 
disease germs, such as those of diphtheria, tuberculosis, etc., and these 
are not present everywhere but only in the bodies of and discharges from 
persons or animals suffering from such diseases. The germs of decom- 
position, however, are almost everywhere present. Without them the 
earth would be covered with dead animal and vegetable matter, for it is 
these germs of decay which transform dead matter into substances which 
plant life uses in its growth. Ordinarily we are protected against these 
germs of decomposition by the unbroken skin, through which they cannot 
pass, but when they get into a wound they begin at once to multiply and 
exercise their power of producing decomposition. Irritation of the 
wound, inflammation, pus and delay in healing are natural consequences. 
Not only this, but other varieties of germs may find their way into 
wounds and set up blood poisoning. In a person with healthy body, and 
if but a small number of germs enter the wound, the healthy cells and 
fluids of the blood and tissues may destroy the intruders before they ac- 
complish harm, yet the danger exists with even the most healthy. Germs 
in an open wound, where they may be washed away by discharges, are 
less dangerous than those in a closed wound where discharge is prevented. 
Thus a small wound contaminated with germs and then dried up or cov- 
ered with sticking plaster may prove much more dangerous than quite a 
large wound which remains open. 

As asepsis means the absence of germs, so a wound is said to be 
aseptic when there are no living germs in it. An aseptic wound, if prop- 
erly closed, will quickly heal without inflammation or pus. The wonder- 
ful development and success of modern surgery is due to this knowledge 
of asepsis and the power to make wounds aseptic. Formerly inflamma- 
tion and pus were invariable accompaniments of large wounds, because 
the principle of asepsis was unknown. To-day a wound with inflamma- 
tion and pus is said to be infected or septic, which is the opposite of 
aseptic. 

When things are aseptic they are said to be surgically clean, which 
is therefore different from ordinary cleanliness. The usual way of mak- 
ing things surgically clean is to thoroughly boil them in water. An article 
that has been well boiled and then kept from exposure is surgically clean 
and will not cause disease or blood poisoning. You may pick up a dirty 
knife off the street and, after boiling it for half an hour, use it imme- 
diately with safety in an operation, while if you took a knife from your 
kitchen and used it without boiling or otherwise making aseptic, the 
55 



866 FIRST AID TO THE INJURED. 

wound would be sure to be infected by germs. Things treated in this 
way by boiling are said to be sterilized. This knowledge is of paramount 
importance in first aid work, because it enables anyone to use whatever 
material be at hand with almost perfect safety, by sterilizing it. It will 
be evident that a fresh wound should not be touched by the hands or 
any unsterilized object or instrument when this can be avoided. Fresh 
towels, handkerchiefs and sheets that have been boiled in the washing are 
usually surgically clean, and this also is true of running water. However, 
it is always safer in connection with wounds to use dressings that have 
been properly sterilized and water that has been boiled. 

Wounds may be operative — that is, made by a surgeon in operation 
— or they may be accidental. In operative wounds aseptic principles are 
religiously adhered to, instruments and dressings are made absolutely 
aseptic, the surgeon wears aseptic apron and in spite of the most scrup- 
ulous care as to the cleanliness of his hands, he usually wears rubber 
gloves which have been specially sterilized for the operation. In the 
case of accidental wounds, however, there is almost always more or less 
contamination and therefore it rarely happens that an accidental wound 
is surgically clean. It is with accidental wounds that we have here to deal. 

At one time it was believed that wounds should be thoroughly washed 
and cleaned at once, but it has been learned in different ways, and espe- 
cially in modern warfare, that as a rule accidental wounds do best if 
simply immediately covered with a sterile dressing and kept at rest with- 
out handling or washing until the patient can be handed over to the 
care of the surgeon. Many of the germs that may have entered the 
wound are washed out by bleeding and the few that are left may be de- 
stroyed by the healing powers of the tissues themselves. Any attempt of 
an unskilled person to wash and clean a fresh wound may result in in- 
troducing more germs than are removed. 

It sometimes happens, however, that a wound is so grossly contam- 
inated by earth or other matter as to demand cleansing before it reaches 
surgeon's hands. In such cases water should be sterilized by boiling and 
poured into the wound from a little height. Or peroxide of hydrogen 
may be used freely in such a wound. Such antiseptics as carbolic acid 
and bichloride of mercury are usually unsafe except in skilled hands. 
Before touching any wound or instruments or materials to be used about 
the wound, thoroughly wash the hands with soap and cleanse the nails 
with brush and piece of clean wood, rinse in hot water and dry on fresh 
towel, after which touch nothing with the hands excepting the wound, 



CONTUSED WOUNDS. 867 

when necessary, and dressings, etc., for it. An exception, of course, is 
that of severe hemorrhage where the first necessity is to stop the flow of 
blood. The following general emergency rules, then, may be adopted in 
respect of the immediate treatment of accidental wounds: 

1. If wound is bleeding severely, treat as described under Hemor- 
rhage. 

2. If wound is not bleeding severely, take a piece of sterilized gauze 
or cotton of the cleanest material obtainable, and simply wipe away any 
blood or loose clots on the surface. If the wound gapes open, draw the 
edges together as well as possible, using pieces of the same material to do 
this, and avoid touching the wound with the fingers. Then place over the 
wound a good-sized pad of the same material and bandage it firmly with 
a handkerchief or other convenient bandage. Where no surgical help 
is obtainable this dressing may remain on the wound until it heals, unless 
it discharges or becomes painful, in which case the dressings should be 
changed every day or oftener and the wound washed by pouring sterilized 
water over it or freely using peroxide of hydrogen. 

Sterilized dressings and emergency necessities should be kept in every 
home, house, shop, factory or camp and carried by those who travel. They 
can be bought very cheaply at any drug store and take up little room. 

Extraction of poison by sucking is highly commendable when pos- 
sible. "Cupping" also may sometimes be employed to advantage (see 
Cupping). 

Wounds, Healing of. — Wounds may heal by what is known as first 
intention or primary union — that is, when asepsis or freedom from germs 
has been obtained and preserved, resulting in that the wound quickly 
heals and leaves but little scar. But if a wound does not heal by first 
intention, then it comes under the slow process of second intention — that 
is, with formation of granulations — and finally leaves a large scar. Sec- 
ond intention is in evidence when the skin has been destroyed over such 
area that the edges cannot be brought together, when the wound is dis- 
turbed, when blood collects in it, forcing it apart, or when the wound is 
dirty — that is, when asepsis has not been preserved. Contused and la- 
cerated wounds generally heal by second intention. 

Wounds, Contused and lacerated. — These are wounds which have 
ragged edges and the skin and soft parts are torn and bruised. These 
occur in accidents where instead of a clean cut there is a tearing or crush- 
ing of the tissues. Eailway, machinery and such like accidents are fre- 
quently of this character. Treat as for general Wounds, but it is to be 



868 FIRST AID TO THE INJURED. 

borne in mind that such wounds are frequently followed by Shock, and 
this should be looked for. 

Wounds, Poisoned — Dissection wound is a term applied not only to 
wounds received by medical students and surgeons in their dissections, 
but to wounds sometimes received by butchers, cooks and fish-dealers, who 
handle putrefying animal matter. Such wounds are particularly viru- 
lent. A wound of this character should be thoroughly washed, and the 
blood squeezed out of it. If a puncture, it should be freely opened and 
swabbed with pure carbolic acid, then washed with bichloride of mercury 
solution, and wet antiseptic dressing applied. Bites by animals should 
be so treated, the human bite being one of the worst. 

Wounds, Punctured — Wounds made by sharp instruments (such as 
a dagger, a splinter, a fork prong, and so forth) have especial dangers, 
and require radical treatment. Foreign bodies are frequently left at the 
depth of such a narrow wound; the opening is small and readily closes, 
locking up infective material ; underlying organs of the abdomen, head or 
chest are liable to injury. Such wounds generally demand the attention 
of the skilled surgeon. He will usually probe for a foreign body and 
will generally open the wound to its depth, often incising it freely, in 
order to disinfect it properly and to allow for drainage. He will deter- 
mine whether underlying organs are injured and any treatment needed 
for such. 

Wounds, Gun-shot — The special dangers to be combated in gun-shot 
wounds are shock, hemorrhage and infection. Injury of vital organs is 
liable. In many cases it is better not to probe for a bullet. The ball 
should be searched for when it has surely carried in with it foreign bodies ; 
when it is in a vital organ, as the brain; and when its presence inter- 
feres with healing. 

Wounds, Crushed Feet, Hands, etc — Displaced tissue should be put 
back and the injured member made to assume as nearly as possible its 
original shape by carefully moulding it with the hands, using as little 
force as possible and endeavoring not to cause excess of pain. Then 
wrap in warm sterilized gauze or cloth and cover the whole warmly with 
cotton, wool or a blanket. If a long bone is fractured in a crushed wound, 
a splint should be applied over the dressing before moving the patient. 

Wounds, Torn-off Limbs. — If a foot, hand or finger is torn off, the 
stump should be considered as a lacerated wound and so treated. 

Wounds with Protrusion of Internal Organs. — In cases of chest and 
abdomen wounds where internal organs are protruding, for instance, the 



INCISED WOUNDS. 869 

bowels, it is generally unwise for anyone but a surgeon to attempt to 
replace them. They should be covered with a warm, moist, sterilized 
cloth until the surgeon arrives. If, however, no doctor can be obtained, 
the protruding part may be gently cleansed with warm, sterilized water 
and replaced, a sterilized compress being bandaged over the external 
wound. Be on lookout for symptoms of shock. If symptoms of shock 
are present they require as careful attention as the wound itself. 

Wounds, Infected. — Contaminated wounds may become red, swollen 
and very painful and give rise to fever. This is proof of the presence 
of germs and all dressings must be removed, the wound opened if neces- 
sary, thoroughly washed out with peroxide of hydrogen or sterilized 
water, and dressed every few hours with wet, sterilized compresses. Such 
cases should always be under a physician's care and those who are un- 
skilled should not attempt to treat excepting in cases where it is impos- 
sible to secure medical assistance. 

Wounds, Incised — See Cuts. 



PART II OF BOOK V 

Describes the different kinds of bandages and the 
manner in which they are applied. 



Abdominal Bandage 874 

Bandage 873 

Abdominal 874 

Breast 879 

Chest 875 

Chin 877 

Cloth 873 

Cotton 873 

Eight, The 875 

Elbow 875 

Flannel 873 

Four-tailed 875 

Gauze 873 

Head 874 

Instep 876 

Knee 876 

Limb 874 

Many-tailed ■ 874 

Muslin 873 

Nose 878 

Oblique 874 

Recurrent 874 

Roller 873 

Rubber 873 

Spica 875 

Spiral 874 

Temple 878 

Thigh 874 

The T- 874 

Triangular 876 

Bandaging 873 

Breast Bandage 879 



Chest Bandage 875 

Chin Bandage 877 

Cloth Bandage 873 

Cotton Bandage 873 

Eight Bandage, The 875 

Elbow Bandage 875 

Fillet, The 877 

Finger Bandage 875 

Flannel Bandage 873 

Four-tailed Bandage 875 

Gauze Bandage 873 

Hand Bandage 875 

Head Band 877 

Head Bandage 874 

Instep Bandage 876 

Knee Bandage 876 

Limb Bandage 874 

Many-tailed Bandage 874 

Muslin Bandage 873 

Nose Bandage 878 

Oblique Bandage 874 

Recurrent Bandage 874 

Roller Bandage 873 

Rubber Bandage 873 

Sling, Triangular 876 

Spica Bandage 875 

Spiral Bandage 874 

T-Bandage, The 874 

Temple Bandage 878 

Thigh Bandage 874 

Triangular Bandage 876 

Triangular Sling 876 



ILLUSTRATIONS 



Breast Bandage 878 

Chin Bandage 876 

Finger Bandage 875 

Hand Bandage 875 



Head Bandage 876 

Roller Bandage 873 

Spiral Bandage 874 

Triangular Sling 877 



871 



872 



INDEX TO PART II OF BOOK V. 



Chin Bandage 876 

Coat Sleeve Sling 876 

Double Handkerchief Sling 876 

Emergency Splint for Broken 

Ankle 875 

Emergency Splint Applied to 

Broken Ankle 875 

Emergency Splint for Broken Leg. 875 
Emergency Splint for Fracture Be- 
low the Knee 878 

Finger Bandage 875 

Hand Bandage 875 

Head Bandage — First Stage 876 

Head Bandage — Second Stage ....876 

Head Bandage 876 

Posterior Splint for Fracture of the 



Forearm 874 

Roller Bandage 873 

Simple Bandage for Foot and 

Ankle 877 

Simple Spiral Bandage 874 

Simple Spiral Bandage Applied 

Over Splint 874 

Spiral Bandage 874 

Spiral Reverse Bandage 875 

Triangular Sling 877 

Triangular Bandage Applied to 

Foot 877 

Tiiangular Bandage as a Sling ....877 
Umbrella as Splint for Fracture 

Below the Knee 878 




W 



S 

i 







- 



c/3 



bo 



■ 




Fig. 7. — Emergency Splint made from cigar-box lid 
for fracture of ankle. 




Fig. 8. — Cigar-box Splint applied to fracture of ankle. 
© E. J. S. 




Fig. 9. — Fracture of knee-cap held in place with 
adhesive plaster and a board. 




Fig. io. — Spiral Reverse Bandage for the arm. 

© E. J. S. 





(§ 




bo 
a 

c 

pq 



.5? 







b/j 

Oj 

P2 



bo 







if. 




© 






Fig. 21. — Triangular Bandage as a Sling. 
©K. J. S. 




Fig. 26. — Bandage used in case of a 
burn on front part of hand, wrist or 
forearm. 



Fig. 27. — Bandage used in case of 
a burn on back of hand, wrist or 
forearm. 




Fig. 28. — Bandage used for frac- 
tured kneecap and steadying joint 
motion. 



Fig. 29. — Bandage used in case of a 
serious wound on lower part of the 
leg. 



E. J. S. 




Fig. 30. — Bandage used to fix the Fig. 31. — Bandage for serious in- 

shoulders back in case of a burn on jury to the eye, to retain dressing 
breast, or broken collar bone. and exclude light. 




Fig. 32. — Simple and effective ban- 
dage for dressing wounds of the 
scalp, or an}- injury of the top or 
sides of the head. 



F\g; 33- — Bandage for fractured 
collar bone, so applied that it cannot 
be removed by a restless patient. 



K.J S. 



ACCIDENTS AND EMERGENCIES 



PART II. 

BANDAGING. 



While this article on bandaging is primarily intended to give knowl- 
edge especially applicable in cases of accident, and the illustrations are 
chiefly in respect of emergencies, and therefore do not show that decision 
of arrangement which would naturally be followed in the operating-room, 
yet both the article and its illustrations will be found applicable in the 
sick room. 

Bandages may be made of gauze, cotton, flannel, rubber, muslin, etc. 
They are used to hold splints or other dressings in place, to give support, 
to make compressions, and to correct deformity. When desirable to have 
a part absolutely rigid, starch, silicate of sodium, plaster-of-paris or like 
material may be incorporated in the bandage. 

There are many different kinds of bandages. They are named from 
their shape, use, mode of application, from a fancied resemblance to 
something, or from the name of their inventors. It is not intended to here 
give details in respect of every class of bandage. It would only be con- 
fusing. It is purposed, however, to give such particulars and illustrations 
as will enable the layman to apply bandages in all cases requiring such 
treatment. 

A stock of bandages and cloths for emergencies should be kept always 
on hand in every home. Bandages and all dressings for wounds should 
be absorbent to admit of ready impregnation with medicines and to allow 
of the absorption of discharges. They should be thoroughly sterilized and 
kept in clean paper and not removed until required for use. 

The Holier Bandage (Fig. 1) is usually 
made of gauze or unbleached muslin which has 
been washed in soda solution to remove the sizing 
and then torn into strips varying from one to five 
inches in width and from three to ten yards long, 

according to the part to be bandaged. Koller bandages may be purchased 

873 




874 



BANDAGING. 



in any drug store in sizes of all lengths and widths. When the bandage is 
made at home care should be taken that the edges be kept true, the loose 
threads picked off and the end of the bandage secured by a pin. 

The T Bandage is made by sewing one piece of bandage at right 
angles to another, is used to retain dressing between the thighs. One part 
of the bandage is tied around the waist, the stem of the T passing between 
the legs, then being brought up and tied to the first part. 

The Many-tailed Bandage is used principally after abdominal opera- 
tions. On applying it the central portion is placed over the spine, and 
beginning at the top, the first tail on one side, then the first tail on the 
opposite side is brought across the abdomen, so alternating and overlapping 
until all the tails are used. 

The Recurrent Bandage is applied to various parts. To adjust it to 
the head make several turns around the head, then pass the bandage back- 
ward and forward over the scalp until the parts are covered. Secure the 
turns with pins or strips of adhesive plaster. 




Fig. 2. 



The Oblique Bandage is begun by several circular turns and is then 
carried up the limbs like the red band on a barber pole. It is rarely used. 

The Spiral Bandage is applied to parts which do not vary in cir- 
cumference. It is applied like the oblique except that the turns overlap 
each other. Figure 4 demonstrates the application of the spiral bandage 
to the hand and wrist. 

The Spiral Reversed Bandage (Figs. 2 and 10) is applied to parts 
which are conical. It is begun like the spiral, but as the legs begin to 



THE FOUR-TAILED BANDAGE. 875 

thicken it will be found that the lower edge of the bandage does not lie 
snugly against the limb. In order to obviate this reverse each turn of the 
bandage, i. e. f the upper edge of the bandage becomes the lower edge. 
Overlap each preceding turn of the bandage at least one-half. 

To confine the bandage the end should be folded on itself, the cor- 
ners again folded under and a pin should be passed in the direction from 
which the end of the bandage has come. 

The Figure of Eight Bandage is applied to the knee, elbow, chest, 
axilla and occiput. Make several circular turns around the limb to fasten, 
pass obliquely downward over the flexor side of the joint to the opposite 
side, make a circular turn below the joint, and pass obliquely up again. 
The figure of eight is repeated, overlapping the turns until the part is 
covered. 

Figure 11 shows an excellent method of binding up the hand and 
wrist by means of a folded handkerchief in times of emergency. Care 
shoudld be taken not to allow any tight constriction around the wrist for 
a prolonged period, as death of the fingers may result. 





Figure No. 11. Figure No. 12. 

Bandages on the hand may be kept in place by use of a glove with 
the fingers cut off as shown in Fig. Wo. 12 and such a glove may also be 
used in keeping wounds clean and in other advantageous ways. 

The Spica Bandage is a figure of eight bandage, each turn overlap- 
ping the previous one so as to resemble a spike of barley. When the 
turns overlap each other from below upward the bandage is called an 
ascending spica ; when from above downward, a descending spica. When 
the turns cross in front it is termed an anterior spica ; in back, a posterior 
spica ; and on the side, a lateral spica ; when two corresponding parts like 
the groin are covered, the bandage is known as a double spica. 

The Four-tailed Bandage is made by taking a square or oblong piece 
of flannel or muslin, and tearing toward the centre from opposite sides, 



876 



BANDAGING. 



so as to make four tails. The size depends on the size of the part to be 
covered. 

For the instep make the bandage about twenty inches long and about 
five inches wide. Double it and tear down the centre, leaving a square 
portion untorn. Apply it by placing the central square portion across 
the instep; bring the two upper ends up around the leg and tie them; 
the lower ends are to be brought about the lower part of the foot and tied 
in a similar manner. This bandage is very effective in confining dress- 
ings to the instep and lower part of the leg. It may also be applied to 
the heel. 





Figure No. 14. 



Figure No. 13. 



For the knee take a strip of muslin eight inches wide and about 
thirty inches long; tear each end down the middle to within six inches 
of the centre. Apply the central portion over the patella, bring the upper 
ends of the bandage around behind the knee, passing obliquely down- 
ward, and tie on the front of the leg below the knee-pan ; the lower ends 
should be crossed behind in a similar manner, and tied on the front of the 
thigh above the knee-pan. 

Figure 13 shows the four-tailed bandage applied to the chin. 

The Triangular Bandage by skillful manipulation has been made to 
perform many and varied offices. 

Figure 14 shows the ordinary triangular bandage applied to the scalp 
in a manner somewhat like that adopted by women to protect the hair 
from dust when sweeping. 

Figure 23 shows the triangular sling applied in the usual way, the 
weight being supported by both shoulders. 



BA1JDAGE FOR CHIN. 



8T7 



In Figure 22 the same bandage is depicted, except that the weight 
of .the forearm falls on the left shoulder. 

In applying the triangular bandage to the knee take a triangle of 
muslin, the base being about two feet long and the apex about ten inches 
from the base. Place the centre of the base across the front of the knee 
just above the knee-pan ; bring the ends around as many times as possi- 
ble and tie them. Dressings are easily held on by this method, and much 
support is given in cases of fracture of the knee-pan. 

The Fillet or Head Band. — Take a piece of flannel twenty-five to 
thirty inches long and about ten inches wide. At the centre of the band- 





Figure No. 22. 



Figure No. 23. 



dage, one-half inch from the lower edge, cut a triangular hole large enough 
for the nose. Stand behind the patient and place the bandage over the 
face, the nose projecting through the hole, the remainder of the upper 
part of the face being covered. The ends are brought together behind and 
pinned. This is an admirable dressing for retaining dressings on the face 
and eyes, especially in burns of the face. 

Bandage for the Chin. — This bandage should be one and a half inches 
wide and about nine yards long. Standing at the back of the patient 
the end of the bandage is placed just over the left eyebrow, and fastened 
by one horizontal turn around the head, then passing around to and below 
the right ear, underneath the chin, and upward over the left side of the 
face, just covering the left ear. Two more turns are to be made over 
the top of the head and underneath the chin, each turn including a 
little more of the anterior part of the chin. The bandage is now to be 
continued around behind the neck, and, in a slanting direction, over the 
head and around the forehead, as before, and then again below the right 



$78 



BANDAGING. 



ear and across the front of the chin and around the neck, drawing this 
part quite snug, and repeating ; then passing under the chin and up on the 
left side of the face, bring the bandage to the top of the head and confine by 
several turns. It is used for fracture of the lower jaw, and for holding 
poultices to the side of the face, and so forth. If any turns be made about 
the neck care should be taken that they are not drawn tight enough to 
interfere with the circulation. 

T-Bandage for the Temple. — Take two pieces of muslin, one two to 
four inches wide and three feet long ; ten to twelve inches from one end, 
at right angles to it, another bandage should be fastened, two inches wide 





Figure No. 24. 



Figure No. 25. 



and seven to eight feet long, one end only extending fifteen to eighteen 
inches beyond the point of junction. 

Place the point of junction of the bandage over the injured temple in 
such a manner that the wide part of the bandage is perpendicular as re- 
gards the head ; the short end is to be brought to the top of the head and 
the long end around under the chin and fastened to the opposite end. The 
narrow part of the bandage is now carried around the head horizontally, 
the short end being confined by the horizontal turns. 

Double T-Bandage for the Nose. — Take a muslin bandage seven to 
eight feet long and one inch wide. At the centre of this, about one inch 
from each other, and at right angles to the first, stitch two other strips 
each two and one-half feet long by three-quarters of an inch wide. 

Place the centre of the main bandage beneath the nose (the two 
shorter pieces passing up on each side, crossing at its base and resting on 
the top of the head) , carry the ends around to the back of the head where 
they cross and are again brought around to the forehead, where they may 



BANDAGE FOR THE BREAST. 879 

be confined after taking several circular turns about tbe head. The ends 
passing over the top of the head may pass down behind and be pinned to 
the main bandage. This bandage is of use in keeping dressings about the 
nose in position. 

Bandages for the Breast. — We will assume the left breast is to be sup- 
ported. It is first covered with a layer of cotton ; then applying the end of 
the bandage about the centre of the back, holding it in place with one hand 
and with the other bringing the roller under the arm and breast, then 
across the chest and over the right shoulder, then under the arm and 
breast again until it is covered ; the bandage should now pass across the 
chest at the level of the lower end of the breast-bone, below the opposite 
breast, and around behind, where it may be confined. (See Figure 24.) 

When both breasts are to be supported the bandage should pass across 
the left shoulder also and below the right breast in the same manner. 
(See Figure 25.) 



PART III OF BOOK V 

Treats of the poisons and their antidotes, giving 
a list of poisons and antidotes for quick reference. 



Absinthe 902 

Acetanilid 901 

Acetic Acid 898 

Aconite 901 

Alcohol 901 

Ammonia 900 

Amyl Nitrite 891 

Aniline 888 

Animal Parasites 908 

Antidotes 883 

Antimony 893 

Antipyrine 901 

Apomorphine 901 

Arsenic 893 

Aspidium 902 

Atropine 902 

Belladonna 902 

Bloodroot 903 

Boric Acid 901 

Brandy as an Antidote 887 

Bromine 888 

Calcium 894 

Cantharides 002 

Camphor 902 

Carbolic Acid 898 

Carbon Dioxide 889 

Carbon Bisulphide 888 

Chlorine 888, 894 

Chloroform 888 

Chromium 894 

Colchicum 902 

Conium 902 

Copper 894 

Corrosive Poisons 898 

Crab Poisoning 909 

Digitalis 902 

Diseased Meats 906 

Eggs as an Antidote 884 

Elaterin ^ 902 

Elaterium 902 

Electric Treatment 890 



Ergot 902 

Ether 888 

Fish, Poisonous 907 

Food for Ptomaine Poison 905 

Fungi 904 

Fusel Oil 902 

Gamboge 902 

Gas, Illuminating 887 

Gases 887 

Gelsemium 902 

Gold 895 

Hematropine 902 

Hemlock 903 

Henbane 903 

Hydrochloric Acid 898 

Hyoscyamus 903 

Illuminating Gas 887 

Iodine 892, 895 

Iodoform 895 

Iron 895 

Jaborandi 903 

Laudanum 903 

Lead 895 

Lime 896 

Lobelia 903 

Lobster Poisoning 909 

Male Fern 902 

Meats, Diseased 906 

Poisonous , 905 

Mercury 896 

Metal Poisoning 893 

Metallic Salt Poisoning 893 

Milk as an Antidote 884 

Milk Poison 009 

Mineral Poisoning 893 

Morphine 903 

Mushroom Poisoning 910 

"Mussels, Poisoning from 908 

Mustard Emetic 884 

Nicotine 903 

Nitric Acid 898 



56 



881 



882 



INDEX TO PAET III OF BOOK V. 



Nitro-benzine 891 

Nitroglycerine 9°3 

Nitrous Oxide 893 

Nux Vomica 903 

Opium 903 

Oxalic Acid 899 

Oyster Poisoning 908 

Paris Green 896 

Phosphorus 896 

Pinkroot 903 

Poison 883 

Poison Ivy 904 

Oak 904 

Symptoms of 883 

Vine 904 

Poisons and their Antidotes 885 

Poke Berry 904 

Poke Root 904 

Potash 901 

Prussic Acid 892 

Ptomaine Poison 905 

Salicyclic Acid 901 

Salt Water as an Antidote 884 

Sanguinaria 903 

Shellfish, Poisonous 908 

Silver 897 



Soda 900 

Spanish Fly 903 

Spigelia 903 

Squills 903 

Stomach Pump 894 

Strychnine 903 

Sugar of Lead 895 

Sulphonal 904 

Sulphuric Acid 899 

Sulphurous Acid 892 

Sumach 904 

Sweet Oil as an Antidote 887 

Table of Poisons with Antidotes . . . .885 

Tansy 904 

Tartar Emetic 886 

Tartaric Acid 900 

Tin 897 

Tobacco 904 

Toxicodendron 904 

Turpentine 892 

Vegetable Poisons 901 

Vegetables, Poisonous 909 

Volatile Substances 5 887 

Vomiting, Elimination of Poison by.. 887 

Wine as an Antidote 887 

Zinc 897 



FIRST AID TO THE INJURED 



PAKT III. 
POISONS AND THEIR ANTIDOTES. 

How Poisons Enter the System. — Under the head of poisons, it is 
intended to include all those substances which exercise pernicious, as dis- 
tinguished from medicinal, effects upon the human body, tending to dis- 
turb its action or organization injuriously, and if not remedied to pos- 
sibly cause death. Such substances may be swallowed, or taken in by 
the breath, absorbed through the skin, or the thinner and more delicate 
mucous membranes, or implanted by bites, stings, or other punctured 
wounds. 

Symptoms of Poison. — In many cases persons are aware almost im- 
mediately after the act that they have swallowed a poison; but in many 
others, also, no suspicion is entertained at first. In a general way, it may 
be stated that it is reasonable to surmise a person has swallowed some 
poisonous substance, if, shortly after taking food or drink, he is seized 
with violent pain in the stomach, with vomiting and purging, especially 
if convulsions or paralysis are present, or if the individual suffer from 
marked giddiness or delirium, or should there be a great tendency to 
sleep. The first thing to do is to send for the nearest reputable physician, 
and any neglect of this involves a heavy responsibility if the illness prove 
mortal, as it is certainly very possible that it will do. 

Never Lose a Moment — In the meantime not a moment should be lost. 
There are three rules which should always guide an effort to remedy the 
effect of poison, no matter what it may be : First, to get rid of the poison ; 
second, to stop its effects ; and, third, to remedy the evil it has done. In 
carrying out the principles thus inculcated, whatever is readiest is best ; 
for the poorest remedy given at the moment, is better than the most 
appropriate, administered an hour later. 

Effect of Some Poisons — A considerable number of poisons are what 
might be called self -evacuating ; that is, having been swallowed, they set 
up vomiting and purging, and are thereby eliminated. In such cases, all 
that is needful is to aid the self-evacuating process, especially to assist the 
vomiting, and so, perhaps, get rid of the poison altogether. If vomiting, 
however, has not occurred, or has not been profuse, the first thing is to 
bring it on immediately. 

(883) 



884 POISONS AND THEIR ANTIDOTES. 

The Mustard Emetic. — The three handy emetics are, usually, mustard, 
common or kitchen salt, and lukewarm water. If we have a choice, mus- 
tard should be used in poisoning where the noxious substance has had a 
sedative influence, and it is less applicable to those cases where an irritant 
effect has been produced. 

Mustard Dose. — The dose of mustard is a tablespoonful, stirred up in 
a pint of warm, not hot, water, and, after drinking it, the patient should 
swallow as much warm water as his stomach will hold, both to dilute the 
poison and to promote the action of the mustard. After a few minutes, 
if no signs of vomiting appear, the back of the throat ought to be tickled 
with a feather, or roll of paper, which will often hasten the emetic effect. 
When the stomach has emptied itself, it is well to repeat the process, so 
as to give it a good washing out. 

Salt Water Dose. — Should there be no mustard at hand, salt water, 
mixed in the proportion of a small handful to a pint of lukewarm fluid, 
and followed by copious draughts of the warm fluid, as before suggested, 
and tickling the throat if needful, will generally answer the purpose. It 
is a good plan to send at once to the nearest drug store for some wine of 
ipecacuanha, to be administered in tablespoonful doses every ten minutes, 
should the ordinary home remedies fail in their customary energetic effect. 

Need of an Antidote. — In some instances, this treatment is all that is 
required, but frequently the simple plan of getting rid of the poison will 
not suffice. Its effects must be neutralized or remedied, or, in other words, 
some antidote is needed. INTo one antidote is suited to all emergencies. 
The antidote is required to be adapted to the poison, and therefore an 
effort should be made, instantly after the emetic is given, to find out 
what kind of a noxious substance has been swallowed, and the proper 
remedy should be administered in accordance with the following sug- 
gestions. 

Object of an Antidote — The object of most antidotes is to render the 
active poison an inert substance, after which treatment may be instituted 
with a view to remedy the mischief which it has previously done. Anti- 
dotes, therefore, are generally chemical agents, which attack or combine 
with the poison in such a way as to render it insoluble, and so inert. But 
some are medicines, the virtues of which are apparently opposed to the 
active qualities of the poison, constituting what may be correctly called 
counter-poisons. 

Milk and Eggs. — If we are totally ignorant of the kind of poison 
which has been swallowed, as may occasionally happen, the treatment 



Alphabetical Table of Principal Poisons With 
Antidotes for Immediate Use. 

A case of poisoning is the mightiest of emergencies — one of life or 
death. Every minute counts. One must know what to fly to on the in- 
stant. Here the poisons are arranged alphabetically so as to be found in a 
second, and followed by their quickest and most effective antidotes at hand 
in the home. 

POISONS ANTIDOTES 

CHLORIDE OF LIME.— Give acids; 
evacuate bowels; stimulate. 

CHLOROFORM.— Emetic of table- 
spoonful of mustard in warm water. 
Follow with stimulating treatment. 

CITRIC ACID.— Chalk or magesia 
water; flaxseed tea; lime water. 

COAL GAS.— See GAS. 

COBALT. — Prompt emetic; soap or mu- 
cilaginous drinks. 

COPPERAS.— Prompt emetic; soap 
or mucilaginous drinks. 

CORROSIVE SUBLIMATE.— Milk or 
white of eggs, freely. Emetic. 

CREOSOTE.— Starch or flour mixed 
with water ; or white of eggs and milk ; 
or evacuate stomach with an emetic. 

DIGITALIS. — Evacuate; lie prone; 
stimulate. 

ERGOT. — Evacuate ; give purgatives ; 
stimulate. 

ETHER.— See CHLOROFORM. 

FISH. — Emetic, followed by saline pur- 
gatives and alkaline drinks ; or 
promptly evacuate stomach and bowels, 
and then stimulate. 

FOWLER'S SOLUTION.— P r o m p t 
emetic of mustard and salt — table- 
spoonful of each. Follow with sweet 
oil, butter or milk. 

GAS. — Remove patient to air, use arti- 
ficial respiration, apply heat to extrem- 
ities; send for doctor. 

HAIR OF CATERPILLAR.— Apply 
cloths saturated with camphor. Don't 
rub. 

HONEY, POISONOUS.— Black coffee, 
smell of camphor, and rub with same. 

ICE CREAM.— Same as MILK. 

IODINE. — Starch, flour, or arrowroot, 
mixed with water. 

IVY, POISON.— Same as SUMACH 

JIMSON WEED.— Prompt emetic of 
mustard and salt — tablespoonful of 
each to pint of warm water, then 
stimulate with coffee or brandv. 



POISONS ANTIDOTES 

ABSINTHE.— Give an active emetic; 
then flaxseed tea freely; stimulate. 

ACETATE OF LEAD.— Same as 
SUGAR OF LEAD. 

ACETIC ACID.— Same as CITRIC 
ACID. 

ALCOHOL.— Treat by emetics, harts- 
horn and external warmth. 

ALKALI, VOLATILE.— Drink freely 
of water with vinegar or lemon juice 
in it. 

AMMONIA. — Lemon juice, diluted vin- 
egar or acetic acid. 

ANTIMONIAL WINE.— Give warm 
water freely to encourage vomiting. 

ANTIMONY.— Same as TARTAR 
EMETIC. 

AQUA FORTIS.— Magnesia or soap 
dissolved in water, every two minutes. 

ARSENIC. — Give prompt emetic of 
mustard and salt — tablespoonful of 
each. Follow with sweet oil, butter or 
milk. 

BED BUG POISON.— Give milk or 
white of eggs in large quantities. 

BELLADONNA.— Active emetic; stim- 
ulate. 

BITTER ALMONDS.— S a m e as 
PEACH KERNELS. 

BLUE VITRIOL.— Same as SUL- 
PHURIC ACID. 

CANTHARIDES.— Evacuate stomach ; 
give mild drinks. 

CARBOLIC ACID.— Give flour and 
water, or other glutinous drinks. 

CARBONATE OF SODA.— Prompt 
emetic ; soap or mucilaginous drinks. 

CAUSTIC POTASH.— Drink freely of 
water with vinegar or lemon juice in 
it. 

CAUSTIC SODA.— Drink freely of 
water, with vinegar or lemon juice 
in it. 

CHEESE.— 'Same as MILK. 

CHLORAL HYDRATE— Cold water 
on head and face; artificial respira- 
tion ; galvanic battery. 



NOTE. — In most cases of poisoning vomiting should be excited at once. The common 
emetics are mustard, a tablespoonful to a pint of warm water; salt, a small handful to a pint 
of warm water; warm water itself, in copious draughts. Salt and mustard mixed, a table- 
spoonful of each to a pint of warm water, make a quick and powerful emetic. Should an 
emetic prove tardy, tickling the throat with a feather will help to promote vomiting. 



(885) 



886 



POISONS AND THEIR ANTIDOTES. 



POISONS ANTIDOTES 

LAUDANUM.— Strong coffee, followed 
by ground mustard or grease in warm 
water to produce vomiting; keep in 
motion. 

LEAD WATER.— Milk or white of 
eggs in large quantities. 

LEAD, WHITE, RED, LITHARGE.— 
Prompt mustard or salt emetic, then 
castor oil ; heat to bowels. 

LIME. — Vinegar or lemon juice, then 
starch water. 

LUNAR CAUSTIC— A strong brine of 
salt ; then milk and sweet or castor oil. 

LYE. — Give vinegar or oil. 

MAD-DOG BITE.— Tie band tightly 
around limb above wound ; cut out and 
cauterize wound; apply antiseptic 
dressing; give purgative and warm 
drinks ; send to Pasteur Institute. 

MATCHES.— See PHOSPHORUS. 

MEATS, PUTREFIED.— Emetic, fol- 
lowed with vinegar or lemon juice. 

MERCURY.— White of eggs freely; 
afterwards evacuate; mild drinks. 

MILK. — Cleanse stomach and bowels ; 
apply heat; stimulate. 

MORPHINE.— Strong coffee, followed 
by ground mustard or grease in warm 
water to produce vomiting; keep in 
motion. 

MURIATIC ACID.— Magnesia or soap 
dissolved in water, every two min- 
utes. 

MUSHROOMS.— Same as TOAD- 
STOOLS. 

NICOTINE.— Same as TOBACCO. 

NIGHTSHADE.— Same as BELLA- 
DONNA. 

NITRATE OF SILVER.— Give com- 
mon salt in water, freely. 

NITRE. — An emetic, then drinks of bar- 
ley water, followed with castor oil. 

NITRIC ACID.— Same as AQUA 
FORTIS. 

NUX VOMICA.— Same as STRYCH- 
NIA. 

OAK, POISON.— Same as SUMACH. 

OIL OF VITRIOL.— Same as SUL- 
PHURIC ACID. 

OPIUM.— Same as LAUDANUM. 

OXALIC ACID. — Magnesia or soap 
dissolved in water, every two minutes. 

PARIS GREEN.— Same as ARSENIC. 

PEACH KERNELS.— Spirits of harts- 
horn, strong coffee; cold applications. 

PHOSPHORUS.— Excite vomiting, 
then give milk and magnesia, followed 
by tea of flaxseed or slippery elm. 

PINK ROOT.— Coffee without milk, 
smell of camphor. 

POKE ROOT AND BERRY.— Evacu- 
ate stomach and bowels; stimulate. 

POTASH.— See CAUSTIC POTASH. 



POISONS ANTIDOTES 

POTASSA, BICARBONATE.— M a g- 
nesia or soap dissolved in water, 
every two minutes. 

PRUSSIC ACID.— Coffee in plenty and 
quickly; smell spirits of ammonia, 
camphor or vinegar, pour water on 
head and back. Death generally en- 
sues so quickly that there is no time 
for emetics. 

RAT PASTE.— Quick emetic of salt and 
mustard, then flaxseed tea freely. 

RED PRECIPITATE.— Milk or white 
of eggs in large quantities. 

SALTPETRE.— Milk or white of eggs 
in large quantities. 

SNAKE BITES, POISON.— Tie band 
around limb above bite; suck out 
venom with mouth ; cauterize wound ; 
give strong stimulants. 

SODA.— See CAUSTIC SODA. 

SPANISH FLY.— Same as CAN- 
THARIDES. 

STINGS. — Apply salt water, or sweet 
oil, or fresh mould. Always take out 
the sting of a bee. 

STRYCHNIA.— Emetic of mustard in 
warm water. 

SUGAR OF LEAD.— Milk or white of 
eggs in large quantities. 

SULPHATE OR CHLORIDE OF 
ZINC. — Solution of soda, milk, white 
of eggs. 

SULPHURIC ACID.— Prompt use of 
magnesia, soap, chalk or lime water. 
Afterwards mucilage water or milk. 

SUMACH. — Apply to parts a paste of 
equal parts of starch and glycerine. 

TANSY. — Evacuate stomach ; stimulate ; 
artificial respiration. 

TARTAR EMETIC— Drink warm 
water freely to encourage vomiting. 

TARTARIC ACID.— Soap water, lime 
water, magnesia or chalk. 

TIN. — White of eggs and milk, or sugar 
water. 

TOADSTOOLS.— Evacuate stomach 
and bowels ; give Epsom salts ; stimu- 
late. 

TOBACCO. — Encourage vomiting with 
salt and mustard water, then stimulate 
with spirits of ammonia or whiskey 
and water. 

TURPENTINE.— Fresh air, flaxseed or 
slippery elm tea. 

VERDIGRIS.— Same as COPPERAS. 

VERMILION— Milk or white of eggs 
in large quantities. 

WHITE PRECIPITATE.— Prompt 
emetic of mustard and salt — table- 
spoonful of each. Follow with sweet 
oil, butter or milk. 

WHITE VITRTOL.— Same as SUL- 
PHATE OF ZINC. 



GASES AND VOLATILE SUBSTANCES. 887 

is first to provoke vomiting, as already advised, and after the stomach is 
completely emptied, to give a moderate quantity of some bland liquid, 
such as milk, eggs beaten up with milk, or sweet oil. 

Wine and Brandy. — If the patient feels cold, and the skin is cool and 
clammy, a little wine or brandy well diluted may be administered ; and if 
he seems drowsy, narcotic poisoning is to be suspected, so that strong 
coffee, and belladonna under the direction of a physician, should be em- 
ployed. 

Hot Water and Mustard. — If the prostration is very great, stimulants 
freely, heat to the skin by hot-water bags or bottles, and mustard plasters 
to the abdomen, are to be resorted to. 

When the poison taken into the stomach is known, and prompt at- 
tempts have been made to eject it by vomiting, then administer its 
antidote. 

Elimination by Vomiting. — Theoretically the administration of the 
chemical antidote is the only requisite, the vomiting, with its accompany- 
ing discomfort and depression, being uncalled for ; but it is safer to elimi- 
nate the poison or what part of it can be removed by vomiting, and so 
take as few chances as possible upon the quality and efficacy of the drug 
used as an antidote. Chemical results obtained in the laboratory are not 
always confirmed when the same combinations are attempted within the 
human system. 

Classification of Poisons — To facilitate the study of the subject some 
system of management should be adopted. No classifications of poisons 
is entirely satisfactory, and the following is offered as probably as good 
as any other for public use : 

1. Gases and volatile substances. 

2. Metals. 

3. Minerals and metallic salts. 

4. Corrosive poisons, acids and alkalies. 

5. Vegetable poisons, in form of drugs. 

6. Vegetable poisons in natural state. 

7. Bacterial and food poisons. 

8. Animal secretions. 

GASES AND VOLATILE SUBSTANCES. 

Illuminating Gas. — In the process of manufacture of illuminating 
gas from coal but little, if any, injury is done the workmen, owing to 
the distillation of its more deadly constituents in retorts. 



888 POISONS AND THEIR ANTIDOTES. 

In its distribution its escape from imperfect pipe connections and 
collection in trenches, sewers and houses occasionally causes poisonings 
and explosions. Illuminating gas known as water-gas is much more deadly 
and much more dangerous on account of its presence being less easily 
detected by smell. 

On animal organism both forms act as a narcotic and depressant of 
the nervous system; uniting with that portion of the blood normally tak- 
ing up the oxygen and displacing the oxygen. 

Symptoms. — These depend upon amount of poison absorbed. When 
poisoning occurs gradually there is discomfort, sense of fullness of blood- 
vessels, headache, dizziness, hot skin, weakness. There may be nausea, 
vomiting and convulsions. Coma occurs, which, in some cases of re- 
covery, may last for days; it may precede death but a few hours, or it 
may continue for days before a fatal termination takes place. 

Treatment. — Removal of the patient to the open air ; the use of arti- 
ficial respiration, and the application of heat to the extremities are about 
all that can be done before the arrival of a physician. Artificial res- 
piration hastens the expulsion of the poison and its substitution by 
oxygen. This result may be effected more promptly by inhalation of 
commercial oxygen. Nitro-glycerine and amyl nitrite might be used 
with advantage. 

Aniline. — This is made from coal tar, a biproduct in the manufac- 
ture of illuminating gas. It is an oily, colorless liquid, but its poisonous 
effects are chiefly caused by its volatility. The vapor produces headache, 
dizziness, marked depression, nausea, vomiting. Delirium and convul- 
sions may occur. 

Treatment should be same as for illuminating gas poisoning. 

Bromine. — This in its commercial form is a red fluid, but to the fumes 
arising from it when pouring, etc., is to be ascribed nearly all cases of 
bromine poisoning. Bromine vapor causes irritation of the respiratory 
organs, cough, spasm of the opening into the larynx and suffocation. It 
also causes increased flow of tears and saliva and bronchial asthma. 

Treatment. — Inhalation of aqueous vapor. 

Carbon Bisulphide — This is a colorless volatile liquid that causes 
poisoning chiefly by the vapor arising from it. It is used very largely 
in the manufacture of rubber goods; has a very offensive odor. Acute 
cases of poisoning do not occur, except where the substance is used for 
suicidal purposes, when the symptoms are pallor, vomiting, depression, 
deep, heavy breathing, characteristic odor of breath, feces and urine. 



<MSES AND VOLATILE SUBSTANCES. 889 

Carbon Dioxide. — This is the poisonous gas sometimes met with in 
wells, cisterns, etc. It is the "after damp" of the coal mines. Its deleteri- 
ous effects and treatment are similar to those of illuminating gas. It 
will not support flame. 

Chlorine. — This is a gas of peculiar odor ; is used chiefly as a bleach- 
ing agent. The public is familiar with it as a disinfectant in the form of 
chloride of lime, made by allowing pure slaked lime to take up all the 
chlorine gas it will absorb. It is a strong irritant to the respiratory tract. 
Continued exposure to it produces skin eruptions, inflamed eyes, asthma 
and bronchitis. 

Chloroform. — This has been taken as a liquid by accident and inten- 
tion. In this form its poisonous effects do not occur so soon as when the 
vapor alone is absorbed. 

One teaspoonful has been known to have brought death to a boy of 
four years. Twelve times this amount killed an adult. Several adults 
have recovered after swallowing sixteen teaspoonfuls. 

Treatment. — 1. Empty the stomach by giving a tablespoonful of 
wine of ipecac, or a tablespoonful of mustard in warm water. Twenty 
grains of sulphate of zinc or thirty grains of powdered ipecac may be 
given in warm water for the same purpose. A hypodermic injection of 
one-tenth grain of hydrochlorate of apomorphine and use of the stomach 
tube are very effective measures to remove the poison from the stomach. 

2. Stimulating treatment must be used extensively, as, for instance, 
brisk switching, or towel slapping or flicking ; hot external applications ; 
injection of hot strong coffee into the rectum, pint at a time ; application 
of mustard plaster to calves and legs and over the heart ; hypodermic in- 
jections of ether and hot brandy, atropine, strychnia and digitalis; use 
of the interrupted current by sweeping poles over the surface of the 
body ; placing victim with his head lower than his body that the brain 
might be supplied with blood with the least possible effort of the heart. 

Even though apparently there is no response to treatment efforts 
at resuscitation should be continued for a comparatively long time, as 
recoveries have occurred at the end of an hour of continuous effort. 

Chloroform — Chloroform taken into the lungs in form of vapor is 
supposed to act more promptly than when taken into the stomach as a 
liquid. In this form there is a wider range between the smallest quantity 
producing death and the largest amount taken without fatal result. 
Eecords show that less than half a teaspoonful mixed with air and ad- 
ministered by a competent person for surgical purposes has caused death, 



890 POISONS AND THEIR ANTIDOTES. 

on the other hand, a woman suffering with convulsions following child- 
birth (post-partum eclampsia) has been kept under the influence of chloro- 
form vapor for seventy hours continuously. 

Symptoms. — The symptoms of poisoning by inhalation of the vapor 
are similar to those following taking the drug in liquid form into the 
stomach. 

Treatment. — 1. The treatment differs only in refraining from any 
attempts at the production of vomiting or emptying the stomach by use 
of stomach pump. Equally applicable to both forms of poisoning are the 
following aids to resuscitation, not previously mentioned: Prompt com- 
mencement of artificial respiration. The occasional inhalation of amyl 
nitrite. The measure advocated in the following quotation might be of 
some avail. 

2. "When the patient seems to be in extremis a couple or more 
violent blows on the chest quickly given may restore the action of the 
heart." 

3. Electric Treatment. — Regarding the use of. the interrupting cur- 
rent as an aid to recovery authorities differ in details of application. 
One advocates placing one pole of the battery at the pit of the stomach 
and the other at the region of the larynx, with the idea of stimulating 
the phrenic nerve, which causes the diaphragm to act and aid respiration. 
Another authority states this method is dangerous, because nerves 
(cardiac inhibitory nerves) which tend to slow or stop the action of the 
heart lie so near the phrenic nerve that it is impossible to stimulate the 
latter without exciting the former to action, and so defeating instead of 
promoting recovery; hence the previously mentioned method of sweeping 
the poles of the battery over the surface of the body. 

Chronic Chloroform Poisoning — Chronic chloroform poisoning is a 
condition the existence of which would not be readily suspected. It 
occurs among a class of people who use chloroform constantly, for the 
same purposes or reasons that the other type of inebriate uses alcohol. 
Although the path to ruin and death is probably more direct by the chloro- 
form than the alcohol method, yet that the former is occasionally com- 
paratively long is shown by the record of a woman dying at the age of 
forty-two in a chloroform stupor, who for at least ten years had taken 
by inhalation a pint of chloroform daily. 

Ether is a colorless volatile liquid. It is highly inflammable, and 
when taken by the mouth imparts a burning taste. It is not so dangerous 
a drug as chloroform when used by inhalation and probably not when 



GASES AND VOLATILE SUBSTANCES. 891 

taken in liquid form. Although less apt to cause death, it has greater 
tendency to produce diseases of the respiratory tract than chloroform 
when taken by inhalation. 

Symptoms of Ether Poisoning. — The symptoms and treatment of poi- 
soning by ether are similar to those of chloroform, except the use of ether 
hypodermically as a stimulant should not be permitted. 

When in poisoning by ether the face becomes cyanotic, flushed, the 
failure to breathe properly is not due to weakness of the heart but to 
respiratory trouble, and the head should not be placed lower than the body. 
When the poisonous effects are carried beyond the cyanotic stage pallor 
succeeds the same as in chloroform poisoning and indicates lowering the 
head below the body in the same way as the latter drug. 

Treatment. — Traction upon the tongue, simulating normal respiration 
in frequency, duration, regularity and evenness is a method of causing re- 
covery that is equally applicable to both ether and chloroform poisoning. 

Amyl Nitrite. — This is a product of the chemical combination of 
amylic alcohol and nitric and nitrous acids. It is a clear volatile liquid 
having an aromatic penetrating odor. For administration by the public it 
is prepared in small glass receptacles called pearls, resembling some forms 
of capsules, and containing from three to five drops. The pearl is broken 
in a handkerchief and the contents inhaled. 

Symptoms of Amyl Poisoning. — An excessive amount causes alarming 
prostration, very rapid and tumultous beating of the heart, difficult respi- 
ration, bursting sensation in the head and roaring in the ears. Eecovery 
is said to have occurred after taking one-third of an ounce. With the ex- 
ception of prussic acid amyl nitrate is the quickest of all nervous depres- 
sants. 

Treatment. — Artificial respiration. Hypodermic injection of strych- 
nia and atropine. Give digitalis and whiskey. Apply heat in form of hot 
water in bottles or rubber bags if required 

Ammonia — See Corrosive Poisons. 

Nitro-benzine. — This is a yellow liquid formed in the manufacture of 
anilene by adding nitric acid to benzine. It has the odor of bitter almonds 
and has been used to perfume soaps. It is a subtle, dangerous poison both 
as a liquid and vapor. 

Symptoms. — Inhalation of a poisonous amount is followed by appear- 
ances of slow intoxication except the mind remains clear until a period of 
insensibility is reached. Insensibility may occur with great suddenness, 



89£ tOlSONS AND THETK ANTIDOTES* 

may be delayed for several hours and may continue for several hours be- 
fore death occurs. 

There is an odor of bitter almonds upon the breath. 

Treatment. — If the liquid has been taken empty the stomach with a 
pump or by emetics. If the poison has been inhaled, or taken into the 
stomach apply heat. Use strychnia and general stimulating treatment. 

Turpentine and white lead instead of white lead and oil are largely 
used for painting interior, and so forth. It is claimed by the painter and 
the physician, and denied by the employer, that the use of turpentine in 
confined places, such as between decks, causes watery discharges from the 
nose, a feeling of fullness or stuffiness in the head, difficult urination and 
bloody urine. 

Treatment. — Recovery follows exposure to the fresh air and use of 
mild bland drinks such as tea made from slippery elm or flaxseed. There 
is no record of the occurrence of any fatalities. Taken into the stomach in 
excessive amounts turpentine produces the same symptoms of strangury 
and bloody urine caused by inhalation of its vapors. In addition it may 
cause inflammation of the kidneys, stomach and intestines. 

Iodine in its process of manufacture and manipulation volatilizes at 
ordinary temperature. In its liberation from seaweed it gives off fumes 
in the same way as chlorine and bromine in their process of extraction. Its 
vapors cause the same effects as those of chlorine and bromine. Eor poi- 
soning resulting from its use in drug form, see Minerals, Metallic Salts. 

Prussic Acid. — This colorless, transparent, inflammable, volatile liquid 
is perhaps the most rapid and deadly of poisons. Taken in sufficient quan- 
tity is has been claimed to have caused almost instant death. 

Symptoms. — These vary with the quantity of poison taken. When not 
sufficient to be promptly fatal there may be open, staring eyes, fixed jaws, 
pallor of cyanosis, depending upon whether the cardiac or respiratory func- 
tions are the more affected, convulsions, vomiting, unconscious discharge 
of feces, urine and semen. The odor of bitter almonds is noticeable upon 
the breath and upon post-mortem examination, but rapidly disappears. 

Treatment — This is, of course, confined to those cases that afford 
time for action and may be outlined as use of stomach pumps, artificial 
respiration, oxygen inhalation, cold applications to head and spine, elec- 
tricity, ammonia by inhalation or intravenously. 

Sulphurous Acid. — This is a strong solution of sulphurous oxide gas. 
Its poisonous effects are directed chiefly against the respiratory tract. 



METALS, MINERALS, METALLIC SALTS. 893 

Remedies. — The remedies are fresh air, artificial respiration and 
stimulants. 

Nitrous Oxide — This is known also as nitrogen monoxide, and laugh- 
ing gas is used chiefly as a brief anesthetic in dentistry. It is capable of 
producing alarming symptoms and even death by respiratory paralysis. 
Recovery is to be attempted by fresh air, rhythmic traction upon the 
tongue, artificial respiration. 

METALS, MINERALS, METALLIC SALTS. 

Antimony. — This is found both as a metal and a mineral. The prep- 
arations of the metal best known to the public, and from the abuse of 
which poisoning is liable to occur, are tartar emetic, oxide of antimony, 
sulphureted antimony, wine of antimony and compound syrup of squills, 
known as Coxe's hive syrup. 

Symptoms of Poisoning. — Marked depression characterizes poisoning 
by this substance. Violent purging and vomiting occur. The bowel dis- 
charges are characteristic and known as rice water stools; that is upon 
standing in a glass a separation can be noticed into two layers : an upper 
watery and clear, and a lower white and flocculent. 

Treatment. — Evacuate the stomach by means of a stomach pump. 
Give tannic acid freely to form the insoluble and inactive tannate of anti- 
mony. The general precautions taken in all cases of depression are to be 
observed. Maintain the prone position, not raising the head to vomit, nor 
the body for defecation. Apply heat and use stimulating treatment, 
whiskey, strychnia and digitalis hypodermically. Give opium to allay 
pain; but counteracting its tendency to after depression by strychnia. 

Arsenic — This is a brittle crystalline metal of steel-gray color. Its 
freshly broken surface is very brilliant. It is found in its native state 
in the rocks of many different localities. It is also a constituent of cobalt, 
copper, nickel and tin ores. 

Symptoms of Poisoning. — "Rarely the course is one of rapid succession 
of severe pain, prostration and death. Frequently the period between 
ingestion and fatal ending is of five or six days' duration, including a time 
when there is an absence of marked symptoms and an apparent begin- 
ning of recovery. There is a burning sensation in the mouth and oeso- 
phagus. The stomach and bowels are strongly irritated. There is violent 
purging and vomiting with great pain over the entire abdominal region. 
The pain is of cramp-like character, and sometimes extends to the calves 



891 POISONS AND THEIR ANTIDOTES. 

of the legs or legs in general. The bowel evacuations are bloody "rice 
water" in character, and contain stringy mucus, supposed to be mucous 
membrane stripped from the bowels. 

Treatment. — The acknowledged effective preparation to counteract 
arsenic when taken into the stomach is hydrated oxide of iron with mag- 
nesia, and is made as follows: Solution of tersulphate of iron, one thou- 
sand parts; magnesia, one hundred and fifty parts; water, a sufficient 
quantity. Mix the solution of tersulphate of iron with twice its weight of 
water, and keep the mixture in a well-stoppered bottle. Rub the mag- 
nesia and water to thin and smooth mixture; transfer this to a bottle 
capable of holding thirty-two fluid ounces, and fill it up with water. 
When the preparation is wanted for use mix the two liquids by adding the 
magnesia mixture gradually to the iron solution, and shake them together 
until a homogeneous mass results. 

The Stomach Pump — This antidote will not produce the desired re- 
sult if the arsenic is not in solution, consequently the stomach pump takes 
a position of primary importance in the attempts at recovery. Following 
the evacuation of the stomach should be the application of external heat 
and the administration of stimulating drugs ; morphia if necessary to quiet 
the pain. Water to flush the entire system. 

Calcium. — This is a very abundant element in nature, occurring as 
limestone, marble, chalk, and so forth. Calcium chloride is perhaps the 
only drug derivative that might prove dangerous to the public. In excess 
this drug is a strong gastro-intestinal irritant, and poisonous effects should 
be treated by vegetable acids and demulcent drinks. Calcium chloride is 
not chloride of lime. For the latter see Lime. 

Chlorine occurs in combination with sodium, potassium, magnesium 
and calcium. It is in its liberation that it proves itself dangerous to life 
on account of its poisonous vapor. (See Gases and Volatile Substances.) 

Chromium. — The preparations of this mineral, most familiar to the 
public, are chromic acid, bichromate of potassium and chromate of lead. 
All the chromium preparations are irritants to the stomach and bowels 
and can cause death when taken internally. To counteract, use the stom- 
ach pump and give demulcent drinks. Administer stimulants under the 
skin and apply heat. Give lime-water or other weak alkalies if chromic 
acid has been taken. 

Copper. — The salts of copper taken into the stomach in excess are 
powerful irritants to the stomach and bowels, giving the following syrup- 



LEAD POISONING. 895 

toms: Copperish taste, intense pain in stomach, vomiting, purging, con- 
vulsions. Death may follow. 

Treatment. — Give the chemical antidote, yellow prussiate of potas- 
sium, mild drinks, such as sweet oil, milk, white of eggs. Soaps and 
alkalies are said to be antidotal. The stomach should be emptied of the 
compounds formed either by emesis or stomach pump. Stimulating treat- 
ment and opium to relieve pain should be given. 

Gold. — The pharmaceutical preparations of gold are decidedly poison- 
ous, the chloride more so than corrosive sublimate, it is claimed. They 
are corrosive in their action, with symptoms similar to copper and other 
gastro-intestinal irritant poisons. 

Treatment. — For treatment, evacuate stomach; stimulate. Sulphate 
of iron is said to be a chemical antidote. 

Iodine. — This is a non-metallic substance, having a metallic lustre. 
It volatilizes at a low temperature and gives off a crimson-purple vapor. 
For poisoning by this drug, see Gases and Volatile Substances. 

Iodoform. — This is a yellowish powder, with a strong and objection- 
able odor. It is used principally in the treatment of surgical wounds, and 
has caused local and systemic poisoning when so applied. 

Symptoms of Poisoning. — Fatal results have been rare, but when oc- 
curring the symptoms were local rash, headache, vomiting, delirium, con- 
vulsions, coma. The kidneys may be affected and retention of urine or 
bloody urine occur. 

Treatment. — Cause sweating by the hot pack and give diuretics to 
relieve the kidneys. Bicarbonate of sodium is said to be useful in pro- 
moting the elimination of the iodine constituent of the drug. Stimulate. 

Iron. — The only salt of iron likely to do harm by its unguarded use 
by the public is the subsulphate or Monsel's salt, a solution of which known 
as Monsel's solution is used to stop hemorrhage. 

Antidote. — The antidote is common soap. Monsel's solution should 
be applied and not taken inwardly. 

Lead. — Perhaps no other metal has such diversity of uses in the arts 
and manufactures. It might be more accurate to say no other metal 
furnishes such an array in number and variety of instances of poisoning. 
As a rule industrial lead poisoning is a slow, chronic process, and does not 
call for the prompt attention required by the ingestion of excessive 
amounts of lead-burdened drugs. 

Sugar of Lead. — Acetate of lead, known to the public as sugar of lead, 



896 POISONS AND THEIR ANTIDOTES. 

is the preparation of lead most frequently prescribed by medical prac- 
titioners. 

Symptoms of Poisoning. — Indications of poisoning are pain in the 
region of the stomach and vomiting of a white, curdy material, resulting 
from the chemical combination of the hydrochloric acid of the gastric 
juice with the lead. Inflammation of the stomach occurs sometimes with 
constipation, sometimes diarrhoea, with black discharges, caused by the 
formation of sulphide of lead in the bowels. 

Treatment — Epsom and Glauber salts are preferred as chemical anti- 
dotes for their effective action chemically and for their purgative influ- 
ence. Other antidotes are alkaline carbonates, soap and salt. Use stom- 
ach pump or emetics to insure evacuation of stomach contents. Apply 
heat and give stimulants. Use opium to relieve pain. 

Lime. — Chloride of lime, used as a disinfectant and germicide, is 
slaked lime to which has been added 35 per cent, of chlorine. Its poison- 
ous properties depend upon the chlorine gas it contains, for which see 
Chlorine, under Gases and Volatile Substances. If lime is taken into 
the stomach it causes great thirst, abdominal pain and constipation. 

Antidotes — To counteract give vegetable acids and demulcent drinks. 
Evacuate stomach; stimulate. 

Mercury. — This is a silvery, white, heavy fluid metal, obtained chiefly 
from cinnabar, a sulphide of the metal. In the mining of the ore and in 
the many industrial uses made of the pure metal, its compounds and com- 
binations, chronic poisoning occurs. Acute poisoning is more frequently 
due to the injudicious use of drugs containing some preparation of the 
metal. 

Symptoms of Poisoning. — In severe cases these are metallic taste, 
burning sensation in the throat and stomach, vomiting, bloody stools, con- 
vulsions, coma. 

Antidote. — The antidote is white of egg; additional treatment same 
as given in case of other corrosive poisons ; evacuation ; bland drinks ; 
stimulants. Potassium iodide to aid in elimination. Opium to relieve 
pain. 

Paris Green — Symptoms of poisoning and treatment same as in 
arsenic. 

Phosphorus is a non-metallic element, discovered in 16G9 by Brandt, 
who obtained it from urine. In 1769 it was found in bones, the chief 
source of supply at present. 

Symptoms of Poisoning. — In acute poisoning symptoms do not appear 



zinc poisoning. 897 

for several hours. Pain in the oesophagus, stomach and "bowels may be 
accompanied by purging or constipation. Discharged matters have char- 
acteristic odor and luminosity in the dark. The second or third day there 
may be a cessation of vomiting or of such symptoms for several hours, 
followed by a jaundice, pain, vomiting, delirium, convulsions, coma. 

Antidotes. — Hare suggests peroxide of hydrogen and permanganate 
of potassium as antidotes. Sulphate of zinc is recommended for the same 
purpose. To the victim rescued from even acute poisoning is held out 
the gloomy prospect of an early death through fatty degeneration of vital 
organs. 

Silver. — The salts of this metal that are most apt to cause poisoning 
are cyanide and nitrate. The cyanide is dangerous on account of its 
liberation of hydrocyanic acid when strongly heated. The nitrate is fre- 
quently used as a caustic, and when taken into the stomach produces 
marked gastric and intestinal inflammatory symptoms. 

Symptoms of Poisoning. — The lips are first white from the caustic 
action of the drug, then become black. The vomited matter and the 
discharges from the bowels turn black upon exposure to the air. Con- 
vulsions, coma, paralysis, death may follow. 

Treatment. — The chemical antidote is common salt. Soap and 
alkalies are supposed to annul the poisonous tendencies or to prevent the 
action of the poison upon the mucous membrane of the alimentary canal. 

Tartar Emetic. — See Antimony. 

Tin. — In the separation of tin from its ores poisoning is a rare 
occurrence, except from the deleterious substances combined with the 
tin. Pharmaceutically it is of little or no value, consequently it is not 
likely to fall into the hands of the public for perverted use. Of the 
chloride, three-quarters of a grain injected into the veins of a dog caused 
death. Fifteen grains introduced into the stomach caused vomiting and 
gastric irritation. Effective treatment would be evacuation, magnesia, 
mucilaginous drinks. 

Zinc. — All the salts of zinc which can be absorbed in excess have a 
strongly depressing, even paralyzing, action upon the heart and all vol- 
untary muscles, and may cause death by this means. Convulsions, coma 
and death is the brief statement of another bond of effects following zinc 
poisoning. 

Treatment. — Empty the stomach. Give milk mixed with sugar and 
white of egg to form insoluble albuminate of zinc. Sodium or potassium 
carbonate, tannic or gallic acid have also been recommended as antidotes. 
57 



POISONS AND THEIR ANTIDOTES. 

Overcome depression by stimulants, strychnia, digitalis, and so forth. 
Apply heat, give morphia for pain. 

CORROSIVE POISONS. 

Acetic Acid. — Acetic acid of the pharmacopeia is very mildly caustic. 
Taken internally it may prove very dangerous. Recovery has followed 
the injection of three ounces, followed by collapse and asphyxia from 
closure of the glottis. Suffocation was prevented by tracheotomy. Gastro- 
enteritis is liable to result. 

Antidotes. — The chemical antidotes are lime-water and soap-water; 
milk and other bland drinks should be given. The stomach pump should 
be applied. Heat and stimulating treatment may be required. 

Carbolic Acid. — This, in its pure state, is a white substance, appear- 
ing as needle-like crystals. It is very deliquescent and, with the addition 
of 10 per cent, of water or glycerine, becomes liquid; in this form it is 
usually dispensed. 

Symptoms of Poisoning — In large doses it has produced death in two 
or three minutes. In smaller doses it causes gastro-enteritis, marked by 
extreme pallor, cold sweats, stupor, coma, subnormal temperature, dark 
urine or suppression of renal secretion, very much contracted pupils. 
The drug has produced poisonous effects by absorption from surgical 
dressings. 

Treatment. — Give soluble sulphates, Epsom or Glauber salts as the 
chemical antidote. A well-known authority says the lapse of several 
hours does not counter-indicate the use of the chemical antidotes as they 
follow the acid into the blood-vessels and tissues to unite with it. The 
stomach pump, heat, hypodermic stimulation, bland drinks should follow 
the use of the soluble sulphates. The use of oil as an emollient drink is 
prohibited owing to the belief that it aids the absorption of carbonic acid. 

Hydrochloric Acid is not so destructive in its action as nitric or 
sulphuric acids. When swallowed the tissues are superficially destroyed, 
but rarely does deep erosion or perforation occur. It causes great thirst 
and restlessness, burning skin, agonizing stomach pain. Chemical anti 
dotes are magnesia, soap or any dilute alkali. Supportive treatment may 
be required. 

Nitric Acid. — In industrial occupations the inhalation of the fumes 
arising from this acid has repeatedly produced death. Its irritative action 
upon the larynx may cause spasm of the glottis severe enough to end 



CORROSIVE POISONS. 899 

fatally by asphyxia. Taking it into the lungs has been followed by pul- 
monary edema and death. As a liquid in excess its action upon the ali- 
mentary canal is extremely corrosive, and where death does not follow 
promptly the following symptoms may appear: 

Symptoms. — Burning of the mouth, oesophagus, stomach and in- 
testines ; intense pain, distention of stomach and intestines, frequent eruc- 
tations, emesis, extremely fetid odor of exhalations and vomit, great thirst, 
cold extremities, anxiety, collapse. The stain upon the clothing and lips 
is yellow in color and is resembled by the stains of iodine and bromide. 
Discolorations made by the latter two drugs can be removed by caustic 
potash, but nitric acid stains are increased in brightness by the same appli- 
cation. 

Treatment — The treatment is the same as for other corrosive acid 
poisons, alkaline solutions, magnesia, soap, chalk, oils, demulcent drinks, 
heat and stimulation. Opium to allay pain. Recovery is rare and usually 
followed by early demise from destructive effects, such as constriction of 
oesophagus or bowels or loss of function in digestive organs. 

Oxalic Acid. — Accidental poisoning has occurred by taking oxalic 
acid in mistake for epsom salts. The sour taste is very different from the 
taste of epsom salts. 

Symptoms vary with the quantity taken. Taylor says the mimimum 
fatal dose is one drachm. Death has occurred as early as ten minutes 
after taking the poison in excess. With large amounts the early indica- 
tions are those of a corrosive poison, pain in oesophagus and stomach, 
retching and bloody vomit. They may be followed by great depression 
and death without a struggle. 

Treatment. — The antidotes are lime-water, magnesia, chalk; plaster 
from the wall has been suggested in emergency. These should be given 
promptly to form insoluble oxalates of magnesium or calcium. The 
oxalates of ammonium and potassium are soluble, poisonous and require 
the same antidotes as oxalic acid. 

Sulphuric Acid. — This is the most corrosive and the most extensively 
used of mineral poisons, having the same poisonous symptoms as the other 
strong corrosive acids. The tissue discoloration due to its action is black. 
Death may be caused by laryngeal obstruction through violent inflam- 
matory effects ; by collapse due to perforation of the stomach or by shock 
due to extensive destruction of tissues. If recovery occurs the injured 
tissue sloughs off and subsequent contracture or loss of function may cause 
death later on. 



900 POISONS AXD THEIR AKTIDOTES. 

Treatment consists in the prompt use of magnesia, soap, chalk, lime- 
water as antidotes. After neutralization of the acid give mucilaginous 
drinks, milk or other bland drinks. The deep and extensive tissue destruc- 
tions render the use of emetics and stomach pump dangerous. The strong 
muscular effort accompanying emesis and the manipulation of the pump 
both tend to result in perforation. Counteraction of depression by heat 
and hypodermic administrations is, of course, strongly indicated. 

Tartaric Acid, more irritant, but less expensive than citric acid, is 
sometimes used instead of the latter in making a substitute for lemonade. 
In large quantities it is a gastro-intestinal poison and has caused fatal 
results. 

Antidotes — Give soap-water, lime-water, magnesia, chalk as anti- 
dotes. Use the stomach pump or emetics; administer stimulants; apply 
heat. 

Ammonia. — This is a transparent, colorless gas, having an acrid taste 
and an exceedingly pungent smell. It is alkaline in reaction. The best 
publicly-known preparation containing this gas is aqua ammonise or water 
of ammonia, a solution of 10 per cent, by weight of the gas in water. 
Death has been caused by inhalation of the gas, by ingestion of the liquid 
and by the muriate and carbonate. Fatal results have followed after the 
lapse of four minutes through spasm of the glottis. The same ending may 
occur after comparatively long periods as with other corrosive poisons, 
causing stricture or prolonged prostration. 

Symptoms. — These are pain, burning sensation from mouth to stom- 
ach, vomiting of bloody mucus. Cardiac and respiratory efforts are 
greatly stimulated, but soon equally depressed. Lachrymation, sneezing 
and cough are marked. Ammonia differs from the other alkalies in affect- 
ing the nervous system, while the other are destructive in local effects 
only. 

Treatment. — As an antidote, lemon juice and dilute vinegar or acetic 
acid may be given. Bland drinks and vigorous efforts to counteract pros- 
tration should follow. Opium may be required to allay pain and reduce 
nervous symptoms. 

Soda. — This is the hydrate of sodium, known commonly as caustic 
soda. When fluid it is moulded and placed upon the market in the shape 
of small sticks or cylinders not quite as large as an ordinary lead pencil. 

Symptoms of Poisoning. — It is corrosive in its action, causing, when 
taken, pain throughout the alimentary tract and destroying, by softening, 
all tissues with which it comes in contact. Vomiting occurs. The soft- 



VEGETABLE POISONS. 901 

ened and destroyed tissues siough, sometimes in mass, and inflammatory 
conditions follow. 

Treatments — Give weak acids, oils, demulcents, and use stimulating 
treatment. 

Potash. — This is the hydrate of potassium, commonly called caustic 
potash. It is more corrosive than caustic soda. Poisonous symptoms and 
treatment are the same. (See Soda.) 



VEGETABLE POISONS (in form of drugs). 

Limited space and the great number of substances included under 
this heading compel the briefest notice of symptoms and treatment where 
poisoning has occurred by accident or overdoses. 

Acetanilid, a white powder; common constituent of advertised head- 
ache powders. Causes cyanosis, prostration, heart failure. Use strong- 
stimulants, external heat. 

Acid, Boric, iu large amount produces nausea, vomiting, collapse, 
cardiac failure. Treatment is to evacuate stomach, stimulate. 

Acid, Salicylic, in large amount causes deafness, delirium, defective 
breathing, respiratory failure. Treatment is by strychnia and other 
stimulants. 

Aconite, a dangerous drug; small amount may prove fatal. 

Symptoms of Poisoning. — Tingling of mouth and throat becoming 
general, pallor, anxiety, slow pulse, weak respiration, great muscular 
weakness, heart failure. 

Treatment. — Keep victim on flat of back, with head below body. Ex- 
ternal heat, hypodermic injections of ether, alcohol, digitalis, strychnia 
in large doses, atropine, artificial respiration if required. 

Alcohol. — Frequent cases of acute alcoholic poisoning occur among 
children. 

Symptoms. — Giddiness, drunken gait and manner, flushed face, may 
be pale, stupor, coma, sometimes death long after apparent recovery. 

Treatment. — Digitalis, strychnia hypodermically, external heat, arti- 
ficial respiration, prone position, with head lower than body. 

Antipyrine — This causes erythema or other skin disturbances, tin- 
gling sensations, depression. Treatment is same as aconite poisoning. 

Apomorphine causes prompt and severe vomiting, depression, cardiac 
failure. Use hypodermic stimulation, external heat as antidotes. 



902 POISONS AND THEIR ANTIDOTES. 

Absinthe causes insensibility, convulsions, involuntary evacuations, 
possibly death. Evacuate stomach, give demulcent drinks, stimulate. 

Aspidium or Male Fern. — Used to destroy tape worm. Overdose might 
cause gastro-enteritis, collapse, death. Evacuate, stimulate. 

Atropine, Belladonna, Hematropine cause flushed face, general redness 
of skin, great dryness of mouth and throat, dilated pupils, prostration. 
Eor treatment insist upon prone position, evacuate stomach if seen early, 
stimulate, use artificial respiration if necessary. 

Bloodroot. — See Sanguinaria. 

Camphor. — In large doses produces roaring in the ears, delirium, con- 
vulsions, possibly gastro-intestinal symptoms. To treat, evacuate, 
stimulate. 

Cantharides. — Produces vomiting, bloody stools, priapism, strangury, 
convulsions, coma, respiratory paralysis. Eor treatment, evacuate, give 
morphia for pain, bland drinks, stimulate. 

Colchicum — Symptoms of gastro-enteritis, great pain, fatal depres- 
sion. Eor treatment, evacuate, give tannic acid, stimulate, morphia for 
pain. 

Conium. — Muscular depression, paralysis of respiratory muscles. 
Evacuate, give tannic acid, atropine, stimulate. 

Digitalis. — Produces headache, slow full pulse becoming irregular; 
great prominence of the eye-ball, pearly color of sclerotic coat, vomiting. 
Death is caused probably by cardiac spasm. 

Treatment. — Give tannic acid as a chemical and aconite as a physi- 
ological antidote. Evacuate, enforce prone position, stimulate. Prone 
position should be maintained for days after apparent recovery, as death 
has immediately followed erect posture after digitalis poisoning of a day 
or two previous. 

Elaterin and Elaterium in excess cause gastro-enteritis. Use stomach 
pump, heat, stimulant, opium. 

Ergot. — Enormous doses are required to cause fatal results. Symp- 
toms are tingling sensations, vomiting, muscular spasm, great coldness 
of the surface. Evacuate, give purgatives, stimulate, enforce prone 
position. 

Fusel Oil causes muscular rigidity, respiratory failure. Evacuate, 
stimulate, use artificial respiration. 

Gamboge causes gastro-enteritis. Evacuate with pump, stimulate, 
apply heat, give demulcent drinks. 

Gelsemium causes great depression, falling or dropping of the eyelids, 



VEGETABLE POISONS. 903 

double vision, respiratory failure. Evacuate, stimulate hypodermically 
with atropine, strychnine, ether, digitalis, apply heat, use artificial res- 
piration. 

Hemlock. — See Conium. 

Henbane. — See Hyosciamus. 

Hyosciamus causes giddiness, incoherence of speech, loss of power to 
swallow, partial loss of voice, difficulty in respiration, delirium. For 
treatment, evacuate, stimulate. 

Jaborandi. — Profuse sweating, salivation, vomiting, diarrhoea, ocular 
irregularities. Give atropine as antidote, evacuate, stimulate. 

Laudanum. — See Opium. 

Lobelia causes vomiting, sometimes purging, great depression, respi- 
ratory failure. Give tannic acid, stimulate, apply heat, use artificial 
respiration. 

Morphine. — See Opium. 

Nicotine — See Tobacco. 

Nitro-Glycerine causes severe headache, rapid, irregular cardiac action, 
collapse. Give atropine, digitalis, strychnine. Maintain recumbent 
position. 

Nux Vomica. — See Strychnia. 

Opium causes mild excitement or contentment, followed quickly by 
sleepiness, stupor. Cyanotic face, contracted pupils, gradually decreased 
frequency of breathing, respiratory failure. For treatment evacuate 
stomach with pump ; give strong coffee by mouth or rectum ; use flagella- 
tion or the battery to keep patient awake ; keeping victim in motion by 
walking is also useful for the purpose, but may exhaust him. Give hypo- 
dermic injection of strychnine ; apply heat ; use artificial respiration. 

Pinkroot. — See Spigelia. 

Bloodroot, Sanguinaria, causes salivation, vomiting, purging, convul- 
sions, respiratory failure. For treatment evacuate, stimulate. 

Spanish Fly. — See Cantharides. 

Spigelia causes dilatation of the pupils, prominence or protrusion 
of the eyeballs, internal strabismus, retching, increasing muscular weak- 
ness, depressed respiration, coma, death. 

Treatment. — Evacuate ; stimulate ; use heat and artificial respiration. 

Squills produce gastro-enteritis, bloody urine, strangury, convulsions, 
death. 

Treatment. — Evacuate ; stimulate ; give demulcent drinks. 
Strychnine. — Symptoms may begin gradually or be pronounced from 



904 POISONS AND THEIR ANTIDOTES. 

beginning. If they come on slowly, there is stiffness of jaw and neck; 
slight, then strong muscular contractions, with body bent backward and 
resting on head and feet. Intervals of relaxation succeeded by tonic con- 
vulsions; death from exhaustion, or more frequently by asphyxia due 
to spasm of muscles of respiration. 

Treatment. — Give tannic acid. Evacuate stomach, administer brom- 
ides and chloral. Amyl nitrite may lessen the spasm. If drugs cannot 
be given by mouth on account of convulsions, prevent same by chloroform, 
and at same time give bromides and chloral per rectum. If periods of 
relaxation are too brief to permit of chloroform securing control give amyl 
nitrite hypodermically. 

Sulphonal causes sleepiness, stupor, scanty or suppressed urine, un- 
consciousness, death by respiratory failure. For treatment evacuate, stim- 
ulate. Give diuretics; use artificial respiration. 

Tansy produces abortive tendencies, convulsion, coma, respiratory 
failure. For treatment evacuate, stimulate, use artificial • respiration. 

Tobacco contains an alkaloid, nicotine, that is said to cause death 
as promptly as hydrocyanic acid. Thirty grains of tobacco or one to two 
drops of nicotine are sufficient to cause death in less than half hour by 
the first and in a few minutes by the second. 

Symptoms — Nausea, vomiting, cold, clammy skin, general muscular 
relaxation, pupils contracted, then dilated, odor of person disagreeable. 

Treatment. — Recumbent position ; tannic acid ; evacuation of stomach ; 
stimulants; heat. 

Fungi, toadstools, and so forth, may cause vomiting, purging, convul- 
sions, delirium, stupor, death. Evacuate, give Glauber or Epsom salts, 
stimulate. 

Poison Ivy, Poison Oak, Poison Vine cause irritation of skin, particu- 
larly of face, itching, swelling, vesicular eruption. If taken inwardly 
drowsiness, stupor, delirium, convulsive movements. 

Treatment. — Externally use alkaline solutions or dilute subacetate 
of lead. Rest, low diet, laxatives, opium. 

Poke Berry and Root causes nausea, vomiting, purging, cardiac and 
respiratory depression, convulsions. Eor treatment evacuate, stimulate. 

Sumach — See Poison Ivy, and so forth. 

Toxicodendron. — See Poison Ivy, and so forth. 



FOOD OB PTOMAINE POISONS. 905 



FOOD OR PTOMAINE POISONS. 



A person can be poisoned from eating foods as : meat, fish, milk, etc. 
The poisons which cause food poisoning (usually called ptomaine poison- 
ing) depend upon their presence in the food when eaten because of the 
development in the food or its mixture with poisons. 

Poisonous Meat — Poisonous meat results from the presence of bac- 
teria and their poisonous secretions. The infection from eating meat 
arises in two ways: 1. The meat derived from an animal which may be 
perfectly healthy and when slaughtered yield flesh entirely wholesome and 
free from bacteria, acquires poisonous properties only by the introduc- 
tion of bacteria from without by being placed or handled in unclean 
utensils, vessels, etc., and thus becomes contaminated. Meat kept in a 
warm temperature favors the development of the bacteria which came 
from without, the germs thus produced multiply and give rise to poison- 
ous products and these render meat dangerous which was previously 
healthy, and this is particularly true in respect of canned meats. The 
chopping of meat favors the spreading of bacteria throughout the mass. 
Secondly, the infection of meat results from the use of meat derived from 
animals which were diseased at the time of slaughter. Meat from such 
a source contains germs which will cause symptoms of poison or allow 
poisonous bacteria to develop rapidly on being kept for a short time. 
Poisoning will follow the eating of this meat and may readily lead to an 
acute infection, rendering the users very ill or cause death. Many cases 
of inflammation of the stomach and bowels (gastro-enteritis) are due to 
the eating of diseased meat. 

Change in the odor or taste of meat is not always indicative of the 
presence of poisonous products. 

Owing to so many poisonous products developing in meat, it is im- 
possible to draw a sharp difference between the symptoms arising from 
the different ones. However, two important forms of symptoms are con- 
trasted In one, the nervous symptoms predominate and are well marked, 
and in the other the symptoms are in the stomach and intestines. The 
first groups of symptoms are spoken of as Botulismus. 

Poisoning from Sausage Bacillus (Botulismus). — Under this title 
are included all forms of poisoning caused by eating sausage. The 
poisonous products in the sausage are a result of the presence of the 
Bacillus Botulismus, named by Van Ermengem, who discovered the germ 
in 1905 in poisonous ham. 



906 POISONS AND THEIR ANTIDOTES. 

Symptoms. — The attack begins in from twenty to thirty-six hours 
after eating the diseased meat. The patient feels like vomiting (nausea) , 
pains in the stomach and vomiting then follow. Diarrhoea or constipation, 
usually the former, are complained of. In thirty-six to forty-eight hours 
interference with vision develops, the patient does not see clearly and does 
not recognize persons about him. Double vision is present, the upper eye- 
lids droop and a peculiar strong stare can be seen. A burning thirst and a 
sensation of strangling are complained of. The mucous membranes of 
the mouth, nose and throat are reddened and covered with a thick, glisten- 
ing mucus, which causes violent attacks of coughing and suffocation. The 
swallowing of food or even water is difficult and causes attacks of chok- 
ing. Extreme weakness of the muscles which lasts for weeks after the 
attack are annoying symptoms. 

Diseased Meats. — Under this title are included the poisons in meat 
which cause sickness due to the animals being diseased at the time of 
slaughter. These constitute the most common form of meat poisoning, 
and cause severe gastro-intestinal (stomach and bowel) symptoms. The 
bacteria symptoms are too numerous to mention here, but they* are said 
to be due to any one of a group of germs in the meat which show close 
affinity on the one hand for the colon bacillus and on the other for the hog- 
cholera bacillus. Each group of these germs cause poisonous symptoms 
which represent a number of diseases, resembling each other as regards 
their symptoms and are difficult to tell apart. 

The Symptoms Arising from Eating Diseased Meat. — The at- 
tacks may begin immediately following a meal, but usually occur in from 
six to eight hours after eating. Patient desires to vomit (nausea) then 
vomiting occurs, followed by sharp, colicky pains in the abdomen, profuse 
diarrhoea and great exhaustion. A rash and itching of the skin is present. 
Death often follows these symptoms, but not as often as in poisoning 
from eating diseased sausage which contains the bacillus botulismus. 

The above symptoms are usually due to eating beef, veal, pork and 
horse flesh derived from animals which suffered at the time of slaughter 
from blood poisoning or intestinal infection. Boiling of such meat does 
not necessarily prevent the human being from suffering from the same 
disease which the animal had when slaughtered. 

Treatment. — Any person taken suddenly with any of 'the above 
symptoms following the eating of meat, should summon the family doctor.- 
Early action may save life. The sufferer can be given hot mustard water 
to cause vomiting. The bowel should be washed out with a rectal syringe, 



FISH POISONING. 907 

using warm salt water (two teaspoonfuls to the quart) every hour until 
the doctor arrives. Calomel in one-fourth grain doses every half hour 
until two grains are taken. Active purging is necessary. Diarrhoea is 
a favorable symptom, as nature is trying to eliminate the poison by the 
bowel, it should not be checked too soon. 

Poisonous Fish. — Many fish are always poisonous, while certain fish 
are only poisonous to man during the spawning period and other fish con- 
tain poisons in the testicles and ovaries which when eaten cause severe and 
even fatal poisoning. The latter are classified as Physiologic Poisons, and 
are simply normal poisons within the body of the fish and are not due to 
bacteria. Another group of fish poisons which occur and are dangerous 
to man when eaten, are the Bacterial Poisons. These are poisons which 
occur in fish and cause disease when eaten. They are due to bacteria 
and may be in fish which were diseased at the time of killing and when 
eaten raw will cause the person to become ill. On the other hand, fish 
may be perfectly wholesome before death and the following careless 
handling and lack of preservation cause bacterial contamination with the 
production of poisonous products. 

The poisons occurring in fish are caused by many varieties of bacilli, 
too numerous to mention in these pages. 

Boiling will not destroy all bacteria in fish, but the danger of infec- 
tion is reduced only by eating fish which is thoroughly boiled or baked. 

Symptoms of Fish Poisoning. — General weakness occurs in from 
ten to twenty-eight hours after eating a meal with fish, the greater the 
severity of the attack if the meal has consisted of fish only. A small amount 
of diseased fish eaten will often prove fatal if the stomach is empty. A 
larger amount may not be so fatal if the person has eaten other foods at 
the same time which have prevented the poisonous fish from being rapidly 
absorbed. Other symptoms are a dull pain in the abdomen, difficult 
breathing, impaired sight, double vision and dizziness, complete dryness 
of the mouth and tongue, inability to swallow and loss of speech. The 
temperature does not rise. 

Another group of symptoms may occur from poisonous fish differ- 
ing from the former. These consist of violent vomiting, excessive diar- 
rhoea, dizziness, the hands and feet tremble, prostration and heart weak- 
ness, and a rash and itching of the skin are present in some cases. 

Canned fish has caused disease, but these cases usually occur from 
the fish having decomposed from either being diseased before packing or 



908 POISONS AND THEIR ANTIDOTES. 

improperly preserved, and these conditions have favored the development 
of bacteria and their poisonous products within the can. 

Animal Parasites. — Worms can develop in the human being from eat- 
ing fish which contain the larvae of these worms. The Bothriocephalu- 
latus is the one most often developed from eating fish. Fish also cause 
disease by eating decomposed meat, etc., and then being eaten by man, 
the poison in the fish poisoning his system. All fish should be thoroughly 
cooked before eating. 

Poisonous Shellfish — These will cause disease because they are found 
in polluted waters and certain bacteria which cause symptoms of fish 
poisoning in man when eaten. 

Poisoning from Mussels. — The common mussel (Mytilus edulis) 
causes poisonous symptoms in man when used as a food, particularly in 
England and on the continent of Europe. 

Symptoms or Mussel Poisoning. — There are three types of symp- 
toms. First type : Severe pains in the stomach, nausea, vomiting, diarrhoea 
come on some hours after eating ; death is rare as a rule. Second type : The 
patient complains of nervous sensations, as of heat, itching of the eyelids, 
this spreads over the rest of the face and may involve a large part of the 
body. A diffused rash with hives develops. Sore throat and difficult 
breathing are sometimes pronounced. Death rarely ever occurs. Third 
type : The symptoms of this type resemble the infection due to the bacillus 
botulismus found in diseased sausage. They arise from eating mussels 
which have lived in polluted water. Boiling does not destroy the germs. 
The onset of symptoms is sudden, almost immediately after eating a meal. 
Giddiness with inability to stand or sit, mental excitement or delirium, 
numbness of the hands and feet, diminished sensation, the pupils dilated, 
abdomen distended, throat dry, the neck constricted and difficulty in 
breathing and swallowing are commonly observed. Death occurs more 
often in this type! 

Oyster Poisoning. — Oysters cause many cases of illness when used 
as a food. This is due to the fact that they come from oyster beds which 
are located in polluted water. They carry typhoid germs which cause 
typhoid fever. Also gastro-intestinal symptoms due to their contained 
bacilli and poisonous products derived from the polluted water. Whole- 
some oysters can be contaminated by dirty handling or improper pre- 
servatives before distribution. 

Symptoms of Oyster Poisoning. — A few hours after a person has 
eaten a raw oyster, he complains of headache, pains in the side, difficulty in 



POISONOUS VEGETABLES. 909 

swallowing, impaired vision, the gait becomes staggering, swallowing 
impossible, speech difficult and mumbling. Rash appears with itching in 
different parts of the body. They usually recover, but death has occurred 
following the eating of raw oysters on an empty stomach. 

lobster and Crab Poisoning — The eating of these as articles of food 
have been followed by severe pains in the stomach, diarrhoea, rash and 
itching of the skin and in some cases symptoms similar to those occurring 
in persons who have eaten oysters, fish and diseased meat. 

Lobsters and crabs are dangerous unless wholesome and alive when 
cooked ; even then they may be dangerous, as they are filled with bacteria 
and their products derived from decomposed fish, slop, etc., which they 
live upon in polluted waters. 

Poisonous Milk and Its Products — Milk is the cause of many cases 
of acute poisoning due to its extensive use in the raw state and ready 
exposure to contamination from bacteria. It also carries typhoid fever, 
diphtheria, scarlet fever. It is responsible for the gastro-intestinal com- 
plaints occurring during the summer months, especially among infants. 
Milk can contain the same bacteria and their poisonous products as are 
found in diseased meat, and thus similar diseases result with the same set 
of symptoms. The products of milk as cheese, ice cream, cream puffs, 
etc., cause diseases due to a poisonous product called tyrotoxicon. This 
arises no doubt as a result of bacterial action and causes severe illness, as 
well as death in some cases. The symptoms derived from decomposed 
milk products are the same in a general was as those caused by bacteria in 
diseased meat, fish, etc. 

Treatment of any of the above diseases consists in summoning a 
physician immediately; cause vomiting by giving mustard water. Calo- 
mel, one-quarter grain every half hour until two grains are taken. Wash 
bowels out with a warm salt solution (two teaspoonfuls to a quart of 
water) and repeat every hour until all signs of poison are removed. 
Apply hot water bottles or bags to warm the patient. 

Any person (or those in attendance) should be careful whenever pos- 
sible to place the can or sample of food from which the person has eaten 
where it can be kept intact until examined by the physician for the pur- 
pose of finding the nature of the poison which caused the patient to be ill. 

Poisonous Vegetables — The eating of vegetables containing bacteria 
and their poisonous products causes the same group of diseases as oc- 
curred from eating diseased meats, fish, etc., showing that the bacteria in- 
fected meat, fish, etc., if contaminated vegetables will have the same result. 



910 POISONS AND THEIR ANTIDOTES. 

Many of the diseases derived from eating canned vegetables are due to 
the presence of metallic poisons, usually due to carelessness or ignorance 
in canning in permitting too much dangerous metal to enter the can. 

People who eat too much rye and other grains, particularly in Euro- 
pean countries, often suffer from Ergot poisoning, caused by the grain 
containing parasitic fungus called Claviceps purpurea, which develops 
in the flowers of rye and other grains. The symptoms of this poisoning 
may be nervousness and convulsions or else gangrenous sores break out 
upon the body. 

Vetch poisoning is another rare condition occurring in Austria and 
Italy, in Northern Africa and India. It is due to the use of Vetch seed 
in the form of a flour as a partial substitute for wheat. Persons after 
eating bread made of this Vetch seed flour, complain of sudden and severe 
pains in the back, inability to walk, due to paralysis of the limbs, also 
tremors and fever. The nature of the poison is not definitely known, but 
it is considered as belonging to the tonal groups of proteins. 

Mushroom Poisoning. — This is due to persons eating the poisonous 
varieties in mistake or ignorance instead of the edible variety, which is 
karmless. The dangerous species contain a highly poisonous substance 
called muscarin. 

Symptoms of Mushroom Poisoning. — Severe depressing of the 
heart and circulation. Severe watery diarrhoea. Pain in the stomach. 
Death may occur in three to four hours after eating. 

Treatment of Mushroom Poisoning. — Send for the nearest phy- 
sician, wash out the stomach with a stomach pump, or cause vomiting by 
taking hot mustard water. Apply external heat and administer a cup of 
kot coffee, or brandy or whiskey in teaspoonful doses every half hour until 
physician arrives. 



BOOK VI 



Is a simple method of diagnosing disease by 
symptoms. 



Abscess, Allevolar 134 

Abscess of the Liver 26 

Abscess of the Tonsil 215 

Acne 175 

Acne Rosacea 139, 177 

Acute Bright's Disease 16 

Acute Gastritis 206 

Acute Indigestion 206 

Acute Nasal Catarrh 136 

Acute Rheumatic Gout in 

Acute Rheumatism 108 

Acute Stomatitis 126 

Adenoids . 218 

Aesophagus, Diseases of 219 

Ague 86 

Allevolar Abscess 134 

Amenorrhea 121 

Amenorrhea, Partial 118 

Anaemia 92, 199 

Angina Pectoris 95 

Anthrax 171 

Anus, Prolapsus 8, 58 

Apoplexy, Congestive 98 

Apoplexy, Hemorrhagic 99 

Aphthous Stomatitis 127 

Appendicitis 153 

Asiatic Cholera 5 

Asthma 32 

Asthma, Hay 140 



B 



Backward displacement of the Womb, 244 

Barber's Itch 194 

Bed-wetting 226 

Beri-Beri 205 

Biliousness 124 

Bilious Colic 148 

Bladder, Inflammation of.... 2, 159, 220 
Bladder, Stone in 4, 157 



Bleeding of the Vulva 230 

Blood Poisoning 27 

Blue Disease 198 

Body, Ringworm of the 193 

Bones, Diseases of the 162 

Boils 181 

Bowels, Falling of the . .' 8 

Bowels, Inflammation of . . . .3, 23, 46, 146 

Break-Bone Fevers 79 

Breast, Cancer of the 42 

Bright's Disease 70, 224 

Bright's Disease, Acute 16 

Bronchitis 38, 54 

Bubonic Plague 80 



Calculus 4, 157 

Cancer 170 

Cancer of the Breast 42 

Cancer of the Stomach 209 

Cancer of the Womb 242 

Cancrum Oris 130 

Carbuncles 182 

Carbuncle, Urethral 233 

Carditis 34, 93 

Catalepsy 102 

Catarrh, Acute Nasal 136 

Catarrh, Chronic Nasal 137 

Catarrh, Fetid 137 

Catarrh, Summer 140 

Cerebro-'Spinal Fever 60, 78 

Change of Life 121 

Chickenpox 75 

Childbed Fever 84 

Chlorosis 122 

Cholera, Asiatic 5 

Cholera, Infantum 25 

Cholera Morbus 24, 97, 151 

Chronic Gout 112 

Chronic Nasal Catarrh 137 

Chronic Rheumatism 109 



911 



912 



INDEX TO BOOK VI. 



Circinatus, Herpes 193 

Cirrhosis of the Liver 156 

Cold, Rose 140 

Colic, Bilious 148 

Colic, Flatulent 149 

Colic, Hepatic 158 

Colic, Inflammatory 149 

Colic, Intestinal 147 

Colic, Lead 61, 150 

Colic, Liver 158 

Colic, Nephritic 17 

Colic, Painter's 61, 150 

Colic, Renal 17 

Complaint, Kidney 160 

Complaint, Liver. .21, 28, 63, 152, 189, 221 

Congestion of the Lungs 30 

Congestive Apoplexy 98 

Consumption 29, 37 56 

Continued Fever, Protracted Simple, 82 

Contraction of the Vagina 231 

Cough, Whooping 40 

Croup 31 

Cyanosis 198 

Cystitis 2, 159 

D 

Degeneration of the Heart, Fatty, 36, 94 

Dengue 79 

Diabetes 11, 225 

Diarrhoea 22, 145 

Diphtheria 45, 216 

Diseases of the Aesophagus 219 

Disease, Acute Bright's 16 

Disease, Blue 198 

Diseases of the Bones 162 

Disease, Bright's 70, 224 

Diseases of the Gullet 219 

Disease, Heart 34 

Disease, Hip 168 

Disease, Kidney 223 

Disorder, Nervous 92 

Displacement of the Womb 244 

Displacement of the Womb, Forward, 243 

Dropsy 211 

Dysentery 20, 144 

Dysmenorrhea 116 

Dyspepsia 92, 207 

E 

Eczema 104, 174 

Endocarditis 34, 93 



Endometritis .237 

Enuriases 226 

Ephemeral Fever 81 

Epidymitis 154 

Epilepsy 100 

Eruptions, Syphilitic 176 

Erysipelas 172 

Excessive Menstruation 117 

F 

Facial Neuralgia 71 

Falling of the Bowels 8 

Falling of the Womb 245 

Fatty Degeneration of the Heart, 36, 94 

Favoso, Tinea 195 

Favus, Tinea 195 

Febris Recurrence 83 

Felon 167 

Ferbicular Fever .81 

Fetid Catarrh 137 

Fever, Break-bone 79 

Fever, Cerebro-spinal 60, 78 

Fever, Childbed 84 

Fever, Ephemeral 81 

Fever, Ferbicular 81 

Fever, Hay 140 

Fever, Malarial 86 

Fever, Protracted, Simple, Continued, 82 

Fever, Puerperal 84 

Fever, Relapsing 83 

Fever, Remittent 87 

Fever, Rheumatic 108 

Fever, Rose 140 

Fever, Scarlet 48, 76 

Fever, Spotted 60, 78 

Fever, Typhoid 51, 85 

Fever, Typhus 50 

Fever, Yellow 88 

Fibrous Tumor of the Womb 239 

Fistula 10 

Flatulent Colic 149 

Floating Kidney 18 

Follicular Stomatitis 127 

Forward Displacement of the Womb, 243 
Fungus Growth 191 

G 

Gall Stones 158 

Gangrene 200 

Gangrenous Stomatitis 130 

Gastralgia 210 



IKDEX TO BOOK VI. 



913 



Gastritis, Acute 206 

Gin-drinker's Liver 156 

Glanders 132 

Gonorrhea 123 

Gout, Acute Rheumatic in 

Gout, Chronic 1 12 

Grape-like Tumors 138 

Gravel . ." 4, 157 

Green Sickness 122 

Grippe, La 52 

Growth, Fungus 191 

Growth, Vegetable Parasitic 191 

Gullet, Diseases of 219 

Gum, Inflammation of 133 

Gumboil 134 

Gum, Red 183 

H 

Hay Asthma 140 

Hay Fever 140 

Head, Ringworm of . . 192 

Headache 91 

Head, Scald 195 

Heartburn 125 

Heart Disease 34 

Heart, Fatty Degeneration of.... 36, 94 

Heart, Neuralgia of 95 

Heart, Palpitation of 35 

Heart Troubles 163 

Heat, Prickly 184 

Hematoma 230 

Hemorrhage of the Lungs 68 

Hemorrhage of the Stomach 69 

Hemorrhagic Apoplexy 99 

Hemorrhoids 9 

Hepatic Colic 158 

Hepatitis 21, 152 

Hernia 6 

Hernia, Strangulated 6 

Herpes Circinatus 193 

Herpes Zoster 178 

Hip Disease 168 

Hives 173 

Hysteria 101 

I 

Impetigo 180 

Incontinence of Urine 226 

Indigestion 96 

Indigestion, Acute 206 

58 



Infantum, Cholera 25 

Inflammation of the Bladder, 2, 159, 220 

of the Bowels 3, 23, 146 

of the Gum 133 

of the Kidneys 15 

of the Larynx 217 

of Lining Membrane of the 

Womb 22,7 

of the Ovary 142 

of the Oviducts 141 

of the Stomach 206 

of the Tonsils 214 

of the Veins 212 

of Walls of Womb 238 

Inflammatory Colic 149 

Inflammatory Rheumatism 108 

Influenza 52 

Intestinal Colic 147 

Itch 103, 196 

Itch, Barber's 194 

Itch, Lice 197 

Itching of the Vulva 229 

J 

Jaundice 71, 189, 222 

K 

Kidney Complaint 160 

Kidney Disease 223 

Kidney, Floating 18 

Kidneys, Inflammation oi 15 

Kidney, Stone in 17 

I 

Laceration of the Perineum 236 

La Grippe 52 

Land Scurvy 203 

Laryngitis 217 

Larynx, Inflammation of 217 

Lead Colic 61, 150 

Lead Poisoning 61, 150 

Leucorrhea 119, 232 

Lichen 184 

Lice Itch 197 

Life, Change of 121 

Lining Membrane of Womb, Inflam- 
mation of 237 

Liver, Abscess of the 26 

Liver, Cirrhosis 156 



914 



INDEX TO BOOK VI. 



Liver Colic 158 

Liver Complaint, 21, 28, 63, 152, 189, 221 

Liver, Gin-drinker's 156 

Lock-jaw 113 

Lumbago 14, no 

Lungs, Congestion of 30 

Lungs, Hemorrhage of 68 

Lung Troubles 163 

M 

Malarial Fever -. 86 

Malignant Pustule 171 

Malignant Tumor of the Vagina ...235 

Mammitis 41 

Mastitis : 41 

Mastoiditis 65 

Measles 49, 77 

Membrane of the Womb, Inflamma- 
tion of Lining 237 

Meningitis 64 

Menopause 121 

Menorrhea 117 

Menstruation, Excessive 117 

Menstruation, Painful 116 

Mercurial Stomatitis 131 

Metritis 238 

Moist Tetter 104 

Morbus, Cholera 24, 97, 151 

Mortification 200 

Mouth, . Putrid Sore 128 

Movable Kidney 18 

Mumps 73 

Muscular Rheumatism 14 

N 

Nasal Catarrh, Acute 136 

Nasal Catarrh, Chronic 137 

Nasal Polyps 138 

Neck, Stiff no 

Neck, Wry no 

Nephritic Colic 17 

Nervous Disorders 92 

Nervous Prostration 19 

Nettle Rash 173 

Neuralgia, Facial 72 

Neuralgia of the Heart 95 

Neuralgia of the Stomach 210 



Neurasthenia 19 

Noma 130 



Orchitis 154 

Oris, Cancrum 130 

Ovaritis 142 

Ovary, Inflammation of the 142 

Ovary, Tumors of 143 

Oviducts, Inflammation of the 141 

Ozena 137 



Painful Menstruation 116 

Painters' Colic 61,150 

Palpitation of the Heart 35 

Parasitic Growth, Vegetable . ... 191 

Parasitic Stomatitis 129 

Partial Amenorrhea 118 

Pectoris, Angina 95 

Pemphigus 34, 93, 179 

Pericarditis 34, 93, 150 

Perineum, Laceration of the 236 

Peritonitis 3, 23, 46, 146 

Phlebitis 212 

Piles g, 59, 105, 155 

Pityriasis 187 

Plague, Bubonic 80 

Pleurisy 33, 39, 43 

Pleurodynia no 

Pneumonia 30, 47, 55, 67 

Poisoning, Blood 27 

Poisoning, Lead 150 

Polyps, Nasal 138 

Polypus Tumor of the Womb 240 

Pregnancy 120 

Prickly Heat 184 

Prolapsus Anus 8, 58 

Prolapsus of the Womb 245 

Prostration, Nervous 19 

Protracted Simple Continued Fever 82 

Prurigo 185 

Pruritis 188, 229 

Psoriasis 186 

Puerperal Fever 84 

Pulmonary Tuberculosis 29, 37, 56 

Purpura 203 

Pustule, Malignant 171 

Putrid Sore Mouth 128 



INDEX TO BOOK VI. 



915 



Pyemia 27 

Q 

Quinsy 215 

R 

Rash, Nettle 173 

Rash, Tooth 183 

Recurrence, Febris 83 

Red Gum 183 

Relapsing Fever 83 

Remittent Fever 87 

Renal Colic 17 

Rheumatic Fever .j:o3 

Rheumatic Gout, Acute 1 1 1 

Rheumatism, Acute 108 

Chronic 109 

Inflammatory 108 

Muscular 14 

Rickets 90 

Ringworm of the Body 193 

Ringworm of the Head 102 

Rosacea, Acne 139, 177 

Rose Cold 140 

Rose Fever 140 

s 

Salivation 131 

Salpingitis 141 

Scabies 103, 196 

Scald Head 195 

Scarlet Fever 48, 76 

Scorbutus 204 

Scrofula 202 

Scurvy 204 

Scurvy, Land , 203 

Seborrhea 190 

Septicemia 27 

Shingles 178 

Sickness, Green 122 

Simple Continued Fever, Protracted, 82 

Simple Stomatitis 126 

Small-pox 74 

Sore Mouth, Putrid 128 

Spinal Fever, Cerebro- 60, 78 

Spotted Fever 60, 78 

Stiff Neck no 



Stomach, Cancr of 209 

Hemorrhage of 69 

Inflammation of 206 

Neuralgia of 210 

Troubles 161 

Ulcer of the 208 

Stomatitis, Acute 126 

Aphthous 127 

Follicular 127 

Gangrenous 130 

Mercurial 131 

Parasitic 129 

Simple 126 

Ulcerative 128 

Stomatitis, Ulcerative 128 

Stone in the Bladder 4, 157 

Stone in the Kidney 17 

Stones, Gall 158 

Strangulated Hernia 6 

Stricture of the Urethra 227 

Strophulus 183 

Summer Catarrh 140 

Swelled Testicles 154 

Sycosis, Tinea 194 

Syphilis 176 

Syphilitic Eruptions 176 

T 

Tape Worm 12 

Testicles, Swelled 154 

Tetanus 113 

Tetter, 186 

Tetter, Moist 104 

Thrush 129 

Tinea Circinati 193 

Tinea Favoso 195 

Tinea Favus 195 

Tinea Sycosis 194 

Tinea Tonsurans 192 

Tonsil, Abscess of the 215 

Tonsilitis 44, 214 

Tonsils, Inflammation of 44,214 

Tooth Rash 183 

Trichiniasis 107 

Troubles, Heart 163 

Troubles, Lung 163 

Troubles, Stomach 161 

Tuberculosis, Pulmonary 29, y], 56 



916 



INDEX TO BOOK VI. 



Tumor of the Vagina, Malignant. . .235 

Tumors, Grape-like 138 

Tumor of the Ovary 143 

Tumor of the Womb, Fibrous 239 

Tumor of the Womb, Polypus 240 

Typhoid Fever 51, 85 

Typhus Fever 50 

IT 

Ulcer 201 

Ulceration of the Womb 241 

Ulcerative Stomatitis 128 

Ulcer of the Stomach 208 

Urethral Carbuncle 233 

Urethra, Stricture of the 227 

Urine, Incontinence of 226 

Urticaria 173 

V 

Vagina, Contraction of 231 

Vagina, Malignant Tumor of 235 

Vaginismus 231 

Vaginitis 234 

Varicose Veins 212 

Vegetable Parasitic Growth 191 

Veins, Inflammation of the 212 

Veins, Varicose 212 



Vulva, Bleeding of 230 

Vulva, Itching 229 

w 

Walls of Womb, Inflammation of.. 238 

Waterbrash 125 

Whites 1 19, 232 

Whitlow 167 

Whooping Cough 40 

Womb, Backward Displacement of.. 244 

Cancer of 242 

Falling of .245 

Fibrous Tumor of 239 

Forward Displacement of 243 

Inflammation of Lining Mem- 
brane of 237 

Inflammation of Walls of 238 

Polypus Tumor of the 240 

Prolapsus of 245 

Ulceration of the 241 

Worms 1, 7, 106 

Worm, Tape 12 

Wry Neck no 

Y 

Yellow Fever 88 



3 4 




CHART 1 

i. Inflamed Eyes or Neuralgia. 

2, 3, 4. May be due to Constipation, 

Dyspepsia, or Nasal disease 

(Frontal Headaches). 

5. Diseased Teeth, Neuralgia. 

6. Diseased Teeth, Neuralgia, Mumps. 

7. Tonsilitis, Inflamed Glands. 

8. Angina Pectoris. 

9. Pregnancy, Ovarian disease, Hys- 
teria, Neuralgia, Abscess, Cyst 
or Cancer of the Breast. 

i 10. Impacted Splenic Colon, Colitis, 
Stomach Ulcer or Cancer, En- 
larged Spleen, Acute Rheuma- 
tism. 

11. Stomach. 

12. Kidney and Gall Bladder. 

13. Stomach, Ulcer, Cancer of Omen- 
tum. 

14. Vermiform Appendix (Appendici- 
tis). 

15. Uterus or Womb. 

16. Cystitis, Neuralgia, Ulcer, Uterine 
or Ovarian disease, Inflamma- 
tion, Menstrual Pains. 

17.. Ovary, Inflammation or Neuralgia. 

18. Ovarian disease. 

19. Ovarian or Uterine disease. Dis- 
placed Uterus, Psoas Abscess. 

20. Rheumatism, Periostitis. Bone Tu- 
berculosis, Locomotor Ataxia. 

21. Rheumatism, sprain at Ankle. 



10- 




CHART 2 

Anaemia, Hysteria, Neurasthenia, 

Uterine and Ovarian. 
May originate in the eye or teeth. 
Earache, Neuralgia, disease of the 

Tongue or Bone. 
Rheumatism, Cerebro-Spinal Menin- 
gitis. 
5. Neurasthenia, Irritation of the Spine, 
Epilepsy, disease of the Verte- 
brae, Uterine, Brain Tumor. 

6. Muscular Rheumatism. 

7. Flatulence (gas), Rheumatism, Gas- 
tritis, Gastric Ulcer. 

8. Diseases of the Stomach. 
Laryngitis, Sore Throat. 
Pleurisy, Pleuro-Pneumonia, Neu- 
ralgia. 

Rheumatism, 

Lumbago, Fatigue, Flatulence, Her- 
nia, Cystitis, Uterine or Ovarian 
disease, Acute Inflammation of 
the Kidneys, Spinal Irritations 

13. Ovarian and Uterine disease, In- 
flammation of the Pelvis, Rectal 
Ulcer, Cancer, Hemorrhoids, 
Hip Joint disease. 

14. Hemorrhoids, Coccygodynia, Fis- 
tula, Abscess, Uterine disease. 

15. Sciatica, Rheumatism. 

16. Cramps, Fatigue, Fallen Arch. 

17. Rheumatism, Fatigue. 

18. Inflammation of Joint, Varicose 
Veins. 

19. Sciatica, Varicose Veins. 

20. Gout, Ingrown Nail. 

21 Gout, Rheumatism. 

22 Sprained Ligaments. 





CHART 3 

1. Diseases of the Eye or Lids, inflam- 

mation or Neuralgia. 

2. Headaches due to Constipation, In- 

digestion and Neuralgia. 
3 Temporal Neuralgia. 

4. Goitre, Laryngitis and various 

Throat diseases. 

5. Diseases of the Spine and Brain, 

Rheumatism. 

6. Muscular Rheumatism. 

7. Pneumonia, Tuberculosis, etc. 

8. Heart and Pericardium. 

9. Rheumatism, Neuralgia, Fatigue. 

10. Pleurisy, Pleuro-Pneumonia. 

11. Appendicitis and Inflammation of 

the Bowels. 

12. Stomach Indigestion, Flatulence, 

Cancer and Ulcer. 

13. Inflammation of the Bowels, Colitis. 

14. Inflammation of the Bladder. 

15. Abscess in Groin. 

16. Rheumatism, Fatigue. 

17. Inflammation of the Joint. 

18. Varicose Veins, Rheumatism. 

19. Inflamed Joint or Torn Ligaments. 

20. Gout. 






CHART 4 

1. Headache or Neuralgia of the Scalp. 

2. Stiff Neck or injury to Spine. 

3. Rheumatism. 

4. Reflected from the Stomach. 

5. Pleurisy may be either side. 

6. Lumbago or Kidney Disease. 

7. Neuritis along either side of arm. 

8. Sciatica running down back of leg. 

9. Sciatica. 

10. Rheumatism or Inflamed Joint. 

11. Enlarged Veins or Rheumatism. 

12. Inflamed joint or Sprained Ankle. 

13. Sciatica. 

14. Gout. 

15. Rheumatism. 



Book VI 



DIAGNOSIS 

OR THE ART OF TELLING A COMPLAINT BY ITS 

SYMPTOMS 



Diagnosis is one of the most difficult things in medical practice,' yet 
in order to give proper treatment it is first necessary to be sure of the 
complaint. Generally this must be discovered by diagnosis, that is by 
taking into consideration various symptoms and their meaning. 

In making diagnosis consideration must be given to age, sex and 
temperament. Symptoms which might indicate serious illness in a child 
might mean nothing with an adult ; a man of highly nervous temperament 
might show peculiarities that in no way would disturb his normal state, 
yet in respect of one of phlegmatic temperament these same symptoms 
might be indicative of very serious trouble ; conditions which might mean 
much in the case of a woman might mean nothing in the case of a man. 
A man who has high brain qualities without proportionate body develop- 
ment will show symptoms which a man whose body development is equal 
to that of his brain would not show. When the brain power is predominant 
the person is said to be of cephalic temperament, that is thinking tempera- 
ment. When the lungs and heart are largely developed and this develop- 
ment preponderates, as shown by large chest, force of circulation, redness 
of skin and general animal activity, the person is said to be of thoracic 
temperament. When the abdomen, which contains the organs of receiving, 
digesting and disposing of the materials which nourish the body, is pre- 
dominant the person is said to be of abdominal temperament. When the 
bones are large and the muscles naturally exceptionally strong and there 
is a largeness of frame and solidity of structure and exceptional powers 
of muscular endurance the person is said be of muscular temperament 

917 



918 DIAGNOSIS OF DISEASE. 

To diagnose a case properly, one must consider: 

(1) The age and sex of the patient. 

(2) The appearance of the patient at the time. 

(3) Whether or not there is suffering and if so, where the pain is 
located. 

(4) How long illness has existed; and what different abnormal 
conditions have shown themselves. 

The temperature, the pulse, the condition of the mouth, the tongue, 
respiration, urine, fecal discharges, etc., must he carefully examined 
and inquiry made as to digestion and generally as to the condition of 
the patient preceding the time of diagnosis. 

One of the great factors in diagnosis is the location of pain. Pain is 
of diagnostic significance and should be carefully studied in -respect of 
every case. It indicates a primary cause but it must not be overlooked 
that the location may be far removed from that part of the body in which 
the cause exists. Pain may be reflex ; that is, it may result from a 
stimulation or irritation of either the cerebro-spinal or the sympathetic 
system of nerves, or both. The cerebro-spinal and sympathetic nerves are 
in close association and there are special nerves for the conduction of pain 
and special organs which are affected thereby and which convey to the 
consciousness the sensation of pain which thereupon attempts to designate 
the locality or region in which the pain is being produced. Sensibility to 
pain differs in degree according to the location of its cause. A nerve may 
be stimulated in any part of the nervous system and if such stimulation 
be sufficient pain will be localized either at or in the neighborhood of the 
end of the nerve. It happens, however, that these nerves are closely 
associated in the brain with nerve fibres which supply structures at distant 
points that they sometimes become irritated and pain will in consequence 
be felt in spots quite remote from the actual seat of trouble (reflex pain). 

It is claimed by some authorities that in disease of any internal organ 
pain is never felt in the organ itself, but is communicated through the 
sympathetic to the cerebro-spinal nerves and then to the surface of the body 
in one or many points, sometimes diffusing over a much greater area than 
that occupied by the organ affected. If the organ be highly inflamed or 
otherwise seriously diseased the nerve may communicate to certain surface 
centres a feeling or sensation of actual pain, but where there is less stimulus 
the sensation of pain may only be felt upon the part of the surface of the 
body in question being touched. In locating pain produced by pressure it 
is necessary to be exact in order to be sure of the particular nerve which is 





1 



%:l 




\ 



'% 



Coated or Bilious Tongue. 



Normal Tongue. 





Herpetic Inflammation of the Tongue. 



Syphilitic Lobulation of the Tongue. 
"Cobblestone Tongue." 



DIAGNOSIS OF DISEASE. 919 

sending the sensation so that this nerve may be traced back and its associa- 
tion with other nerves in the cerebro-spinal and sympathetic systems 
properly considered. 

Without years of stndy of the human body it is impossible for any 
layman to correctly locate the exact seat of a trouble without full and 
exact description and tables showing clearly the action of the nerves upon 
-different parts of the body in respect of the various diseases to which the 
organs of the body are subject. The object of this present chapter is to 
give such tables and so clearly set forth the effect of different diseases 
upon different parts of the body that the layman may, in a vast majority 
of cases, as efficiently diagnose most diseases as the ordinary physician. 

In diagnosing care should be taken to exactly locate any pain. 
Consideration should be given as to how long the pain has been felt. 
Is the pain continuous or intermittent, and if the latter does it appear 
at any particular part of the day or night, or after eating, going to stool, 
urinating, etc. ? Is it worse at certain times of the year or in certain 
kinds of weather? Is it relieved or increased by any special posture or 
action ? The question of intensity of pain is important, yet is oftentimes 
hard to arrive at. People suffering from nervous troubles are apt to 
exaggerate the severity of the pain they feel. Temperament modifies 
the expression of pain complained of. Some patients complain bitterly 
of slight pain, others pride themselves upon being stoical. The pulse 
and temperature when the pain is at its height should be compared with 
the pulse and temperature during intervals of relief. Consideration 
should be given to the quality of the pain, whether it is spasmodic, darting, 
gnawing, burning, tingling, griping, and so forth. It must be remembered, 
too, that the same disease may manifest itself in different ways in different 
people, and so it happens that what is the most prominent symptom with 
one patient may be a minor symptom with another. Thus in pleurisy, 
the most distressing feature with one patient may seem to be the coughing 
spell, while with another the coughing spell may not be particularly 
noticeable, but respiration be so painful that the difficulty in breathing 
becomes the outstanding feature. 

It is to be borne in mind by everyone in studying a table or descrip- 
tion of symptoms that there is always a possibility of the reader coming 
to the conclusion that he has this or that symptom of some disease, when 
as a matter of fact, such symptoms are in reality lacking. In their early 
study of disease at college, medical students frequently become obsessed 
with the idea that they have this or that disease from reading and studying 



920 DIAGNOSIS OF DISEASE 

such disease and then imagining that they have the symptoms described. 
Quack doctors and patent medicine men so thoroughly appreciate this 
that they build up their advertising literature to impress people who may 
read that they are sufferers from the complaint which the quack or the 
patent medicine is supposed to cure. This fact must always be kept in 
mind, not only in studying the table of symptoms which is here given, 
but in reading the general description of disease in the special articles 
in respect thereof to be found in different parts of this work. 

TABLE OF SYMPTOMS. 

The following table if carefully studied in conjunction with the 
special articles throughout this work on the diseases indicated will prove a 
ready and practical method of telling what complaints may be by their 
symptoms. To illustrate : Someone in your family may have a chill. It 
may be of such character that no one need be concerned, or it may be 
the onset of some serious illness. It is important to know at once. You 
turn to the following table and run your finger down the first column 
(Most ^Noticeable Symptoms), which is arranged alphabetically, until 
you come to the word Chills; you then consult the second and third columns 
("Additional Symptoms" and "Disease Indicated") in line with the 
word Chills and you see that chills, when accompanied with piercing pain 
on on© side of the chest, dry cough, short breathing and difficulty ofi 
lying on affected side are set down as the symptoms of Pleurisy, while 
chills followed by violent pain in the abdomen, increased by the slightest 
pressure, nausea, dry tongue and full hard pulse, are symptoms of Peri- 
tonitis. Suppose the symptoms point to Peritonitis; you at once turn 
to the index in the back of the book and find at what page or pages informa- 
tion may be found in respect of this disease and you are at once in 
possession of the best knowledge extant in respect of the subject. 

It is to be observed also that each set of symptoms as hereafter follow- 
ing is numbered and that at the end of this chapter there is an index 
showing the symptom number or numbers of the different diseases for 
which symptoms are given in this chapter. This index relates only 
to the actual contents of this chapter, its object being to enable the reader 
to quickly turn to different outstanding symptoms in the same disease, 
and it must not be confused with the general index at the back of the book 
which refers to articles throughout the whole book. Thus symptom No. 2 
indicates inflammation of the bladder and by turning to the index at 



DIAGNOSIS OF DISEASE. 921 

end of this chapter we find that symptom No. 150 and 220 also refer to 
the same disease hut give different outstanding features; hut when it is 
desired to read full particulars in regard to this disease reference must 
he made to the general index at the hack of the hook, where reference 
will he found to special articles on the disease. 



922 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



O 
O 

Q 

O 

CO 

o 

h 

Oh 

o 

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<! 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 


dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




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Inflammation oif the 
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(Cystitis.) 


Inflammation of the 

Bowels. 

(Peritonitis.) 


Gravel or Stone in the 

Bladder, 

(Calculus.) 


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Picking at the nose ; itching about anus ; 
grinding of teeth in sleep. 


2 
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scanty, high colored, even bloody, sometimes 
with mucus or pus; much straining with 
sometimes but a few drops passed at time. 


3 

Pain increased by slightest pressure even of 
bedclothes; high temperature; rapid, wiry 
pulse; inclination to draw up the legs in re- 
laxation of the abdominal muscles ; abdomen 
tense from distension; pinched and anxious 
appearance of face; skin cold and clammy. 


4 

Severe pains in one loin extending to the 
hip on the same side and running down the 
groin to the bladder ; frequent urination ; 
stream suddenly interrupted after starting; 
pain or crawling sensation at head of penis 
(males) or in the vagina (females) ; bloody 
urine; sometimes nausea and vomiting. 


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Pain when urinat- 
ing. 

• 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



923 



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924 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



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TABLE OF SYMPTOMS FOK DIAGNOSIS. 



925 



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926 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 


- 






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Intermittent sensations of pain and ten- 
derness over the spinal column, radiating to 
the chest and extremities; convulsive 
twitchings; sometimes hysteria; mental las- 
situde; muscular weakness; wakefulness; 
sometimes derangement of sexual func- 
tions. 


20 

Tenderness over bowels; slight fever; 
mucous or blood passages; colicky pains; 
constant desire to defecate; stools of 
bloody slime, having peculiar offensive 
odor. 


21 

Irregular action, one day costive, next re- 
laxed; pain in right side; coated tongue; 
headache. 


22 

Griping pains in stomach, sometimes 
twisting; coated tongue; fever; tenderness 
cf stomach; frequent loose, watery stools. 


2 3 

Vomiting, tenderness; pain; thirst; quick, 

high pulse. 


24 

Cold, clammy skin ; small, weak pulse ; 
collapse; violent vomiting and diarrhoea. 


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TABLE OF SYMPTOMS FOE, DIAGNOSIS. 



927 









For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 


formulas for home prep- 
aration will be found at 
page 1231. For treat- 


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Consumption 
(Pulmonary Tuber- 
culosis). 


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Relaxed; great pain; feverishness and 
thirst; head hot; tenderness of abdomen. 


26 

Hectic fever, high in the evening and low 
in the morning; chilli sometimes present; pain 
is variable and may be felt in back of right 
shoulder; liver is enlarged, painful and tender; 
marked jaundice is rare; there may be bulg- 
ing which is apt to vary at different times. 


27 

Poisoning of the blood which may come 
from internal causes or be introduced into the 
system through external wounds, give symp- 
toms of chill, followed by high fever ; profuse 
sweating; great prostration, delirium, etc. 
There may or may not be abscesses. 


28 

Constipation; headache; pain in head and 
right shoulder. 


2 9 

Fatigue on slight exertion; loss of weight, 

debility; loss of appetite; anaemia; hectic 
flush in cheeks; hacking cough with con- 
siderable expectoration; night sweats. 


30 

Sudden hard chill and sharp pain in side; 
high fever; short dry cough with brownish 
or blood-stained sputum. 


31 

Usually sudden attack at night; child 
gasps for air and breathing causes a pe- 
culiar whistling sound; barking cough; 
hoarse whispering voice; muscular contrac- 
tions of fingers and toes; sometimes con- 
vulsions 


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Body- 
Pain, liver and right 
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Breathing — 
Laborious 
(Children). 



928 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 


formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 










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Heart Disease 
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Consumption 
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Inspiration short and jerky; expiration 
inordinately prolonged; breathing produces 
a wheezing or whistling sound; face pallid 
and distressed. 


33 

Pronounced chill followed by fever; 
sharp, stabbing pain in the side, aggra- 
vated by motion, coughing or attempt to 
take long breath; pain usually high up in 
region of nipple, but may extend to the 
shoulder, armpit and back; painful cough 
accompanied by expectoration streaked 
with blood and sometimes pus; vomiting; 
tongue parched; decided thirst; urine 
scanty and high-colored. 


34 

Palpitation or throbbing of the heart; 
occasional short, sharp pains in the region 
of the heart; swelling of the feet, particu- 
larly in the evening. 


35 

Irregular beating of the heart, which 
sometimes seems to pound. 


36 

Irregular, feeble and slow pulse; heart 
beats almost imperceptible; vertigo; fre- 
quently severe pains in chest; pallid face; 
enfeebled muscular power; cold feet and 
hands; swelling of feet. 


37 

Short, dry cough; hectic fever; night 
sweats; general debility; loss of appetite; 
constipation. 




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Breathing — 

Affected by exer- 
tion. 


O 

c 

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en 

u 





TABLE OF SYMPTOMS FOR DIAGNOSIS. 



929 



j 




•«-« en 

u e 

o3 O 
O 

ca o 

o * J 
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the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




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38 

Aggravated by coughing and feeling of 
rawness extending through chest into the 
back; severe cold in head; shortness of 
breath; husky voice; wheezy respiration; 
inflamed throat; barking cough; coated 
tongue; fever; full pulse. 


CO 
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40 

For week or ten days, symptoms of an 
ordinary cold, with cough, slight fever, etc. 
Cough gradually increases and assumes 
a spasmodic character; paroxysms consist 
of a series of short, expulsive soughs, in 
which child often becomes blue in the face 
and apparently on the verge of suffocation, 
when a long-drawn, noisy, whooping inspi- 
ration occurs; expectoration of thick, 
stringy mucus, often with vomiting and 
sometime with hemorrhages from nose, 
lungs, and so forth; several attacks may 
follow in close succession, followed by a 
respite of varying length. 


41 

Uneasiness of the breast in either male or 
female followed by a chill and usually fever; 
gland becomes intensely swollen, red and ex- 
ceedingly painful ; inflammation may be so 
great as to cause an abscess. 


Most Noticeable 
Symptoms 

T 


Chest- 
Feeling of rawness. 


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Chest- 
Inflammation of the 
breast. 



59 



930 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 







For the main article 
on the subject consult 
the general index. See 
chapter index^ page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






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Pneumonia. 


Accompanying and Following 
Symptoms 


42 

When a woman discovers a lump in the 
breast she should at once consult a physician 
as, although it may be a simple matter, it may, 
on the other hand, be the first indication of 
a cancerous growth. 


43 

Lancinating pain on one side of the chest; 
dry cough; difficulty of lying on affected 
side. 


44 

Headache; fever; high pulse; hoarseness; 
dry skin; ulcerated sore throat. 


45 

Fever; backache; whitish ulcers in 

throat; vomiting; great prostration. 


46 

Pain increased by slightest pressure, 
even the bedclothes; nausea; dry tongue; 
full, hard pulse. 


Chill followed by pain; pulse quick and 
hard; pain aggravated by cough. 


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Chills — 
With short breath- 
ing. 


Chills- 
Swelling of throat 
and tonsils. 


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Chills- 
Violent pain in ab- 
domen. 


Chill— 

With shortness of 
breath. 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



931 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






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Sore throat; pain in chest; nausea; scar- 
let rash in about forty-eight hours, face, 
neck, throat and limbs. 


49 

Headache; vomiting; rash usually comes 
on early, generally first or second day; 
nausea; dry, irritating cough. 


5° 

Tongue and teeth coated with a dark 

brown fur; headache; vomiting; clammy 
perspiration. 


Slight prostration; skin hot and dry; 
pulse rapid; temperature high; frequently 
diarrhoea. 


52 

Great prostration; severe pains in head; 
sneezing; hoarseness; paroxysmal hard 
cough; impaired breathing; running from 
nose; acute nervous symptoms; severe gas- 
tric disturbance. 


53 

In addition to the foregoing specific dis- 
eases which commence with chill it may be 
stated that almost all acute diseases start 
with chills or chilly sensations. 


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Chill— 

With intense head- 
ache. 


Chill- 
Followed by watery 
eyes. 


Chill- 
Pain at pit of stom- 
ach. 


Chill- 
Pain in head and 
limbs. 


Chill- 
Pain in muscles of 
neck, back and 
legs. 


1 

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932 



TABLE OF SYMPTOMS FOB, DIAGNOSIS. 



5 RJ 



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TABLE OF SYMPTOMS FOR DIAGNOSIS. 



933 



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934 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 



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For the main article 
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the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
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Accompanying and Following 
Symptoms 


74 

Violent chill in adults and convulsions in 
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from commencement; delirium usually 
present and frequently violent; face flushed; 
eyes bright and clear; eruption of small red 
spots, appearing on the third or fourth day, 
first on forehead and wrists and rapidly 
spreading over the face and body. 


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TABLE OF SYMPTOMS FOE DIAGNOSIS. 



037 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 


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78 
chilliness, followed by fever, vomiting, 
intense headache, vertigo, painful muscular 
stiffness, soon developing into continuous 
spasms, particularly affecting the muscles 
of the head and back; breathing rapid; 
pulse irregular, varying from 30 to 40 beats 
within a few hours. In malignant cases 
there is usually a rash. 


79 

Onset three to five days after incubation, 
attack usualy sudden, frequently a night 
after retiring in usual health; temperature 
rises in a few hours to 103 degrees and in 
one or two days may reach 106 or 107 de- 
grees; skin becomes dry and hot; coun- 
tenance indicates utter helplessness and 
prostration; usually pain in the head, back, 
limbs and small joints, which latter swell 
up as in Rheumatism; rapid pulse; loss of 
appetite; coated tongue; slight nocturnal 
delirium; concentrated urine. 
^ The pain may be so severe that the pa- 
tient cannot move. 

First stage lasts about forty-eight hours, 
but may vary from twelve hours to three 
days, when symptoms subside and there is 
a period of two or three days remission, 
general debility and muscular pains pre- 
dominating and fever usually absent, but on 
fourth day reappears; on fifth or sixth day 
an eruption develops, which is sometimes 
more like the flush of erysipelas than the 


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Fever — 
Eruptive. 



938 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicinesee page 1491. 




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Ferbicular or Ephemeral 
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papules of Measles or Scarlet Kever, though 
the color is not so intense. 

The eruption spreads over the whole 
body. When it reaches its height, painful 
swellings of the lymphatic glands of neck, 
back of head, armpits and groins occur, the 
nose, mouth and throat becoming impli- 
cated, swelling up and growing excessively 
painful. On the seventh or eighth day 
scaling commences and the acute stage ter- 
minates. 


80 

Violent headache; transient shiverings; 
palpitation of the heart; irregularity of the 
pulse; vomiting; difficulty in breathing; 
spitting of blood; syncope or fainting; pale 
face; apathetic expression, eyes dull and 
pupils dilated; patient lies three or four 
hours in state of absolute prostration, then 
has violent fever with delirium, during 
which urine is suppressed and bowels con- 
stipated; dark purplish spots, from one- 
tenth of an inch to one inch in diameter, 
appear over the body, exhaling a peculiar 
odor somewhat resembling honey. 


81 
Moderate fever elevation rarely exceed- 
ing 103 degrees; frequent pulse; flushed 
face; headache; sense of lassitude and 
weariness; loss of appetite; nausea and 
restlessness; in children perhaps delirium; 
termination usually sudden on third or 
fourth day. Smyptoms much like those of 
Typhoid, but Diarrhoea and other symp- 
toms are absent. 


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Fever — 
Eruptive. 


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TABLE OF SYMPTOMS FOE, DIAGNOSIS. 



939 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 


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82 

Slight chill or chilly feelings, followed in 
a few hours by headache, quickened pulse, 
rise in temperature and constipation; fre- 
quently nausea and sometimes vomiting 
during first twelve or twenty-four hours; 
sometimes a slight eruption of Roseola or 
Prickly Heat about the loins and over the 
back; sometimes delirium, especially at 
night; fever usually subsides without fur- 
ther derangement of the system than 
copious and debilitating perspiration, or 
perhaps an outbreak of vesicles of Herpes, 
commonly called cold sores about the face 
or elsewhere. 


83 

Incubation period short, attacks may oc- 
cur promptly after exposure, but usually 
from five to eight days; onset generally 
abrupt without preliminary symptoms; 
fever severe, but of short duration, ■ and 
when over the patient is left comparatively 
well for a few days; after interval of about 
a week there is another attack; onset of 
malady is marked by chill or shivering fit, 
severe headache, vomiting and often jaun- 
dice; white, moist tongue; tenderness over 
pit of stomach; constipation; enlarged liver 
and spleen; high-colored urine; frequent, 
full and often bounding pulse; pains in back 
and limbs; frequently delirium. 


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Non-eruptive. 


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For the main article fej 
on the subject consult co 
the general index. See rf 
chapter index, page 1257, jg 
for simple home reme- h 
dies. Prescriptions and g 
formulas for home prep- ^ 
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page 1231. For treat- 
ment by various schools W 
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Accompanying and Following 
Symptoms 
* 


87 

Sometimes prolonged chilliness and in 
other cases chill hardly perceptible; rise in 
temperature usually slow; face pallid at 
commencement, but gradually becoming 
flushed as fever rises; frontal headache; 
nausea; belching; sometimes delirium at 
night; eyes more or less yellow; urine dark 
and cloudy. Duration of attack is usually 
twenty hours or longer; reoccurrence at un- 
certain intervals, sometimes every twenty- 
four hours, sometimes forty-eight hours or 
longer. 


88 

Chill followed by intense fever; jaundiced 
face and anxious countenance; scanty, albu- 
minous urine of high color, sometimes al- 
most completely suppressed; rapid pulse; 
high temperature; profuse vomiting, matter 
vomited being of coffee color, frequently 
called black vomit; watery and somewhat 
reddened eyes; mind usually clear. 


89 

Fever occurs in cannection with many 
other ills. Whenever normal conditions of 
the body are disturbed fever is a possible 
symptom and therefore other symptoms 
must be taken into consideration therewith. 


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94:2 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 


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90 

Dull, languid child; capricious appetite; ir- 
regular bowels; pale, unhealthy stools; ema- 
ciated limbs; tumid belly; face full and head 
disproportionately large, forehead projecting 
and the sutures of • the cranium remaining 
open, sometimes expanding; extremities of 
the long bones swollen out into knobs; legs 
bent outward at knee; chest deformity. 


91 

Headache may be due to some local dis- 
turbance, such as might be caused by over- 
eating, or it may be one of the symptoms 
of many different diseases. 


92 

This may be a symptom of heart disease, 
but commonly it is due to some functional 
disorder without disease of the heart of 
any kind. It often thus occurs in anaemia 
and is not uncommon in dyspepsia. It is 
sometimes caused by the use of tobacco, 
alcohol, strong tea or coffee. 


93 

Shortness of breath; swelling of feet, 
especially in the evening; occasional pains 
over the heart region. 


u 

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'£ 2 

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*£ 
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03 

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13 C 
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1 

<v 
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03 
13 
03 
<D 

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Heart- 
Palpitation of, with- 
out other notice- 
able symptoms. 


Heart- 
Palpitation of, with 
swelling of feet. 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



943 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






T3 
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94 

Heartbeats almost undiscernable; pulse 
slow, irregular and feeble; difficult breath- 
ing, especially on exertion; dizziness and 
sometimes attacks of faintness; frequent 
pain in the heart region; cold hands and 
feet; slight swelling^ of feet with stout 
people; poor digestion; weak muscular 
power. 


95 

Agonizingly sharp pains, chiefly on the 
left side in the heart region, but sometimes 
extending to both sides of chest and to 
shoulders and arms. Pain generally of 
short duration, but during occurrence 
arouses fear of death. 


96 

With uneasy, rather distressing feeling in 
stomach; sometimes belching. 


97 
With griping pains; belching; retching; 
vomiting; tenderness at pit of stomach; 
looseness of bowels. 


3 

Oft 

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Heart- 
Slow action accom- 
panied by difficult 
breathing, etc. 


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944 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 



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TABLE OF SYMPTOMS FOR DIAGNOSIS. 



945 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






id 

u 

G 

V 

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id 
u 

W 

5 




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CD 
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Itch 
(Scabies). 


e 
o 

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ft 

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11 

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a 
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ness. Then follows frothing at mouth; 
biting of the tongue; clenching of fingers; 
face becomes bluish; pupils dilated; stupor 
for a varying period. There is soreness, 
weakness and mental confusion on return 
to consciousness. 


IOI 

A "fit of hysterics" may vary from mere 
uncontrollable laughter to severe convul- 
sions in which epilepsy is simulated, but 
the patient usually falls in a comfortable 
place and while feigning unconsciousness is 
in reality quite aware of what is going on. 


- - 

102 

State of trance; patient apparently insen- 
sible and sometimes having the general 
characteristics of death; breathing sus- 
pended; limbs remain in any position 
placed; patient is powerless to speak or 
make movement of any muscle, yet is men- 
tally conscious of all that takes place. 
There is danger of burying patient alive 
while in this state. 


103 

Very severe itching of small, pointed ves- 
icles which usually first appear on the 
wrists and between fingers, but if not at 
once eradicated quickly spread to any and 
all parts of the body excepting the face; 
itching always worse at night, when it be- 
comes almost unbearable. Extremely con- 
tagions. 


1) 

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o 




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C 


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r° — 

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60 



946 



TABLE OF SYMPTOMS FOB DIAGNOSIS. 



■=3 e> *> <U 55 Oh Oj 






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C/5C55 "S "J3 C 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



947 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




T3 

y 

c 

M 
09 

rt 

0) 






Acute or Inflammatory 
Rheumatism, or Rheu- 
matic Fever,. 


Chronic Rheumatism. 


1 
£ 

•J .3 

.„ c 

5 

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in 


bfl 
C 

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en 

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a 

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of first week, edematous swelling of the eye- 
lids and root of the nose, which are charac- 
teristic ; sometimes severe hiccough, hoarse- 
ness and loss of voice; if the case be severe 
a paralyzed condition of the muscles may occur. 


108 

Chills and fever followed or accompanied 
by pain, heat, redness and swelling of one 
or more joints, with tendency to leave one 
point suddenly and fasten upon another; 
sore throat; irregular fever; acid sweats; 
tendency to attack the heart; larger joints, 
such as hips, knees, wrists, ankles, are 
more generally the seats of trouble than 
are the smaller joints. 


109 

Stiff, swollen painful joints, aggravated 
by motion; no general fever and appetite 
may be good and digestion sound; smaller 
joints commonly attacked, sometimes ren- 
dering them permanently swollen and de- 
formed and causing atrophy of the muscles 
connected with them. 


no 

Generally located in either the neck, the 
back or the side; pain severe but spas- 
modic; relieved if restful in one position, 
but suddenly acute upon any movement af- 
fecting the muscles concerned. 


JO 

3 
a in 

•rt O 

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3 




1. 

eu m 

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■si 

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Joints and Muscles — 
Swollen and pain- 
ful. 


i 

<u • 
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O CD 
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3 ej 

E 

c c 

en.S 





948 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 








■d 

O 

u 

a 

h-l 

BO 

CO 

e 

CO 

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p 




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u 

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+1 



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3t 






C 
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ft 

CO 

ca 
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< 


III 

Indisposition, sometimes impaired diges- 
tion, nausea and vomiting with light fever, 
suddenly followed by an acute pain in one 
of the smaller joints, usually the big toe. 
The pain is intense during attack, but the 
attack is usually of short duration. After 
one attack there is generally reoccurrence 
at more or less frequent intervals. 


112 
Constant or semi-constant painful swell- 
ing and immobility of smaller joints, which 
sometimes become permanently deformed. 
Pain is absent and swelling less for more 
or less longer periods, but suddenly re- 
turns in full severity after slight exposure 
to cold and moisture, excess at table or 
vivid emotions. There is tendency for pain 
to suddenly leave one joint for another. 


113 

Stiffness of the jaws; rigidity of muscles; 
arching of the body upon the neck and 
heels; difficult respiration; chewing of food 
impossible. 


114 

See Nos. II, 15, 16, 17, 18, 70, 71, 160, 189, 
222, 223, 224. 


VO 
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CU 

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Joints and Muscles — 
Occasional painful 
affection of the 
smaller joints. 


Joints and Muscles — 
Chronic affection of 
smaller joints. 


Joints and Muscles- 
Stiffness in jaw 
muscles. 


1 

en 

CU 

2 


\ 
en 

3 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



949 









For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for" simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 


- 


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03 


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Change of Life 
(Menopause or Amenor- 
rhea). 


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CO 

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116 

Griping pains, colic and cramps at time 
of menses; sometimes convulsions. 


117 

Excessive flow of blood at the regular 
monthly periods. 


Il8 

Small flow of blood, continuing perhaps 
only one or two days and sometimes occur- 
ring at six weeks or other irregular periods. 


Discharge whitish, thick and gelatinous 
or thin and milky. 


120 

Morning sickness; enlargment of the nip- 
ples; darkening and increase in size of the 
areolas. 


121 

Irregularity in menstrual flow after forty- 
five years of age (occasionally earlier) ; in- 
tervals extended to five six or seven weeks; 
period last longer; nervous headache; in- 
somnia; general disarrangement of nervous 
system; sometimes disorders of digestive 
system and mind sometimes affected. 


u 
n> c/i 

.§1 
"I 

WW 



3 


1| 


cu 

> 
1-3 

is 

CU [l 

a x 
5w 


en *rj 


Menses — 

Whitish discharge. 


O 

c 

en o3 

cu en 

SS 

cuU 


Menses- 
Irregularity and fi- 
nal cessation. 



950 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 



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TABLE OF SYMPTOMS FOE DIAGNOSIS. 



951 



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o o\ 
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co b<0 

fa C3 

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Mcu" 

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beg b 

as fa<-M 
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956 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 


page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




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Epidymitis 
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ticles). 


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150 

Paroxysmal followed by continuous pain in 
neighborhood of stomach; vomiting; consti- 
pation ; pain in limbs ; blue line around gums. 


M 
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to" 


PQ 

<v 

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Pain in right side, sometimes shooting to 
breast bone, shoulder blade or right arm ; 
urine dark and clouded; jaundiced face and 
eyes; bitter taste in mouth; vomiting; irregu- 
lar action of bowels, one day costive and next 
relaxed. 


General indisposition for two or three days; 
onset is uusually with colicky pains which at 
first may be general over whole abdomen, but 
particularly around navel; by second day pain 
distinctly located in appendix region (see man- 
ikin) ; right leg drawn up; rapid pulse; fever; 
nausea, vomiting; constipation; tenderness. 


154 
Premonitory symptoms are : Pain in groin 

with a dragging sensation ; backache ; fever. 

These are followed by swelling of the testicles 

accompanied by sharp shooting or aching pains 

in testicles, which become hard yet tender to 

touch; Neuralgic pains in back, hips and 

thighs. 


i2 
n) (A 

Is- 

eot/l 
O 


Pain in Body — 
(Abdominal region) 
With constipation 
and vomiting. 


Pain in Body — 
(Abdominal region) 
Vomiting; clam- 
my skin. 


Pain in Body — 
(Abdominal region) 
Vomiting ; Jaun- 
diced appearance. 




"So 

<v 

I u 

IS 
m'e 
.s-8 


Pain in Body — 
(Abdominal region) 
With tenderness 
of groin. 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



957 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




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Gravel or Stone in the 

Bladder 

(Calculus). 



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Inflammation of the 

Bladder 

(Cystitis). 


c 

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156 

Feeling of fullness; dyspepsia; flatulence; 
emaciation ; swelling of abdomen ; feet swollen 
in morning ; dark-colored urine ; clayey stools ; 
bleeding piles. 




c 

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158 

Sudden and intense pains in region of the 
Jiver, shooting over the abdomen; abdominal 
muscles tense and tender to pressure ; com- 
monly nausea and vomiting ; constipation ; 
generally jaundiced appearance; pain ceases 
suddenly on passage of stone through the 
gall duct. 


»o . 

M <N 

6 

c 
<u 

B 


< 

<v 

CO 


rt co 
O 


Pain in Body — 
(Abdominal region) 
Itching and pain 
in anus. 


Pain in Body — 
(Abdominal region) 
Affecting liver. 


Pain in Body — 
(Abdominal region) 
Affecting loins 
and bladder. 


Pain in Body — 
(Abdominal region) 
Affecting region 
of the liven 


Pain in Body — 
(Abdominal region) 
With fruitless 
straining at urina- 
tion. 



958 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 









For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions 'and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine seepage 1491. 








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160 

See: 
Back, No. 15 (Inflammation of Kidneys). 
Back, No. 17 (Stone in Kidney). 
Back, No. 18 (Floating or Movable Kidney). 




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162 

Pain in bones of any part of body, usually 
worse at night ; gradual swelling of the affect- 
ed part; tenderness on pressure; skin over 
the inflamed area becomes red. See article on 
Diseases of Bone as per general index. 


! 5- 

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165 

Headache may be due to some local disturb- 
ance, such as might be caused by overeating, 
or it may be one of the symptoms of many 
different diseases. 


166 

See Joints and Muscles, Nos. 108, 109, ill, 
112. 


rt oo 

•si 

♦J >> 

O 


Pain in Body — 
(Abdominal region) 
Affecting kidneys 
and felt in differ- 
ent parts. 


Pain in Bod)- — 

(Region of Stom- 
ach) 


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TABLE OF SYMPTOMS FOR DIAGNOSIS. 



959 







For the main article 
on the subject consult 
the general index. Se2 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions' and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page I49 1 - 






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Accompanying and Following 
Symptoms 


Swelling and intense pain at end of a finger, 
accompanied by great heat at the location, 
becoming very sore; festering, even to the 
bone. 


168 

Usually the chief premonitary symptom is 
pain in the knee, generally with a small red 
spot on the knee-cap ; more or less pain and 
inability to use the limb; after rest of a day or 
two symptoms disappear and little is thought 
of the matter until reoccurence some weeks 
later ; pain increased on moving the limb, by 
rotating it, or by turning the foot outward. 
The position in which the leg is kept by the 
patient is peculiar; in the early stages of the 
disease there is a tendency to support the 
weight on the toes, the knee being bent and 
turned out. As the disease advances the 
affected side is higher than the undiseased side. 


169 

See Joints and Muscles, Nos. 108, 109, in, 
112. 


170 

When a malignant pimple or small growth 
appears on the face, hand or other part of the 
body, the possibility of its being cancerous 
should be considered and the family physician 
consulted. See article on cancer in the chap- 
ter on constitutional diseases. 


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Pain in Fingers — 


Pain in Hip or Knee — 


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960 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 



- 


For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




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171 

Red spot, something like a mosquito bite 
appears on exposed surfaces, such as arms, 
face or hands, which is soon followed by a 
spreading hardness of the surrounding tissues, 
which mortify and turn black; secondary ves- 
icles appear, neighboring lymphatic glands 
become inflamed, breath grows fetid and there 
is thirst, high temperature and frequent pulse; 
general symptoms of severe blood poisoning. 


172 

Feverish condition ; swelling and tension of 
skin, rapidly increasing ; inflammatory redness ; 
may first appear at different parts but com- 
monly is first noticed over the bridge of the 
nose and on the cheeks; inflammation quickly 
spreads ; tenderness and burning pain in af- 
fected part ; chill and high fever ; inflamed 
area has distinct margin separating it from 
the heathy skin. 


173 

Appears suddenly and is characterized by 
formation of "Wheals* or rounded patches of 
elevated skin, whiter than the surrounding 
parts, which are slightly reddened at the mar- 
gins ; may occur on any or all parts of the 
body, but is usually rather general over the 
whole body ; itching is a prominent feature ; 
usually occurs only in hot weather. Infants 
and fat people are especially liable and are 
commonly affected behind the joints. 


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Skin — 

Redness, ^ swelling 
and tension of. 


Skin — 
Slight redness with 
itching. 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



961 



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962 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






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Eruption appearing on any part of the body 
in form of little blisters which come out in 
small groups, and which when appearing about 
the mouth and nose, constitute the cold sores 
with which almost everyone is familiar. 


179 

Blisters from one-half to two inches in 
diameter, resting on slightly reddened sur- 
faces and usually attended with severe itch- 
ing. These blisters sometimes appear on 
the fingers, but commonly attack the lower 
limbs. They generally indicate an impov- 
erished state of the system. 


180 

Separate pustules somewhat like those of 
smallpox. They may attack any part of the 
body, but are most apt to appear upon the face 
and limbs. 


181 

Boils begin with pain and itching, the skin 
being tight; a hard point forms, at first only 
perceptible to the touch, but grows larger until 
it reaches the size of a pea, a cherry, or even 
as large as a hickory nut, the skin being red 
and tense. One boil is generally followed by 
a number of others. 




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TABLE OF SYMPTOMS FOR DIAGNOSIS. 



963 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine seepage 1491. 




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Red Gum or Tooth-rash. 
(Strophulus). 


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Prurigo. 


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182 

Carbuncles differ from boils in the larger 
area inflamed ; a core of dead connective tissue, 
called a "slough," several inches in diameter 
may come away. They are apt to come on 
the nape of the neck and the back, but may 
appear on any part of the body. A large 
carbuncle may keep a patient in bed for a 
month or six weeks. The pain and exhausting 
discharge are very wearing on the strength 
and may cause death. 


183 

Eruption of innumerable small reddish pim- 
ples occuring chiefly on the face, neck and 
arms; irritation and general disturbance is 
slight. Eruption is usually due to digestive 
derangement, such as may be caused by the 
cutting of a tooth and passes away with cessa- 
tion of the cause. 


184 

Reddish pimples or small granules, appearing 
on the body and limbs during hot weather and 
which subside on the approach of the cooler 
season; occasionally cases take on a severe 
form and may become chronic. 


x . 8 5 

Eruption of pale, slightly elevated pimples, 

generally on the trunk of the body ; intense 
irritation, especially at night, causing the 
patient to scratch to such an extent that 
marks of the nails can almost always be seen, 
and aid in recognizing the malady. It is fre- 
quently the result of the presence of vermin. 


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Skin — 
Prickly heat, with 
pimples. 


Skin — 
Pale, elevated pim- 
ples. 



964 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






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186 

Oval or rounded patches of slight irritation 
followed by an eruption of scales, which grow 
dense and white toward the center. Afterward 
the spot expands from its outer edge, the skin 
generally being reddened and slightly raised 
above the level of the surrounding surface. 
The whole body may be covered with these 
white scales, excepting the face, the palms of 
the hands and the soles of the feet and even 
these are sometimes subject. After some time 
the skin chaps and breaks ; severe soreness 
with exudation of fluid, intense irritation and 
itching, with great physical exhaustion, lasting 
for many weeks, or perhaps months. Is prone 
to reoccur in a patient who has once suffered. 
It is often hereditary. It is not contagious. 


. l8 7 

In mild form it gives rise to the shedding 

of an immense number of bran-like scales, 
resembling an exuberant crop of dandruff. A 
rare variety affects the whole body, generally 
proving fatal. 


188 

General itching without any eruption or 
other apparent change in the appearance of 
the part affected. Children and elderly people 
are particularly apt to suffer and the localities 
involved are generally those about the orifices 
of the body. 


189 

See Nos. 21, 28, 63, 124, 148, 152, 156, 158, 
189, 221. 


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TABLE OF SYMPTOMS FOE DIAGNOSIS. 



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966 



TABLE OF SYMPTOMS FOE, DIAGNOSIS. 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 


dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




Disease Indicated 




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its healing up in the middle, presenting after 
a time a patch of healthy or slightly reddened 
skin, surrounded by an angry red ring about a 
quarter of an inch wide. 


194 

A fungous parasitic vegetable growth of 
the nature of ringworm forming on the face 
of an adult male. Much irritation from the 
roots of the hairs of the beard, extending 
'deeply into the skin and growing down 
along the sides of the hair follicles; large 
papules and even pustules; itching and 
burning. 


J 95 

Of ringworm character, peculiar dry, sul- 
phur-yellow crusts, in form of little cups about 
a quarter of an inch in diameter, these cups, 
as the disease advances, so running together 
that they are only recognizable at the edge of 
a patch; peculiar mouse-like odor emitted 
from head. Disease frequently occurs with 
neglected, ill-nourished children. 


196 

Intense itching, generally much worse at 
night, after becoming warm in bed. The parts 
most commonly affected are the hollows of 
the elbows and knees, the fronts of the wrists, 
and the backs of the hands just between the 
roots of the fingers, but other parts of the 
body are subject, especially where the skin is 
tender, and the palms of the hands and the 
soles of the feet are sometimes affected, not- 
withstanding the thickness of the skin in these 


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TABLE OF SY^IPTOALS FOK DIAGNOSIS. 



967 



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968 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 



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TABLE OF SYMPTOMS FOR DIAGNOSIS. 



969 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 


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Scurvy 
(Scorbutus). 


Beri-Beri. 


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204 
Langour, debility and lowness of spirits 
first occur, then swelling; sponginess and 
bleeding of gums, loosening of teeth and offen- 
sive breath, — palpitation of the heart and diffi- 
culty in breathing sometimes present; spots on 
limbs ; diarrhoea and dysentery commonly oc- 
cur; all parts of the body extremely sensitive 
to pressure ; slightest possible blow may pro- 
duce extensive bruise ; small eruptions like 
flea bites are often to be seen on the legs and 
about the same time the muscles of legs and 
thighs become hard and painful, the skin grows 
yellow and then purple and thus appears in 
spots over the body, the spots at the com- 
mencement being frequently as large as the 
palm of the hand, and afterward usually ex- 
tend until they cover a large area. 


205 

Symptoms of Anaemia developing into acute 
dropsy; coldness of hands and feet; palpitation 
of the heart; difficult respiration after the 
slightest exercise; rapid pulse; marked pal- 
lidity of face; debility in action of the kid- 
neys; tongue of a semi-bloodless appearance. 
The progress of the disease is very slow and 
insidious; in the later stages langour, swelling 
of the extremities with partial loss of muscu- 
lar power and finally complete loss; dropsical 
swelling of feet and legs gradually extends 
upward until the whole body seems to be 
bloated with water ; urine is passed in very 
small quantities of light color; constipation; 
nausea; hot and dry skin. 


Most Noticeable 
Symptoms 


Skin — 

Flea bite-like erup- 
tions 


c 


•d 

c 



u 

is 



970 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






V 

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u 

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n 

V 

« 

CO 

s 


Acute Indigestion or In- 
flammation of the Stom- 
ach. 

(Acute Gastritis). 


Dyspepsia. 


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£ 


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206 

Severe pains over pit of stomach shooting 
through to the back, increased by taking food 
and temporarily relieved by vomiting; vom- 
ited matter consists of the glairy mucus, stain- 
ed with bile of a greenish-yellow or bright 
green color ; coated tongue, the edges and tip 
frequently being red and irritated ; bowels 
usually confined ; scanty and high-colored ur- 
ine. Symptoms often commence with chilli- 
ness followed by hot skin, weak, rapid pulse, 
difficult breathing and obstinate hiccough. In 
severe cases there may be great prostration. 


207 

The symptoms of Dyspepsia are so many 
and so varied, including as they do, heartburn, 
pyrosis, waterbrash, distension of stomach, 
etc., that to gain any adequate idea the full 
article on Dyspepsia must be read. Sec gen- 
eral index at back of book. 


208 

Pain and tenderness over pit of stomach, 
shortly after eating and increasing until re- 
lieved by vomiting; sometimes distress extends 
through to the back; seat of tenderness coin- 
cides with that of pain and is localized over 
comparatively small surface. Vomiting of 
blood occurs in about one-third of cases and 
is usually profuse ; it may be in black clots or 
fresh blood, also blood is frequently passed 
by the bowels. The pain is often described by 




Most Noticeable 
Symptoms 


.S 

V 
ki 

•4-1 
en 


xi 

Is 

CO 


Stomach — 
Gnawing pain after 
eating. 







o 

For the main article m 
on the subject consult 
the general index. See 
chapter index, page 1257, ^ 
for simple home reme- g 
dies. Prescriptions and g 
formulas for home prep- 
aration will be found at 
page 1231. For treat- W 
ment by various schools y 
of medicine*seepage 1491. fl 



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3 
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Accompanying and Following 
Symptoms 


patients as of a gnawing character and is gen- 
erally made worse by condiments, animal food, 
saccharine substances and alcohol. Usually 
occurs in early rather than advanced life. 


209 

Ordinary symptoms of Gastritis or mere 
Dyspepsia followed in a few weeks or months 
as a rule by the vomiting of small quantities 
of blood so mixed with gastric juice as to pre- 
sent a brown color, which with the minute clots 
have caused the expressive name of "coffee- 
ground vomit," — not an infallible sign, but 
constituting one of the surest early evidences 
of cancer of the stomach. TheMisease re- 
sembles ulcer of the stomach, but is distin- 
guished by the fact that it occurs in advanced 
life instead of youth, by the character of the 
blood vomit, by greater diffusion of the tender- 
nes, by constancy of the pain, by the anaemic 
state and by the increasing tumor which gen- 
erally can be felt through the thin walls of the 
abdomen. 


210 

This is a purely nervous affection, its only 
symptom being intense pain in the region of 
the stomach, shooting outward in different di- 
rections. The pain may be so great that the 
patient will roll upon the floor and writhe in 
agony. There is no tenderness over the stom- 
ach and pressure sometimes relieves pain to a 
certain extent. 


4) 

cd to 

SE 

at 

WW 

O 

3 




IS 


cd c 
S « 


Stomach — 
Neuralgia in. 



972 



TABLE OF SYMPTOMS FOR DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






T3 
V 

■M 

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CJ 

C 

h- 1 

V 

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tf 

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Varicose Veins 

(Phlebitis) 

Inflammation of the Veins. 




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211 
Soft, inelastic swelling of feet and ankles; 
pressure of the finger upon swollen part creates 
an indentation which remains for a minute or 
so before it is filled up by return of watery 
fluid; the reproductive organs often become 
enormously swollen and the disease soon 
reaches the abdomen; distress in breathing 
as disease progresses; scanty urine; palpi- 
tation of the heart; deficient perspiration; 
mental distress; thirst; constipation; daily 
increasing weakness. 


212 

Hard, swollen, knotted veins of dark blue 
or purple color, the legs and thighs being 
most commonly affected. 


213 

Swelling is also an accompaniment of 
sprains, bruises and many minor troubles, 
and if occurring apart from the foregoing 
general symptoms, some other prominent 
symptom, occuring in connection with the 
swelling must be looked for. 


214 

Chill, followed by rise of temperature; 
pains in back and limbs; redness and dry- 
ness of throat with painful swallowing; ton- 
sils may be felt as hard lumps behind the 
angle of the jaw; if only one tonsil swollen, 
the uvula is drawn to the affected side; 
usually white patches cover the tonsils, 




01 

t— < 

,o 
a) co 

Oft 

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cotyj 
o 

3 


Swelling — 
Of the feet and an- 
kles. 


en 

.5 
'<D 

|o 
m 


1 

in 


Throat- 
Inflamed. 





TABLE OF SYMPTOMS FOR DIAGNOSIS. 



973 



c 




For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicinesee page 1491. 




V 

-t-> 
Cfl 
U 

h- 1 

V 
09 
(0 

CO 

s 






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in _ ; 

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Diphtheria. 




C 

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o 

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to 

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which must not be confused with diph- 
theria, in which the white coating is conti- 
nuous over the tonsils and extends up upon 
the fauces and uvula and is grayish-white 
in color, tonsilitis on the contrary being in 
patches of white or whitish color. 


215 

Abcess or boil forms in the substance of 
the tonsils attended with great pain and 
swelling, difficulty of swallowing and some 
loss of strength; sometimes earache; breath- 
ing much interfered with; abcess may break 
on fifth day or linger until tenth day, after 
which recovery is usually rapid. 


....... 

216 

Symptoms of slight cold, feeling of full- 
ness and irritation within the throat; mod- 
erate fever, chilliness and general lassitude; 
pain in back; although sometimes delayed 
a day or two, small whitish-gray spots ap- 
pear on one or both tonsils which sprea'd 
more or less rapidly, often involving the 
pharynx and nose and extending downward 
to the larynx. Color soon becomes dirty 
gray or yellowish, if membrane be removed 
new membrane quickly takes its place. 
Great prostration. 




3 

03 (A 

•Si 
^ e 

o 




v> 
V 

en 


Throat- 
Membranous, whit- 
ish-gray coating 
of. 





974 



TABLE OF SYMPTOMS TOR DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 






V 

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c 

V 

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Inflammation of the 

Larynx. 

(Laryngitis). 


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217 

Slight catarrh quickly followed by high 
fever; hoarseness of voice which soon be- 
comes whispering; cough at first clear and 
shrill, then harsh and croupy, is also re- 
duced to little more than a whisper, and a 
peculiar noise like a loud whisper accom- 
panies both inspiration and expiration, 
which, from almost the beginning, are la- 
borious and wheezing. Dropsical swelling 
soon comes on, narrowing the opening of 
the glottis, making it painful and difficult 
to breathe, and causing an expression of 
great anxiety on the patient's face. 


218 
Growth at the back part of the nose pas- 
sages; difficult breathing with inclination to 
breathe through the mouth; snoring when 
asleep; chiefly prevalent in children. 


219 

Spasmodic stricture of the gullet caused 
by simple contraction of its muscular fibres, 
— common in hysterical females; similar 
condition produced by the swallowing of 
scalding water or some corrosive substance, 
usually followed by ulceration. A cancerous 
growth in the gullet may produce same 
symptoms. 


220 

Frequent desire to urinate; burning pain 
at bottom of abdomen; nausea and vomit- 
ing. 


3 
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Throat — 

Difficulty in breath- 
ing. 


O 

O 

Ll 

Is 


Urine — 

Frequent urination 
with burning at 
abdomen. 



TABLE OF SYMPTOMS VOR DIAGNOSIS. 



975 



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976 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 



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TABLE OF SYMPTOMS FOE DIAGNOSIS. 



97' 



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233 

Small raspberry-like growth at the mout 
of the urethra giving rise to severe itchin 
and pain; during urination, the water runnin 
over the growth, the pain is so excruciatin 
that women oftentimes will withhold fror 
passing water until they can no longer with 
stand the call of nature. 




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itraction of the vagi 
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i the parts, fissures 
carbuncle. 


CO 


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e vagina ; pain in t 
ing of the part; bac 
desire to urinate; lc 
s nausea. 


5 

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tion ; a foul dischar 
e ; discharge may 

watery; pain is n 
ut becomes so as t 


23 

Painful, spasmodic coi 
which more or less prev 
be due to sensitive rem 
of the vagina, erosion 
the anus or an urethral 


23 

Thick, whitish and g 
milky discharge. 


23 

I ( eel ing of heat in th 
pelvis; itching and burn 
ache; usually frequent 
of appetite and at time: 


23 

Hemorrhage of the v 
straining at stool or coi 
which is very repulsiv 
thick, but as a rule is 
marked at beginning, b 
disease develops. 








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Severe 
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62 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 



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TABLE OF SYMPTOMS FOR DIAGNOSIS. 



979 







For the main article 
on the subject consult 
the general index. See 
chapter index, page 1257, 
for simple, home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
of medicine see page 1491. 




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Disease Indicated 


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Accompanying and Following 
Symptoms 


240 

Profuse menstruation and as disease pro- 
gresses, frequent discharges of blood between 
the periods, often amounting to attacks of 
flooding; leucorrheal discharge which may 
be tinged with blood; occasional par- 
oxysms of pain. 


241 

Inflammations and ulcerations of the womb 
mix and run into each other, resulting in raw 
places, forming granulations or pimply sur- 
faces and hardened spots; sometimes the pim- 
ply patches become red and hard, the whole 
surface spongy; pus flows freely at times and 
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242 

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9S0 



TABLE OF SYMPTOMS FOE DIAGNOSIS. 





For the main article 
on the subject consult 
the general index. Sec 
chapter index, page 1257, 
for simple home reme- 
dies. Prescriptions and 
formulas for home prep- 
aration will be found at 
page 1231. For treat- 
ment by various schools 
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Painful menstruation the first day or two 
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back ; dragging pains in the lower part of the 
abdomen and thighs ; headache ; constipation ; 
bowel movements at times painful; bladder 
may be irritable, and at times the urine may 
escape when the woman laughs heartily. 


245 

Sensation of fullness and weight about the 
pelvis ; wearisome backache ; leucorrhea ; ob- 
stinate constipation ; as disease advances fre- 
quent desire to urinate and inability to com- 
pletely empty each time, resulting in an in- 
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981 



PART I OF BOOK VII 

Treats of the science of nursing. It is a most com- 
plete and up-to-date treatise on what a nurse should 
know in regard to the care of the patient, the sick 
room and her personal qualifications. 



Albumen 1036 

Amiability 987 

Appearance 989 

Arrow-root Gruel 1035 

Asparagus, Puree of 1035 

Barley Water 1035 

Baths 1009 

Bed, the 99§ 

Bed Making 999 

Bed Sores 1000 

Bedding 999 

Beef Essence 1032 

Beef Juice 1032 

Beefsteak 1033 

Beef Tea 1032 

Breathing of Patient 995 

Broths 1032 

Calmness 987 

Chart, Keeping 1019 

Cheerfulness 987 

Chicken 1033 

Clam Broth 1033 

Clothing 989 

Cocoa 1036 

Cold Application 1009 

Compress 1003 

Contagious Disease, Preventing 

Spread of 1036 

Convalescence 1038 

Cough 996 

Cupping 1005 

Discharges 996 

Disposition 987 

Douches 1014 

Dry Heat Application 1008 



Eggs 1033 

Eggnog 1033 

Egg Water 1034 

Embrocations 1007 

Emetics 1018 

Enemata 101 1 

Epidermic Medication 1013 

External Remedies 1001 

Farina Gruel 1035 

Fever Nursing 1021 

Firmness 988 

Flaxseed Tea 1035 

Flour Ball 1035 

Flour Gruel 1035 

Fly Blisters 1003 

Food, Selection of 1028 

Foods, Predigested 1036 

Fomentations 1003 

General Consideration 985 

Gruel 1035 

Hypodermic Injections 1013 

Iceland Jelly 1035 

Internal Remedies 1015 

Irish-moss Jelly 1035 

Junket 1031 

Lamb Chops 1033 

Leeches 1006 

Liniments , 1007 

Lotions 1007 

Manner -. . . 989 

Massage 1028 

Measuring of Medicine 1015 

Milk 1031 

Moving a Patient 1020 

Nurse, Qualifications of 987 



983 



984 



IXDEX TO PAST I OF BOOK VII. 



Nursing Q#5 

Nursing Fever 1021 

Oatmeal Gruel 1035 

Observation 988 

Observation of Symptoms 994 

Ointments 1007 

Oysters 1033 

Packs 1004 

Panada 1034 

Patience 988 

Patient, Moving 1018 

Personal Conduct 989 

Physical Soundness 988 

Pills 1015 

Plasters 1008 

Poultices 1001 

Powders 1015 

Powdered Yolk 1033 

Pulse 995 

Qualifications of the Nurse 987 

Record, Keeping 1019 

Rectal Injections 1011 

Respiration of Patient 995 

Scraped Beef 1032 

Sick Diet 1028 

Sick Room, The 990 

Sick Room Utensils 997 



Speech 989 

Squab 1033 

Study of Disposition 990 

Stupes 1003 

Suppositories 1014 

Surgical Cases, Nursing of 1024 

Sweet Breads 1033 

Sympathy , 987 

Syrups 1017 

Tact 088 

Tapioca, Puree of 1035 

Technical Details 986 

Temperature, Bodily 994 

The Nurse at Work 989 

Things to Avoid 1026 

Tinctures 1016 

Toast 1034 

Touch 089 

Undersheet, Changing the 999 

Unselfishness 987 

Upper Sheet, Changing the 1000 

Vaginal Injections 1014 

Vegetable Sick Foods 1034 

What Nurse Should Avoid 990 

Wheat Foods 1034 

Whey 1030 

Wine Jelly 1035 



Book VII 



THE SICK ROOM IN THE HOME 



PAKT I. 

NURSING 



General Consideration — There is no room to doubt that faithful, in- 
telligent and efficient care of the sick is often responsible in large measure 
for recovery from attacks of severe illness and that the ministrations of a 
well-qualified nurse are second only in importance to skillful medical 
attendance. In fact there are diseases in which good nursing is more 
essential to the welfare of the patient than medicines, and in which these 
would be of little avail, unless accompanied by conscientious services of 
this character. At best the physician can spend but a few moments each 
day in a single sick room, and the remaining hours must be given over to 
the care and superintendence of some other person. 

The employment of a trained nurse is expensive. Moreover, it is 
not always easy to secure one that is satisfactory, — for many so-called 
"trained" nurses are incompetent. Not only this, but even when she is 
competent there is apt to be a certain mechanism about her work which 
comes from a lack of that personal regard for the patient which can only 
be bestowed where ties of blood or dearest friendship exist. 

No one can or will care for the ill so well as the mother, if she be 
competent. But she is not competent if she has not the scientific knowl- 
edge of what is best to do in respect of each and every circumstance 
as it may arise. Every mother should have knowledge of the science of 
nursing if she would have her husband and her children receive the 
best care, for even where a nurse is employed it is of inestimable value 
that the mother should know whether the nurse is in every way doing her 
duty. Where there is a grown daughter in the family she, too, should be 
thoroughly informed in nursing that she may take the mother's place, 

985 



986 NURSING. 

or in case of need be the mother's nurse. If accompanied by proper 
knowledge the care by loved ones brings a rest and comfort to the ill 
which cannot be brought about by the mere stranger who does her work 
for hire, no matter how competent she may be. But, without proper 
knowledge, with all the mother's love, sins of both omission and com- 
mission are sure to occur and there is danger of sympathy overriding 
judgment. Specific knowledge of the exact requirements in respect of 
each and every incident as it may occur is essential, and it is the purpose 
of this chapter not only to supply such knowledge but to present it in 
such shape as to make it a ready reference to which the mother may 
quickly turn in all matters that come within the scope of nursing. And, 
it is to be borne in mind that a competent nurse is the doctor's greatest 
friend, for the physician can treat his case with greater certainty and 
success if his aide-de-camp, the nurse, be efficient. 

The Nurse is Doctor's Assistant. — The nurse is the physician's as- 
sistant, and he often depends, in forming his estimate of the condition 
and needs of his patient, largely upon the observation and judgment of 
the one who is in constant attendance on the case, who sees the changes 
which occur at different times of day or night, who notes the effect of this 
remedy or of that food, and who makes to him reports based upon what 
transpires during his absence. 

What the Doctor Gains. — Thus he often gains valuable suggestions re- 
garding the course and management of the case from what to the inex- 
perienced and untrained might be considered a trivial symptom or a cir- 
cumstance not worth repeating. 

It is not the office of the nurse to discriminate between the important 
and unimportant features of a case, but to endeavor to give the medical 
attendant a faithful picture of the case as she has seen it, leaving it for him 
to weigh the evidence given, to form a just estimate of its value. On his 
departure the responsibility of the execution of his orders devolves upon 
her, and until his return it is she who assumes the control of the case and 
gives directions. 

Technical Details. — These embrace information on such matters as the 
care of the patient, including moving, lifting, bathing, dressing, and at- 
tending to his wants and comfort; such details as relate particularly to 
the management of the case, as taking temperature, pulse and respiration, 
observing symptoms, administering medicines and applying external 
agents; the preparation and giving of food and drink; the care of the 



QUALIFICATIONS OF THE NUKSE. 987 

room, attention to the room, including its general cleanliness, order, dis- 
infection, heat and ventilation ; and the care of the bed, etc. 

But the true nurse does not confine herself to the mere mechanical 
carrying out of such details, — she brings to bear her best thought and all 
the kindliness of her nature in endeavor to make the ill one happy and 
content in spite of suffering, and yet with a firmness that brooks not of 
over sympathy when this might interfere with duty. A brief considera- 
tion will here be given to some of these essential qualities. 

QUALIFICATIONS OF THE NURSE. 

Disposition. — Lamentable failure will inevitably attend the efforts of 
any one attempting to nurse, if she has not a suitable disposition. The 
qualities which constitute an ideal disposition for a nurse unfortunately 
are rarely all found in any one person. It will nevertheless be useful to 
consider some of the most important of them. 

1. Amiability. — Essentially the product of a benevolent nature, this 
is a trait of prime importance. A spontaneous flow of kind acts and con- 
siderate attentions should characterize the nurse ; whereas, irritability of 
temper and thoughtless and inconsiderate acts are so inexcusable as to at 
once disqualify her for her work. Therefore, siie must naturally be hind 
in thought, word and deed. 

2. Sympathy. — Sympathy with a patient's distress, without weak 
sentimentality is an outgrowth of this attitude of mind, which is of value 
to the nurse and of benefit to the patient, if not too freely exercised. 

3. Cheerfulness — A bright and sunny disposition not only brings life, 
hope and cheer into the sick room, and thus aids in the favorable progress 
of the case, but sheds its influence through the entire household, lighten- 
ing the burden of trouble from those who are in distress. The sick room 
is not the place for a gloomy or morose person. 

4. Unselfishness. — Disregard for personal comfort and convenience 
and untiring devotion to the interests of the patient are demanded of the 
nurse. Hers should be largely a labor of love, in conformity with which, 
she should be willing to sacrifice herself in behalf of her patient. 

5. Calmness. — A nurse with an excitable temperament, who is upset 
by trivial circumstances, and who cannot even in an extremity exhibit 
composure, will not tend to tranquilize a patient who is already in a state 
of nervous irritability. Cool judgment, calm demeanor, and, when not 
accompanied by hesitancy, deliberate action, will tend to inspire conn- 



988 XTJBSING. 

dence in her intelligence and proficiency, a fact of no little importance in 
serious illness. 

6. Patience — The trying circumstances incident to the sick room and 
the exacting requirements of the patient, often call for the exercise of the 
most unbounded patience. Those who ordinarily are thoughtful and 
considerate are frequently, when sick, unreasonable in the extreme, and 
their demands for attentions, which are often unnecessary, become most 
exasperating. 

7. Firmness. — It is desirable for the nurse to be sufficiently resolute to 
secure compliance with her instructions, but it is not needful to maintain, 
as is often done, a dogged and uncompromising attitude, and to be in- 
movable to appeal in non-essentials. Arbitrary refusal in such matters 
creates antagonism on the part of the patient, which more than counter- 
balances what has been gained by the nurse and which materially lessens 
her influence and usefulness. 

8. Tact. — Not only in these matters but in her general deportment in 
the sick room is there opportunity for the exercise of tact. To divert the 
patient from an undesirable train of thought without making it apparent ; 
to be discreet about the subject of conversation, neither unbosoming all 
her family affairs nor detailing the histories of all her previous cases ; to 
avoid either depressing, exciting, tiresome or otherwise objectionable 
topics when reading is permissible ; to regulate the matter of visitors with- 
out giving offense ; in these and in manifold ways are shown the import- 
ance of having good, sound common sense, a quality unfortunately far 
too rare among those who engage in this art. 

9. Observation — The nurse should be a careful observer, able to 
notice differences in the condition of the patient, and to recognize at least 
in a measure the meaning of symptoms which she sees. Frequently it is 
left to her judgment to give more or less of a medicine prescribed, or to 
change one remedy for another, according to the condition of the patient, 
and a failure to correctly observe and properly interpret what is seen will 
work to the detriment of the patient. 

10. Physical Soundness. — The strain, physical and nervous, caused by 
untiring vigilance, loss of sleep, irregular meals, confinement to the sick 
room, and anxiety, are such as to make essential to the nurse an excep- 
tionally sound, healthy body, endued with the power of endurance. In 
addition there should be good vision, good hearing and good sense of smell, 
all of these faculties being called into frequent requisition. 



THE NLESE AT WORK. 989 



THE NURSE AT WORK. 



Personal Conduct. — Granted that a nurse has enough qualifications to 
make her an efficient nurse, there are still some details pertaining to her 
personal conduct in the sick room, and which are largely under her control, 
the observance or neglect of which will make the difference, often, between 
her being acceptable or not to her patients. Some of these are quite 
essential, while others may appear to be of little consequence, yet to those 
suffering from severe illness there are no trifles; mole-hills appear as 
mountains, and the insignificant become matters of great moment, and 
these very trifles often have much to do with the comfort and peace of 
mind of the one under the nurse's care. 

Reference is had to such matters as dress, personal appearance and 
habits, movements, manner of speaking, touch, etc. 

Clothing — The outer clothing of the nurse should be of plain, modest 
color and preferably of wash material, an indispensable requirement in 
infectious cases. Starched clothing should not be so stiff as to make a 
constant rustling with every movement. The shoes should be noiseless. 

Speech. — The nurse should endeavor to speak distinctly and evenly, 
though never abruptly nor in loud and rasping tones. Equally objection- 
able is it to whisper, as this almost invariably is annoying to the patient if 
he is awake. The voice should be cheerful and reassuring and calculated 
to inspire with hope and confidence. Very many questions of the patient 
must be answered adroitly, yet in such a manner as not to convey the im- 
pression that attempts are being made to conceal from him what he desires 
to know. 

Touch. — The hands should be always warm, smooth and scrupulously 
clean and the nails well trimmed. A combination of gentleness and firm- 
ness is to be desired in handling and moving the patient, efforts of this 
sort being steady and deliberate, not sudden and jerking. 

Appearance. — General neatness of the hair and person should be 
strictly regarded. She who is careless of her appearance and tidiness will 
presumably be equally so of the one under her charge. 

Manner. — If nurse is lacking in the ability to make herself acceptable 
to her patient she is confronted by an insuperable obstacle to success. 
This will depend almost wholly on her deportment in the sick room. An 
awkward, boisterous, bustling nurse will not compare favorably with one 
who quietly and unobtrusively accomplishes her tasks without confusion 



990 NURSING. 

and noise. Nor, on the other hand, will the nurse who stealthily creeps 
around on tip-toe he likely to prove acceptable to her patient. 

Study of Disposition. — A studious observance of the patient's disposi- 
tion and a readily ascertainable knowledge of his likes and dislikes will 
soon enable the nurse to anticipate his wants, to scrupulously avoid that 
which is likely to annoy and to secure for him that which will give com- 
fort and pleasure or bring repose of body or mind. It is this considerate- 
ness for the wishes and feelings of the patient which so often constitutes 
the difference between success and failure and the lack of which to a sen- 
sitive nature is a constant source of irritation and annoyance. 

What a Nurse Should Avoid. — A nurse should not forget that a 
patient's progress toward recovery is retarded by such practices as the fol- 
lowing : To rock incessantly in a squeaky chair ; to sit and constantly tap 
with the foot or fingers ; to noisily prepare for bed in the room after the 
patient is ready to sleep ; to so time the administration of food and med- 
icine, where this can be avoided, as to disturb the patient just as he has 
settled comfortably for a nap ; to be continually asking whether he would 
like something done for him; to make unnecessary noise with dishes or 
papers ; to allow the light to shine uncomfortably in his eyes ; to hurry him 
with his meals ; to shake his bed, and so forth. 

THE SICK ROOM. 

Location. — This is a matter of much importance and may vitally af- 
fect the patient's progress. The ideal sick room is one that is large and 
cheerful, having southern exposure, high ceilings and plenty of windows 
to admit sunshine and air. There should be a fireplace, more for ventila- 
tion and cheeriness than warmth, and the location of the room should be 
away from annoying noises and smells, such as from kitchen or stable. 
The furniture should be simple yet pleasing and the curtains of muslin, 
linen or other washable material. It is seldom that all these conditions 
may be had, but the more nearly they may be reached the better for the 
progress of the patient. In cases of contagious disease it is especially 
desirable to have the room isolated from other rooms. 

Ventilation. — It is almost impossible to overestimate the importance 
of proper ventilation in the siek room. ]N"o matter how poorly their 
living-rooms may be ventilated, people who are well are usually part of 
the time out of doors and so get at least a certain amount of fresh air. 
But the patienl who }]<■< in an unventilated sick room breathes day and 
night over and over again an atmosphere poisoned by the breath of himself 



THE SICK BOOM. 991 

and others, by exhalations from his skin and evacuation and perhaps from 
discharging of wounds. There should he a constant and uniform supply 
of fresh air and not only must fresh air be let in but the foul air must 
be let out. Xothing is better for getting out foul air than an open grate 
fire which causes a constant draught up chimney and carries the foul 
air up from below while fresh air may be brought in through open win- 
dows. But it is seldom that a sick room has the advantage of a fireplace 
and the next best thing is to open at the bottom a window farthest from 
the patient and lower the other windows of the room from the top, thus 
creating the necessary draught to drive out the foul air and replace it 
with fresh. If the air blows uncomfortably on the patient a screen can 
be arranged. ^N"ot only is pure air necessary but all sources of contamina- 
tion must be cut off. If there is set bowl or anything else communicating 
with sewer all exit holes must be closed and everything possible done to 
keep the air of the room continuously pure and wholesome. 

Temperature of Room. — The sick room should be kept at low rather 
than high temperature, especially in fever cases. Pneumonia is success- 
fully treated even in the open air both day and night. The patient is pro- 
tected from the cold by fever and bedclothes, but the attendants may 
find it necessary to wear heavy outer garments to keep warm. Tt is well 
to remember, however, that cold is greatest and the body least able to 
resist it at about three or four o'clock in the morning, and at these hours 
the covering of the patient should be given careful attention. Also at 
times of washing or dressing the patient, changing sheets, etc., the room 
should be comfortably warm. About 70° F. or a little over is a good tem- 
perature at such times. 

Cleanliness. — Dirt in the sick room breeds disease. With cleanliness 
and proper care even the most virulent of contagious and infectious dis- 
eases may be confined to a single member of a household. Carelessness 
in respect of even the smallest detail, such as permitting a single article 
of soiled linen to stand without being disinfected, or allowing flies to 
enter and leave the room, may result not only in giving the disease to 
others of the household, but perhaps in spreading it throughout the entire 
neighborhood and in creating an epidemic. 

The nurse should bathe frequently. Her own health demands it and 
not only so, but the patient is highly sensitive to and affected by the 
cleanliness or otherwise of the attendant. This cleanness should extend 
not only to the body, but the clothes as well. The "Sairey Gamp" of 
Charles Dickens' fame has passed, we hope, forever from the sick room. 



992 NURSING. 

The nurse should be dressed plainly in some wash material, the hair kept 
combed and in control and the hands and nails must be kept immaculately 
clean. An untidy, unkempt nurse has a reactionary and ill effect on the 
patient, while cleanly sweetness acts as a tonic. 

The patient should be frequently bathed. The pores of the skin 
must be kept open and clean. The patient may object, but the patient 
must not be permitted to be the judge. Every morning, every noon and 
every evening the face and hands at least must be carefully sponged, 
the mouth and teeth carefully cleaned and the hair brushed, and this must 
be faithfully attended to even when the patient is unconscious. The effect 
is marvelous in refreshing and cheering the patient. Alcohol sponge 
bathing of the body is especially recommended in cases of fever. 

In fever patients the care of the teeth, the tongue and the roof of the 
mouth is imperative. Without frequent and proper care they will be- 
come filled with sores and there will be hardening and cracking, the 
breath will become foul and the patient will needlessly suffer. The 
patient should rinse the mouth frequently with a boracic acid solution or 
a mild salt solution, and when the patient is too weak to do this the 
nurse should wash the patients' mouth frequently and carefully — always 
after eating. Do not use soda, as it dries the membrane and causes the 
tongue and lips to crack. In washing the mouth use antiseptic gauze 
or fine aseptic muslin, which can be done with a piece of gauze over the 
index finger or by winding the end of a stick with absorbent cotton or 
gauze. As preventive of cracking, oil the patient's lips with cold cream, 
cocoa butter or some similar non-irritating salve. 

In all fever cases the nostrils of the patient should be carefully 
watched as excretions become hardened and soon obstruct the nasal 
passages. Hardening excretions should be gently removed and the nostrils 
from time to time gently bathed with olive oil, cold cream or the like, to 
prevent the formation of sores. Thoughtful, attentive watching in these 
little things is one of the great perquisites of the trained nurse and must 
be followed by the non-professional nurse if she would successfully attend 
her patient. 

Dust in the sick room is dangerous. Keep everything clear of it by 
going over it frequently with a cloth well wrung out in a weak carbolic 
solution or other disinfectant. This should be done at least twice a day 
and its faithful observance will do much in preventing disease germs float- 
ing through the house. 

All towels, linen, bedclothes, etc., used in the sick room should be 



THE SICK ROOM. 993 

dipped in a carbolic or other antiseptic solution. A properly prepared 
carbolic solution has an advantage in that it does not stain or otherwise 
injure the linen, yet is an excellent germicide. After being wrung out 
in the solution they should be put in a boiler and boiled for an hour. 
Under no circumstances should they be allowed to stand without thorough 
disinfection. 

The infection of typhoid fever is through the urine and stools, and 
the smallest indiscretion on the part of the nurse may result in the spread 
of the disease not only through the household, but possibly throughout 
the whole neighborhood. Watch the bed linens carefully and allow no 
spots to remain after the bedpan or urinal has been used. Small stains 
may be disinfected with a solution of bichloride without removing the 
sheets, but if large the sheets should be removed. Always bathe the hands 
of the patient after any action of either the bowels or kidneys. Typhoid 
germs come only in the discharge of typhoid patients, chiefly the stools 
and urine, and to give the disease to someone else they must be swallowed 
by such other person. Revolting as this may seem, it is the simple truth, 
and the only way in which typhoid may be conveyed from one person to 
another. These germs usually get into food and drink through careless 
personal habits of attendants upon the patient or of the patient himself 
when he has become convalescent or even apparently well. The amount 
of minute particles from body discharges need not be enough to be de- 
tected by our senses in order to pollute milk, drinking water Or food 
7 whether cooked or to be eaten raw. Milk cans which have been washed in 
polluted water can spread typhoid through the milk put into them. The 
prevention of spread of typhoid is simply a matter of care that germ- 
laden discharges from the patient — the stools and urine — are so disposed 
of that not even the minutest particle can find its way through food or 
drink to the mouths of other persons. Those who have the care of typhoid 
patients, and the patients themselves as they grow better, must observe 
cleanliness of the most perfect kind. After the toilet they should thor- 
oughly scrub their hands and finger-nails with soap and water and then 
wash them in a disinfectant solution. Ordinary washing of the hands with 
soap and water is not sufficient to cleanse or kill the germs on typhoid- 
polluted hands. A good disinfecting wash for the hands is a three per 
cent, solution of carbolic acid, creolin or lysol in water. Elies should not 
be allowed to come in contact with the discharges or soiled clothing of 
typhoid patients. They eat the discharges from the bowels and bladder 
and carry the germ-laden filth into the food and drink of other people. 
63 



994; NUBSING. 



OBSERVATION OF SYMPTOMS. 

To intelligently observe the condition of the patient from time to 
time in order that she may make correct reports to the medical attendant 
is one of the most important duties of the nurse. Accordingly attention 
must be given to some of the symptoms which she will be expected to 
notice. 

Temperature. — At stated times during the day, usually morning and 
night, it will be her duty in the large majority of cases to take and record 
the bodily temperature. A self-registering thermometer should be used, 
and after cleansing it the nurse should see that the column of mercury is 
as low as 96 degrees. If not, the thermometer should be firmly held by its 
upper end, with the arm raised and extended, and the thermometer swung 
downward with considerable force, care of course being taken to avoid 
striking it against anything. This process should be repeated as often as 
necessary, care being taken not to make the column of mercury go entirely 
into the bulb, or it will fail to be self-registering. The thermometer is 
usually held in the mouth, beneath the tongue, or in the armpit, five min- 
utes being required to determine the temperature accurately in the latter 
place, while three minutes in the mouth is a sufficient time. If the arm- 
pit is selected it should be thoroughly dried and the thermometer held 
firmly in place by the arm being closely drawn to the side ; if the mouth 
be chosen no cold drink should be given for at least ten minutes before and 
the lips should be kept tightly closed while the thermometer is in place. 
Care must also be exercised to prevent the thermometer being bitten, 
especially by children or by those who are at all irrational. With these 
the mouth had better not be chosen. The temperature normally is about 
98| degrees, although it is usually slightly lowered during the early morn- 
ing hours and slightly raised in the early evening. In case of depression 
it may fall one or two degrees; in fever it rarely rises more than about 
seven degrees, and even at this height the patient is usually in a perilous 
condition. Between 100 degrees and 103 degrees the fever may be said to 
be moderate; above 103 degrees high. The gravity of high temperature 
varies in different diseases; in inflammatory rheumatism and in hysteria 
for instance the temperature may reach 108 degrees or more and recovery 
still take place, while a temperature of 105 degrees in inflammation of the 
bowels would indicate great danger. * In very young children the best 
method is to take the temperature through the rectum. The child should 



EESPIEATION. 995 

be laid face down on the lap and the thermometer gently inserted about 
an inch into the rectum and left there for five minutes. The temperature 
taken in the rectum registers about a degree higher than when taken in 
the mouth or armpit. 

Pulse. — The pulse marks the movement of blood within the arteries, 
and the movement being caused by the contraction and expansion of the 
heart, there is variation in accord with the condition of the heart and the 
blood vessels. The pulse rate of the average adult is about 72 beats per 
minute, but varies greatly according to age, activity, position of the body 
and so forth. At birth the rate is 130 to 140; during first year 115 to 
130 ; during second year 100 to 115 ; during third year 95 to 105 ; from 
seventh to fourteenth year 80 to 90; from fourteenth to twenty-first 
year 75 to 80. In old age the rate is from 80 to 85 per minute. The 
pulse of the female is more rapid than that of the male of the same age. 
Exertion, excitement and taking food quicken the pulse, and it is re- 
tarded by cold, rest and fatigue. The recumbent position causes a 
lowering of the pulse of about eight or more beats per minute. To count 
pulse place a finger (not thumb) over the artery at the wrist and count 
the beats for one minute. Full and frequent pulse (100 to 110) indicates 
fever; a bounding pulse (110 to 125) indicates high fever; a soft, fre- 
quent pulse (100 to 120) indicates advanced continued fever with de- 
bility; a wiry, frequent pulse, hard and not easily compressed, indicates 
fever with inflammation and that the disease is of serious character; a 
weak, intermitting pulse, or a thin, thread-like pulse, with or without 
short intermissions, indicates extreme prostration and may precede death 
or occur as result of hemorrhage or during a fainting fit. In such cases 
active stimulants must be promptly and energetically used. An inter- 
mitting pulse occurs in certain forms of heart disease, when the general 
health seems good. 

Respiration (Breathing.) — Kespiration is the alternate inspiration and 
expiration of atmospheric air. In drawing air into the lungs the ribs are 
raised and the diaphragm, or thin flat muscle which separates the cavity 
of the chest from that of the abdomen, is drawn down. The cavity of the 
chest is enlarged by this movement and simultaneously with the creation 
of vacuum the air rushes in as into a bellows. The movement of dia- 
phragm and ribs which causes this inrush of air is caused by muscular 
contraction and the whole act is called inspiration, and the act of inspira- 
tion being completed the ribs return to their former position, the dia- 
phragm rises, the Tungs collapse and the air is forced out, and this act 



996 NURSING. 

of expulsion is called expiration. The successive movements of inspira- 
tion and expiration are known as respiration or breathing. In health the 
average adult breathes from 17 to 20 times a minute. Respiration in 
the female is usually a trifle faster than in the male, especially during 
pregnancy. The respiration should be regular and involve the muscles 
of both chest and abdomen. The following table indicates average respira- 
tion at various ages: \ 

Two months to two years, 35 per minute. 

Two years to six years, 23 per minute. 

Six years to twelve years, 20 per minute. ■ 

Twelve years to fifteen years, 18 per minute. 

Fifteen to twenty-one years, 16 to 18 per minute. 

The number of respirations should be counted when the patient is 
unaware of it. This can be done by watching the rise and fall of the 
chest. The general nature of respiration varies in different diseases and 
should be carefully noted. In pneumonia and other pulmonary diseases 
there is a marked increase in respirations. In case of worms in chil- 
dren or any bowel trouble in infants, there is marked increase. Pleurisy, 
heart trouble causes shortness, gasping or catching of the breath. For 
record the respirations should be counted for a full minute and prefer- 
ably when the patient is awake. 

Cough. — If cough is present it should be noticed at what times it is 
worse, the frequency, duration and character of the paroxysms. If fliere 
is expectoration its features should be observed, its color, whether profuse 
or scanty, thick, tenacious, frothy, bloody, and so forth. 

Discharges — The discharges of the patient should be noticed and any 
departure from the normal reported. The frequency, color, consistence 
and general characteristics of the movements should be known. The color, 
odor and quantity of urine, the character of sediments, if any are present, 
the frequency with which it is voided, and so forth, should be ascertained. 
In saving a specimen for examination that which has collected during the 
night is to be preferred. Incontinence of urine, or the inability to retain 
it ; and retention, in which it cannot be voided, sometimes occur. Occa- 
sionally in retention the bladder becomes overdistended and the urine 
dribbles away, this condition simulating incontinence. The use of the 
catheter will be necessary in this as in the ordinary form of retention. 

Miscellaneous Symptoms — The condition of the tongue, whether it is 
clean, furred, coated, flabby, indented, and so forth, and whether it is pro- 
truded slowly or quickly ; the skin, as to moisture, warmth, color and gen- 



SICK ROOM UTENSILS. 997 

eral appearance ; the expression, whether wan, pinched, anxious, placid or 
otherwise ; the eye, whether there is swelling of the lids, undue sensitive- 
ness to light, alteration in color, or in the size of the pupils, and so forth ; 
his general attitude and demeanor of the patient; the way he speaks, 
whether nervous, irritable, restless, rational ; the amount and character of 
sleep ; the extent and kind of delirium, if present ; the sensations of the 
patient as described to the nurse; the location and character of pain — 
whether diminished or aggravated by pressure, whether constant or inter- 
mittent, stationary or movable. 

UTENSILS OF THE SICK ROOM. 

The following articles are practically indispensable in the sick room. 
They are not expensive and can be secured at almost all drug stores and 
of general dealers : 

1. At least one, and if possible several, two-quart water bottles for 
purpose of either hot or cold applications as required. Cloth-covered 
water bottles are obtainable and to be recommended, as they prevent burn- 
ing when hot water is used. If bag is not cloth covered a flannel cover- 
slip should be made and always put over the bottle prior to placing it 
with hot water against the patient. A bag that is wrapped in a loose 
flannel or towel may slip from its covering and burn the patient. Only 
fill bottle half full and then expel air before putting in the stopper. 
Where rubber bottles cannot be obtained or a greater number than on hand 
required, quart glass bottles wrapped in towels or flannels and securely 
fastened with safety pins may be used, but utmost care must be exercised 
that they do not break and scald the patient. 

2. A good atomizer or sprayer for spraying the nose, throat, etc. 

3. A graduated medicine glass for measuring liquids. 

4. A glass tube for administering liquids to patients who cannot be 
raised and a special feeding cup for reclining patients. 

5. Syringes and Douches: One bag or fountain syringe; one bulb 
syringe and one glass or hard rubber syringe. 

6. Bedpan. There are several varieties, but the square, porcelain 
pan is especially to be recommended. The pan should always be warmed 
before using and the patient should be raised slightly at the hips when 
placing and removing the pan. It should be gently placed and gently 
removed. After using the pan should be immediately removed from the 
room, cleansed and kept in a convenient place outside the sick room. 



998 NURSING. 

In certain diseases, such as typhoid the evacuations should be thoroughly- 
disinfected before emptying them. In all cases it is well to have a dis- 
infectant solution at hand and keep some of it in bedpans and urinals 
when not in use. Two pounds of sulphate of iron and two ounces of car- 
bolic acid dissolved in about five quarts of water is a good solution for 
such purposes and is so cheap that it may be used freely. 

7. A bath towel ; pure, moderately scented or unscented soap ; a fine, 
medium-sized sponge; several rolls of antiseptic gauze bandage and a 
package of antiseptic gauze. 

8. A slop jar with tightly fitting cover. Porcelain or china ones are 
good. They should be such as will stand the use of chloride of lime and 
other disinfectants. 

9. A sputum cup. This may be of china or porcelain and must be 
covered. A small piece of chloride of lime or other disinfectant should be 
kept in the cup, which must be cleaned frequently. Gauze or old cloths 
should be used for sputum and these should be burned 

10. One clinical thermometer for taking the temperature of the 
patient and one ordinary thermometer for judging as to the temperature 
of the room. A third thermometer specially adapted to taking tempera- 
ture of the bath may also be secured, but when this is not convenient the 
ordinary house thermometer answers the requirements. 

11. One small and one large pair of scissors and a good knife. Also 
where possible a manicuring set is to be recommended as it is important 
that the hands and nails of both nurse and patient should be kept con- 
tinuously clean. Such utensils should always be sterilized. 

12. Ice bag. This is a rubber cap or bag so constructed as to be filled 
with chopped ice and placed over the patient's head, a sponge being placed 
properly within to catch leakage as ice melts. The head should first be 
well bound with a soft moist cloth which protects the head from direct con- 
tact with the rubber but together with the sponge prevents the ice from 
having undue effect, as, should the ice be in direct contact with the head 
there would be danger of freezing. In severe fever cases and skull trouble 
the ice cap is invaluable. 

THE BED. 

In ordinary illness the wide bed placed so that the nurse can go to 
both sides and having a spring mattress covered with one of horsehair or 
other such material, is fully adequate and has one advantage over a nar- 
row bedstead in that the patient may be refreshed by moving him to a 



•* 






? 










Changing Sheets — First. 




E. J. S. 




Properly Made Bed. 




Ideal Sick Room. 
© E. J. S. 



THE BED IN THE SICK ROOM. 999 

cool side of the bed. However, for most cases, and especially surgical 
cases, it is preferable to use a narrow iron bedstead about three feet 
wide, six feet three inches long and of a height to bring the patient two 
feet from the floor when the mattress is on. A good plan is to kave two 
of these beds, one for the night and the other for the day, or for change 
at any time. By rolling the two beds close together the patient can be 
easily transferred. 

Bedding — Sheets, light blankets and hair mattress are proper. 
Blankets are usually better than coverlids, quilts and counterpanes be- 
cause they are generally of lighter weight, and it is not well for the patient 
to be weighted down with heavy covering. A light counterpane, however, 
may be spread on top for sake of appearance. 

Bed Making — The careful making of the bed is not only important 
for the patient's comfort, but it is necessary as a preventive measure 
against bedsores. First lay a soft pad or blanket over the mattress to 
prevent irritation from mattress buttons. See that this pad or blanket is 
absolutely smooth and then pin it to the mattress at the corners with 
strong safety pins so that it may not become wrinkled. Cover the pad 
with a rubber sheet about three feet square which must be drawn smooth 
and pinned to the edge of the mattress. Over this place what is known as 
a "draw sheet" and which is made by folding an ordinary sheet lengthwise 
so as to make it half its original width. This is laid across the bed in such 
manner that the whole of the extra length will be on one side of the 
bed and so may be drawn to the other side to bring a fresh part under the 
patient. This draw sheet must be drawn tightly and smoothly across the 
bed and firmly fastened with safety pins. An upper sheet is smoothly 
laid and well tucked in under the foot of the mattress and the patient then 
covered with blanket and such light covering as deemed necessary. 

Changing the TJndersheet. — Commence on the opposite side from the 
patient and roll the sheet until it rests against him. A clean sheet should 
be previously folded in narrow, lengthwise pleats up to its middle and 
this pleated portion should now be placed against the roll of the old sheet, 
the remaining half covering the bare part of the bed, then push the two 
sheets well under the patient gently rolling him from you for the purpose. 
Going to the other side of the bed, roll the patient gently back over the 
sheets and pull them out. Then remove the soiled sheets and smooth out 
the fresh one. If desired the draw sheet and rubber sheet may be removed 
at the same time by rolling them all together. Another manner of chang- 
ing the under sheet is to roll up the fresh sheet from the end, commencing 



1000 NURSING. 

at the head of the bed, work the sheet toward the foot, the soiled sheet 
being pushed before it, the patient by himself or with assistance lifting 
successively the different parts of the body as the sheet is pushed down. 

Changing Upper Sheet. — All the covering should be removed but the 
sheet and one blanket, on top of which lay a fresh sheet and blanket and 
then remove the soiled sheet and blanket from under the fresh ones. When 
sufficiently strong the patient may assist by holding on to the fresh sheet 
and blanket while the soiled ones are being removed. 

Bed Sores. — It is not an uncommon thing for people who have been 
long confined to bed to die of bed sores caused by neglect and that often- 
times without either patient or nurse being aware of what is happening 
until the ill is done. They are to be especially watched for in emaciated 
persons. They form about the hips, down the spine, on the shoulder 
blades, the heels and other points where the tissues over the bones are so 
thin that constant pressure upon them stops circulation and a sore results. 
There is a noticeable redness first, and, if given attention at such time, 
the trouble may be stopped. The parts should be bathed frequently with 
warm water and castile soap and then rubbed well with alcohol and zinc 
stearate ; the skin, too, may be toughened by using a solution of alum and 
alcoholic tannic acid powder. The most important thing, however, is that 
undue pressure shall not be permitted at any point. The patient should 
not be allowed to lie in one position hour after hour, but should be fre- 
quently though very gently moved. Turning the patient a little every 
three or four hours allows the blood to circulate through a part where 
it has become congested by the weight of the body or limb upon the bed. 
In some cases such as fracture of the hip it is not possible to frequently 
move the patient, but relief may be given by arranging small pillows 
in such manner as to support the body without the threatened part or parts 
coming in direct contact, or by placing an air pillow so that the affected 
parts comes over the opening. Care should be taken to use soft sheets 
and to see that they are always without wrinkles. A frequent massage 
of the back, hips and shoulders is helpful in preventing congestion of 
blood at any point. Wet beds are one of the most conducive things to 
bed sores and every effort must be made to keep both bed and patient 
clean and dry. When bed sores do appear everything possible must be 
done to heal them without delay as they may become a more serious mat- 
ter than the original illness for which the patient is being treated. Cleanse 
with soap and water and solutions as has been directed, being careful to 
use only sterilized absorbent cotton, bandages, etc., and make everjr 



POULTICES. 1001 

effort to remove pressure on the afflicted part. If not carefully and prop- 
erly attended to there is danger of blood poisoning. 

EXTERNAL REMEDIES. 

Poultices and Fomentations — The effect of poultices is to soften and 
relax the tissues by the application of heat and moisture. In this way 
pain is relieved in many cases of inflammation, suppuration is prevented 
unless the process has gone too far, or if it is imminent or present it is 
hastened, and the healing of wounds and ulcerating surfaces promoted. 
If too long applied they do injury by lowering the ton^ of the parts. 

Making and Applying Poultices. — Powdered slippery-elm bark, Indian 
meal or "mush," flaxseed meal, bread, or any similar substance which will 
retain the heat and moisture well, are employed. Hot water is gradually 
added to the material selected, until it is thick enough to stick to the wall 
if thrown against it. It is then spread quickly on a piece of thin material 
as muslin, to a thickness of about three-quarters of an inch, leaving a 
margin twice that wide. It is then covered by a similar piece of muslin, 
or preferably of thinner material, as cheese cloth and the edges turned 
to the affected surface, over which a little glycerine has previously been 
rubbed to prevent sticking. The poultice should be covered by a piece of 
rubber or some water-proof material to aid in retaining the heat and 
moisture. A hot poultice should be ready to replace the one in use as soon 
as it begins to cool. If used on the trunk, care should be taken to prevent 
catching cold by permitting only the briefest possible exposure of the 
heated part while changing the poultices, and after they are discontinued 
a thin sheet of cotton or a light flannel cloth should be applied as a 
protective. 

Medicated Poultices. — Both poultices and fomentations may be medi- 
cated by the additions of antiseptics, laudanum, turpentine, and so forth, 
and materials having medicinal qualities, such as hops, poppy and digitalis 
may be used in poultice form for the relief of certain conditions by placing 
them in a bag, preferably flannel, and dipping into hot water, hot vine- 
gar or hot alcohol. 

Spiced Poultices. — Spice poultices or plasters are made in this way for 
mild counter-irritation in colic, and so forth, equal quantities of ginger, 
cayenne pepper, cinnamon and cloves being mixed together. 

Pepper Plasters. — Pepper plasters are made of cayenne pepper the 
same way as spice plasters ; or flour, pepper and water may be mixed to- 



1002 NURSING. 

gether as an ordinary poultice, or to the white of an egg the pepper may 
be gradually added until of the proper consistence. The latter plan is said 
to have the merit of efficacy without causing much irritation and is useful 
in neuralgic affections. 

Mustard Poultices. — These are made by mixing mustard flour with 
warm (not hot) water, and if desired adding a third or a half of wheat 
flour. The white of an egg may be advantageously added, or to relieve the 
burning the surface may be dusted after the poultice is removed, with a 
cooling powder, such as compound stearate of zinc with boric acid, or with 
menthol, or a soothing ointment such as cold cream, zinc ointment or 
vaseline. From fifteen to thirty minutes is a sufficient time to apply mus- 
tard poultices, the aim being merely to produce sufficient irritation to 
thoroughly redden the skin. Never should a blister be allowed to form, 
as the resulting sore is very painful and slow to heal. 

Poke-Root Poultice — Eoast fresh poke-root until soft ; pound it. Mix 
with cornmeal to consistency of poultice. Used on tumor to scatter them. 
Remove every four hours. 

Charcoal Poultice. — Take bread and milk or Indian meal, make to 
consistency of poultice with water, stir in half a teacupful of pulverized 
charcoal. Good to clean ulcers and foul sores. 

Slippery Elm Poultice. — Stir ground slippery elm bark in water to 
consistency of a thick paste. An excellent poultice for irritable sores. 

Carrot Poultice — Boil carrots until soft, mash them to a pulp, add 
lard or sweet oil sufficient to keep it from getting hard. Spread and ap- 
ply. Excellent for offensive sores. 

Onion Poultice. — Made the same way as carrot poultice. Excellent 
for slow boils and stimulating to indolent sores. 

Bread Poultice. — Put needed quantity of boiling water in basin. 
Throw in bread or cracker. When these have soaked up all they will, 
pour off water. Spread half-inch thick on cloth and apply. 

Lobelia Poultice. — Take one ounce each of powdered lobelia and 
ground slippery elm bark. Stir into hot weak lye to poultice consistency. 
Excellent when applied to wounds, fistula, felon, boils, erysipelas, insect 
stings. 

Arrow-Root Poultice. — Mix two tablespoonfuls of arrow-root with as 
much cold water as it will unite with. Add boiling water and stir till 
a thick paste is formed. 

Oatmeal Poultice. — Stir oatmeal slowly into hot water, boiling water 



MEDICINES. 1003 

while stirring, till poultice thickness is reached — that is, till it will not 
run when spread on the rag. 

Indian Meal Poultice. — Made same as oatmeal poultice. 

Yeast Poultice. — Mix half pint yeast with one pound flaxseed meal to 
make thick paste. Stir constantly while heating. 

Flaxseed Poultice. — Stir flaxseed into boiling water till thick paste is 
formed. Spread on linen and apply hot. 

Compress. — Compresses are folded pieces of lint or rag so contrived 
as, by the aid of a bandage, to make due pressure upon any part, accord- 
ing to their shape, direction and use. Compresses have been called long, 
square, triangular, split, uniting, cubiform, and so forth. The compress 
of the hydropathists is a cloth well wetted with cold water, applied to the 
surface near the supposed seat of disease, securely covered with a dry 
cloth, and changed as often as it becomes dry. It is sometimes covered 
with a layer of oiled silk to prevent evaporation. 

Fomentations (sometimes called "Stupes"). — A fomentation is the ap- 
plication of relief to any part of the body by means of hot, wet flannels, 
which may or may not be medicated. Two or three pieces of flannel should 
be placed in the middle of a towel, which is then folded once over them. 
Dip this into boiling water and wring out by twisting the ends of the towel 
in opposite directions. Carry it to the bedside, take the flannels out 
together and quickly shake to let in air, which will cause them to retain 
heat longer. Cover the flannels with thin, dry towel and apply to affected 
part of patient. A teaspoonful of laudanum or turpentine sprinkled over 
the hot flannels will increase effect. A mustard stupe or fomentation is 
made by making a paste of one tablespoonful of mustard and adding this 
to one pint of hot water (not boiling, as boiling water destroys action of 
the mustard) ; then proceed as with other fomentations. In order to keep 
the fomentations continuously hot two sets of fomentations should be kept 
going at the same time, changing them every few minutes, one remain- 
ing on the patient till the fresh one is ready to take its place. When the 
fomentations are finally discontinued the part should be dried and a dry 
flannel put in its place to prevent the patient from taking cold. 

Counter Irritants These include poultices, fomentations, etc., and 

may be applied directly over the seat of trouble or may be placed on some 
remote part to obtain what is called revulsive action. Thus headache 
is sometimes relieved by mustard footbaths. 

Fly Blisters. — This is a mode of producing counter irritation by means 
of Cantharides or Spanish Flies, which at one time was much resorted to, 



1004 NUBSING. 

but now seldom adopted, and as a rule is only advisable under direction of 
a physician. Cantharides should never be applied where the skin is 
broken or tender. Oiled tissue paper between the plaster and the skin 
acts as protection to the skin and at the same time hastens the action of 
the blister. The part to be blistered should be thoroughly washed with 
castile soap and water, then putting on a little vinegar and permitting 
evaporation to do the drying. Where there is growth of hair it is well to 
first shave this off. The cantharides should be held in place by bandage 
and not by adhesive plaster, as in the latter case there is danger of break- 
ing the skin upon removal. From six to eight hours is the usual time for 
blistering, and if this has not occurred within twelve hours, the can- 
tharides should be removed and a poultice applied, when desired results 
will generally be produced. Great care should be exercised not to tear the 
skin in removal. All particles of the cantharides must be carefully re- 
moved by using oil, after which if the blister is full of watery matter or 
serum a small incision should be made at the bottom of the blister to 
permit of its draining out. The after application is simply cold cream, 
olive oil or other soothing application. 

The Telini Fly, of India, as also a number of other flies, possess 
this blistering quality, owing to the cantharidin they possess, but the 
Spanish Fly is the one most commonly known and used. Practically the 
same results are secured by moistening gauze or cotton with chloroform or 
ammonia and applying as a blister. If left long such applications are 
apt to burn deeply and it is seldom advisable to use them excepting under 
direction of physician. 

Packs, Hot and Cold — The Hot Pack is given to accelerate active cir- 
culation of the blood and produce warmth. The bed is covered with a rub- 
ber sheet or oilcloth, over which a dry blanket is placed. Then a blanket 
which has been wrung out in boiling water is placed over the first blanket. 
The patient is laid on this hot wet blanket naked and the blanket then 
wrapped quickly about him so that each and every part of the body's sur- 
face is in contact with the hot blanket, which must be well tucked in at 
the neck and feet. The under blanket is then folded over the patient and 
snugly tucked in. A cold, wet towel is laid over the patient's head. The 
pack should be continued ten or fifteen minutes, when the patient is dried 
and put back into a warm bed, great care being taken that cold is not 
caught in tliis latter operation. 

The fold pack is given in a similar manner to the hot pack, only on 
top of the first blanket a cotton sheet wrung in ice-cold water is sub- 



cupping. 1005 

stituted for the hot wet blanket. The cold pack is used to reduce tem- 
perature in many acute diseases, such as fevers, pneumonia, etc., but as 
a rule should only be given under direction of physician. 

Dry Packs — -The dry pack is sometimes recommended as a means of 
producing perspiration. It is more particularly intended for full-blooded 
persons who would not be harmed by a reasonable depletion in avoirdupois. 
It is good for gout, rheumatism and some other chronic troubles, but must 
be avoided by those who are weak or ansemic, as it is very weakening in its 
effects. The patient is wrapped in a large, thick, woolen blanket in such 
thorough manner that no air can penetrate either at the neck, the feet nor 
elsewhere. Generally two or three blankets are used with a feather pilloAV 
at the feet, whilst an eiderdown quilt completes the wrappings, but still 
over this a further warm cover, which must be thoroughly tucked in. To 
avoid rush of blood to the head a cold compress is applied to the back 
of the head. The windows should be opened as soon as the patient is 
packed. The nurse must be in constant attendance and give the patient 
a glass of cold water every ten or fifteen minutes or oftener. After the 
dry pack the patient should be given a thorough alcohol sponge bath, and 
if sufficiently strong and the weather propitious will find it advantageous 
to take some outdoor exercise, or if condition does not permit of this should 
be put into a clean, dry bed. 

Clipping. — Pain and congestion are sometimes relieved by what is 
known as "cupping." It is an operation requiring skill and care and is 
seldom advisable excepting under direction of a physician, especially as 
respects what is known as wet cupping. 

In dry cupping the most convenient form is a set of glasses of differ- 
ent sizes, provided with valves, and from which the air is exhausted after 
closely applying the cup to the surface of the body by means cf a vacuum 
pump. Several of these may be placed in succession along side of each 
other. As the vacuum is produced the skin rises in the cup and the blood 
flows to the part. When it is desired to remove the cup, the skin may be 
pressed near the cup so as to admit the air beneath. 

In the absence of this cupping apparatus, the operation may be per- 
formed with small tumblers or wine-glasses with smooth edges. There 
should be at hand a lighted taper or candle, some alcohol in a glass and a 
small swab or fine brush. The glasses must be clean and dry. The part 
of the patient to be cupped should bo exposed so that no time may be 
lost at the moment for cupping. "Rub the inside of the cupping glas* 
with the swab which must have been made sufficiently wet with the alcohol 



1006 NURSING. 

to moisten the inside of the glass, but not enough to trickle down the side 
of the glass when turned upside down as this would result in more or 
less seriously burning the patient. Pass the inverted glass over the taper 
or candle flame when a blue flame will appear within the glass, lasting 
3 or 4 seconds, and before it disappears place it over and press it upon 
the part to be cupped. The oxygen having been burned out of the 
glass a vacuum will have formed which will have sufficient suction to 
draw the flesh well up. Another glass should be ready for use as soon 
as the first one is released which it will the least of air entering. The 
second or succeeding cups should not be placed in precisely the same 
place, that is one glass should not be placed within ring formed by a 
preceding one. Be careful that enough alcohol is not used to heat the 
edge of the glass or drop on the patient. Remove the glass before dis- 
coloration appears. The top of the glass should be taken in one hand 
while the other is employed in pressing away the flesh from the edge. 

Wet cupping is used for purposes of local blood letting in which, 
after dry cupping, the part is scarified with superficial incisions; the 
cups are sometimes replaced in order to promote the flow of blood. It is a 
practice which belongs, however, more to the domain of surgery than of 
nursing. 

Leeches. — The use of the leech is mainly for local blood-letting. At 
one time the medical profession used them by the millions, but in modern 
times the practice has greatly diminished, indeed the younger generation 
of American and European medical men seldom or never employ them. 
They are to be found in America and in Europe, the latter being con- 
sidered the better for medicinal use because they are more voracious and 
will suck in four or five times their weight in blood. 

It is possible for leeches to cause severe hemorrhage and for this 
reason they should not be applied over large blood-vessels, but instead 
should be placed upon a bony surface upon which pressure can be made 
in case it is necessary to check the hemorrhage, and not only should special 
attention be paid to this where leeches are applied to children, but as they 
are more easily acted upon by the leech than are adults, the less voracious 
or American leech is the preferable for use. The surface to which the 
leech is to be applied should first be well washed and dried and the leeches 
— which should also be washed and dried in a towel or the like — should 
not be handled. If to be used in the mouth or nose, run a silk thread 
through the tail to prevent swallowing. If swallowed a strong solution 
of salt and water will prevent any harm, or a glassful or two of wine may 



OINTMENTS. 1007 

be taken. Should hemorrhage be severe it may be stopped by application 
of vinegar or by touching with nitrate of silver. Simple hot or cold ap- 
plications with pressure are usually sufficient. Do not attempt to pull 
a leech off by force as their teeth may be left in the wound and abscesses 
may result or erysipelas set in. The leech will drop off itself when it is 
full or if desired before he is full sprinkle some salt on the head of the 
leech, when it will immediately release itself and drop off. The bite of 
the leech leaves a small, permanent star-shaped scar. 

Lotions, Ointments, Embrocations, liniments. — Lotions are remedies 
applied to the exterior of the body by simply painting, washing or mop- 
ping the surface. If they are intended to reduce heat and inflammation 
by evaporation they should be left without covering or as little as pos- 
sible. Ointments are fatty substances applied either with or without rub- 
bing and are usually supposed to be of more or less healing nature. Em- 
brocations and liniments are usually somewhat counter-irritant and are 
external applications in which rubbing is employed. Usually liniments 
contain ingredients that would be very poisonous if taken internally and 
so great caution should be taken that they are not left where someone may 
take them by mistake, or even as has sometimes happened, administer 
them by mistake. 

Sulphur Ointment — Melt half a pound of lard, and add one ounce 
sulphur, one drachm each of ammoniated mercury, benzoic acid, sulphuric 
acid and oil bergamot, and two drachms of nitrate of potassa. Stir con- 
stantly till cold. An excellent ointment for itch. 

Pile Ointment. — Add to a quart of water three handfuls each of witch- 
hazel bark, oak bark and apple tree bark. Boil to a pint and strain. Add 
half a pound of lard, and simmer till water disappears. This forms an 
ointment valuable as a pile remedy. 

Tar Ointment. — Melt a pound of suet. Add the tar. Stir till cold. 
Excellent ointment for scaly eruptions like scald head. 

Spermaceti Ointment. — To a pint of olive oil add five ounces of sper- 
maceti and fourteen of white wax. Melt together, stirring constantly. 
Good dressing for blisters and burns. 

Simple Ointment. — Melt a pound of white wax with four pounds of 
lard. Let the heat be gentle, and stir till cold. 

Poke Ointment. — Mix a drachm of extract of poke with one ounce of 
lard. Good for ulcers, itch, scald head, etc. 

Oxide of Zinc Ointment. — Hub together half an ounce of oxide of 



1008 NURSING. 

zinc and tkree ounces of lard. Good for eruptions of skin and sore 
nipples. 

Ointment of Galls. — Rub together six ounces lard, six drachms pow- 
dered galls and a drachm and a half of pulverized opium. Good for piles. 

Belladonna Ointment — Mix an ounce of lard with a drachm of extract 
of belladonna. Affords relief in neuralgia and painful tumors. 

Ointment of Bayberry. — To half a pound of tallow add half a pound 
each of turpentine and bayberry, and four ounces of olive oil. Good 
application for scrofulous sores and ulcers. 

Lead Ointment — Add two and a half drachms of powdered acetate of 
lead to two ounces of white wax and four ounces of lard. Melt together, 
stirring till cold. Good for burns, scalds, ulcers and cuts. 

PLASTERS. 

Spiced Plaster. — Mix an ounce each of powdered ginger, cloves, cin- 
namon and black pepper with one drachm pulverized cayenne. Add a 
fluid ounce tincture of ginger and enough honey to make stiff poultice. 
A plaster of this applied to stomach stops nausea and vomiting. 

Lead Plaster. — Melt one pound lead plaster, add two ounces each of 
linseed oil and tincture of opium, six ounces of oil of turpentine and 
eight ounces of oil of organum. Stir together till cold. Good for 
burns, chilblains, scalds, etc. 

Capsicum Plaster. — Mix half pound resin and two ounces beeswax. 
Add a pint of spirit, in which two ounces of cayenne inclosed in bag has 
been steeped in gentle heat for two hours. Evaporate the spirit by gentle 
heat, add an ounce of powdered camphor. An excellent stimulating 
plaster. 

Belladonna Plaster. — Melt three ounces of resin plaster and add an 
ounce and a half of extract of belladonna. An excellent application in 
neuralgia and rheumatism. 

Dry Heat. — This is used to impart warmth, restore suspended anima- 
tion, relieve pain, as in cases of neuralgia and muscular rheumatism and 
in other affections. Appliances are now procurable for use in the home 
in which the affected part may be treated by air heated to a temperature of 
several hundred degrees. Hot water bags and bottles, hot stove lids, irons, 
bricks and plates, bags of salt, sand and ashes are common examples of the 
modes of applying heat. All these should be properly wrapped to prevent 
burning the patient. Where bottles or rubber bags are used the stopper** 



BATHS. 1009 

should be carefully fitted to prevent the possibility of leaking; the bag 
should be seamless lest the heat melt the cement and the patient be 
scalded, and it should only be half filled in order that it may conform 
more comfortably to the shape of the body. 

Cold. — Cold is applied for the reduction of temperature, for the relief 
of inflammation and sometimes in the treatment of pain. Muslin cloths 
laid on ice, constantly renewed, cloths wrung out of ice water and rubber 
bags partially filled with small pieces of ice are the ordinary means of 
applying it. Coils of rubber tubing through which ice water is made to 
flow are also convenient. The same may be used for hot water. Ice 
bags should have between them and the surface of the skin a thin layer 
of flannel or other material. If folded in a napkin or other cloth they 
may be conveniently pinned to the clothing of the patient, or where ap- 
plied to the head, to the pillow, to keep in position. 

Miscellaneous Application of Remedies.^Eemedies are also applied to 
the mucous surfaces by injection, suppositories, douches, inhalation, dust- 
ing, and so forth, by absorption through the skin into the general system ; 
and by injection under the skin or into the deeper structures of the body. 
The utmost care should be observed to have all appliances used for these 
purposes scrupulously clean to avoid the danger of infection. Of these 
methods several must be more than mentioned. 

BATHS. 

The temperature of water in a bath in the sick room should always 
be tested with a thermometer. Xever trust to impressions nor hand 
tests, — they are unreliable and may be sufficiently in error to cause grave 
consequences. A special bath thermometer may be obtained from any 
drug store, but the ordinary thermometer answers all requirements. For 
clinical consideration the temperatures of different kinds of baths may 
be classified thus: 

Cold bath 50° to 70° F. 

Tepid bath 80° to 92° F. 

Warm bath 92° to 98° F. 

Hot bath 98° to 110° F. 

Cold baths induce capillary circulation and stimulate a healthy 
action of the skin, fortifying it against atmospheric changes. The cold 
64 



1010 NURSING. 

water drives the blood from the surface to the internal organs and this 
is followed by a reaction, and as the blood returns there is a feeling of 
warmth and a reddening of the skin. For those in health a cold plunge 
first thing in the morning is most exhilarating, but should not be taken 
for several hours after eating. With the sick the cold bath should only be 
given on physician's order, excepting in cases where his advice cannot 
be had and it is known that it is the proper treatment. It is sometimes 
indicated for heatstroke when the temperature reaches 104 degrees or 
more, but the patient should not be plunged into the extreme cold as a well 
person would do, but instead the water at the start should be at a tem- 
perature of from 70 to 90 degrees and gradually it should be reduced by 
adding cold water until the desired temperature is reached, say 65 degrees 
F. or at lowest 60 degrees. The patient according to circumstances may 
be kept in the bath for fifteen to thirty minutes, but if at any moment 
there be symptoms of f aintness or of chills, he should be immediately taken 
out and hurried to a warm bed, where stimulants should be administered. 

Hot baths and hot packs draw the blood to the surface and relieve 
congestion of the internal organs. They are of special worth in cases of 
shock, exposure to cold and like instances, where there is great depression 
and it is requisite to stimulate the nervous system. They are used to 
great advantage in cases of convulsions of children. On taking him 
from the bath the skin must be quickly but gently dried and the patient 
hastened into a warm bed, care being taken throughout that the tempera- 
ture of the room is proper and that there are no draughts. Hot baths 
may produce faintness and the patient should be continuously watched, as 
if left alone even briefly there is danger of sudden collapse and possible 
drowning in the bath. 

Warm and Tepid Baths. — These have a calming, soothing effect upon 
the nervous system. They are of especial value when there is excitement 
or irritability. 

Hip Baths. — These are given with intent to act specially upon the 
abdominal organs. They may be hot or warm. They should be given in 
baths specially constructed for the purpose and which can be readily pur- 
chased, but in emergency an ordinary tub may be used. Care must be 
taken that the patient's shoulders and feet are warmly covered during 
the period of the bath. 

Foot-baths. — These are often valuable in refreshing the patient and 
also in drawing cold from the system. For the former the water should 
be tepid and the duration from five to ten minutes. For the latter the 



ENEMATA. 1011 

water should be as hot as the patient can bear and kept up for from ten 
to twenty minutes, hot water being added to keep up temperature of water. 
A tablespoonful of mustard should be stirred in the water, and it will 
aid if the patient's ankles and feet are gently rubbed downward. 

For description, etc. of other kinds of baths read special articles. 

ENEMATA, OR BECTAL INJECTIONS. 

Liquids injected into the rectum are called enemata (plural of 
enema) and are given for various purposes, such as the relieving of 
constipation, the checking of diarrhoea, the relief of flatulence, etc., when 
they are called simple enemata, and also are given to administer nourish- 
ment which cannot be taken into the stomach, when they are called nutri- 
tive enemata. Simple enemata may be administered either with a bulb 
syringe or with a fountain syringe; that is, a water bottle hung at con- 
venient height above patient and having connecting rubber tube with 
proper nozzle. Fluids as a rule should be warmed to a little above blood 
heat (98° to 100° F.), say from 105° to 108° F. The most enemata 
consist of warm water made soapy with any good soap and is simply for 
the purpose of evacuating the bowels. The tube should be oiled with 
vaseline or sweet oil and gently pushed into the rectum by an upward 
and slightly backward movement. The tube is held in place while the 
injection is slowly given. The following details as to different enemata 
will be found of value : 

1. — Purgative Enemata : 

(a) Olive oil or castor oil. Six ounces of warm oil should be in- 
jected slowly and as high as possible, its purpose being to soften the 
movement. About half an hour afterward follow with an enema of one 
quart of warm soap suds. 

(b) Glycerine enemata. Half an ounce to two ounces of pure gly- 
cerine with an equal amount of warm soap suds should be injected. 

(c) Turpentine enemata. Mix one-half ounce of turpentine with 
three ounces of warm water. Half an hour afterward follow by an enema 
of about one pint of soap suds. 

(d) Eochelle salts and epsom salts. One ounce of either salt should 
be mixed with two teaspoonfuls of turpentine and one pint of warm soap 
suds. 

(e) Molasses. Mix from two to ten ounces of molasses with one pint 
of warm soap suds. 



1012 NURSING. 

2. — Astringent Enemata: These are oftentimes found very effi- 
cacious in cases of diarrhoea. They must be given very slowly, should be 
injected as high as possible and be retained by the patient as long as he 
is able to. 

(a) Starch and laudanum. The starch is boiled as if for laundry 
purposes and then thinned with lukewarm water until it is thin enough to 
flow readily through the tube, and of this take three ounces. In mild 
cases this of itself is often sufficient, but where there is much pain, desire 
to move the bowels and straining, fifteen drops of laudanum or thirty 
drops of paregoric may be added, but this addition should not be made 
without permission of physician. 

3. — Stimulating Enemata: These are sometimes found valuable in 
cases of shock following an accident or in cases of exhausting illness, 
where it is deemed wise to stimulate through the rectum. 

(a) Salt Enema. A mildly stimulating enema may be made with 
two teaspoonfuls of salt dissolved in one quart of hot water. This may 
be strengthened in effect by addition of half an ounce to one ounce of 
whiskey. 

(b) Black Coffee. An injection made of half a pint to one pint of 
black coffee makes a powerful stimulant. It should be first strained 
through a handkerchief or fine cloth and administered as hot as can be 
endured. 

4. — Nutritive Enemata: In some cases it is necessary to feed the 
patient through the rectum. Naturally but a very limited variety of food 
can be thus administered. No one injection should consist of more than 
four to six ounces of fluid, and they should not be given oftener than at 
four hour intervals, as if more frequently administered the rectum will 
become so sore that they will have to be discontinued. In giving nutri- 
tive injections make sure that there is no air in the syringe, and to avoid 
their being expelled they must be administered very slowly. In case of 
being expelled decrease the dose. The smaller and more concentrated the 
dose the greater is the chance of its being retained. Where there is 
great difficulty of retention ten drops of laudanum or paregoric added to 
the enema will sometimes effect retention. The following are some of 
the most efficacious nutritive enemata : 

(a) Four ounces of peptonized milk; white of one egg; a pinch of 
salt. 

(b) Three ounces strong beef tea; one ounce cream; one ounce 
brandy. 



HYPODERMIC INJECTIONS. 1013 

(c) Two ounces each of beef blood and pure milk. The beef blood 
should be from very rare beef. 

(d) One ounce each of yolk of egg, milk, brandy and beef -tea. 

(e) Two ounces of egg-nogg (made as for drinking) with two ounces 
of codliver oil, or four ounces of the egg-nogg may be given without the oil. 

When a patient is being fed by nutritive enemata the bowels should 
be washed out once a day by simple enema. 

In giving an enema the patient should preferably lie on the left side. 
If impossible to lie on the left side then he should lie on his back or take 
it in the "knee-chest position" — that is, with the knees drawn up to the 
chest. The patient must never be given an enema while lying on the 
right side. 

In giving enemata the bed of course should be protected with rubber 
sheet or with proper cloths. 

EPIDERMIC MEDICATION. 

Feeding the patient through the agency of the skin is known as epi- 
dermic medication. It is only used in rare cases, though some constitu- 
tional diseases are still treated with mercurial inunction and cod liver oil 
is sometimes applied to the skin of consumptives and rubbed in by mas- 
sage. Epidermic medication should only be administered by direction of 
a physician. 

HYPODERMIC INJECTIONS. 

These should never be used excepting by direction of the physician, 
yet when he prescribes them they may be easily administered by the nurse 
and quick results in stimulants and other drugs are obtainable and some- 
times advisable. Tablets and triturates are now obtainable which phy- 
sicians feel safe in prescribing for hypodermic use. The operation is 
very simple. A proper hypodermic needle must be had and this must be 
carefully sterilized by boiling in hot water or by subjecting carbolic acid 
or alcohol, both before and after each injection. Make solution as di- 
rected by the doctor, then with a piece of gauze rub the part to be pierced 
with alcohol to bring the blood to the surface. With the thumb and index 
finger of the left hand pinch up a little piece of the flesh and with the right 
insert the needle with a quick, stab-like motion. Press the piston slowly, 
permitting the solution to diffuse, then quickly withdraw it and again rub 
the part with alcohol. The patient will feel almost no pain. 



1014 NUBSING. 



VAGINAL INJECTIONS AND DOUCHES. 

These are necessary for cleanliness and as palliative in different 
diseases. Either bulb or fountain syringe may be used, but probably 
there is nothing more satisfactory than a good fountain syringe, which 
is simply a rubber bag or other vessel for holding one or two quarts of 
water, which can be hung on a hook or set on a shelf about six feet from 
the floor, or other height sufficient to give natural force to the flow of 
water. To this vessel a long rubber tube is attached with a nozzle at the 
end. There should be at least two interchangeable nozzles, one providing 
for a straight flow of water and the other for a spray. A snap spring 
about the tube near the nozzle may be used to start or shut off the 
flow of water. The patient should lie on her back with the hips raised 
on pillows and the knees drawn up, a bedpan being placed under the 
hips to catch the returning water. Where this is not possible the patient 
should lie at the edge of the bed with a vessel arranged to catch the over- 
flow. The nozzle should be oiled and then gently introduced and held in 
place by the patient while the nurse gives the injection. An improvised 
fountain syringe can be made by placing a pitcher at a suitable height 
and using a piece of rubber tubing as a syphon. Of course with well 
persons and that especially with the fountain syringe, douches may be 
taken without assistance. The injections may consist of warm or hot 
water, to each pint of which, if desired, a teaspoonful of Condy's fluid 
or of a five per cent, solution of carbolic acid may be added. 

SUPPOSITORIES. 

These are small masses, usually conical in shape, and composed of 
cocoa butter or some other material which will melt at the temperature of 
the body. These masses are medicated to suit requirements of different 
ill-. They are used for introduction into the rectum, vagina or uterus, 
and, except in the case of the last named, readily slip into position if 
lubricated with a little oil or vaseline. They may be introduced by pa- 
tient or nurse. Tf introduced by nurse the forefinger should be oiled. 
The suppository should be introduced gently, and when by rectum should 
be pushed up about one inch until it is seized by the muscles. The finger 
should be withdrawn very slowly so that the suppository may not be forced 
out. When patient has not been accustomed to introduction of supposi- 



INTERNAL REMEDIES. 1015 

tories an evacuation may follow in a few minutes and a bedpan should 
therefore be in readiness. As suppositories melt at body heat they should 
be kept in a cool place. 

INTERNAL REMEDIES. 

Liquids, powders and pills and the modifications of the latter, tablets 
and capsules are the modes by which medicines are administered intern- 
ally. As much as possible an array of medicines should not be on ex- 
hibition in the sick room. Any which in their administration require 
special care, such as poisons, should be kept in a place by themselves and 
some means adopted for distinguishing them by the sense of touch, such 
as a piece of ribbon tied about them. 

Pills and Powders. — To give pills, powders, etc., they should be placed 
as far back on the tongue as possible and a large swallow of water taken. 
Some powders are quite readily taken by floating them on a teaspoonful 
of water, others by mixing them into a paste with a few drops of water 
and placing on the tongue, a drink being taken to wash it down. Medi- 
cines in liquid form, unless specific directions to the contrary are given, 
had usually better be freely diluted. The mere addition of water does not 
usually diminish the efficacy of a drug, whereas when undiluted remedies 
are often too strong. 

Measuring of Medicines. — Since spoons vary in size and drops differ 
according to the consistence of the liquid, droppers and graduated medi- 
cine glasses are better for measuring liquids. One teaspoonful should 
equal a drachm, two teaspoonfuls a dessertspoonful, two dessertspoonfuls 
a tablespoonful, two tablespoonfuls an ounce, two ounces a wineglassful, 
two wineglassfuls a teacupful, two teacupfuls a coffeecupful, and two 
coffeecupfuls a pint. In measuring liquids, the glass should be held per- 
fectly even, on a level with the eye, and the liquid slowly poured out from 
the bottle, on the side opposite the label, to prevent soiling the latter by 
drops rolling down the outside. If the medicine is measured by a spoon, 
it should be poured into a larger receptacle in order that it may not be 
spilled while administering it. In dropping from a bottle, the lip should 
be moistened in one spot with a drop of the liquid, and side of the 
cork held against the moistened edge at an angle of about 45 degrees; if 
the bottle is carefully tilted its contents may be accurately dropped out. 



1016 NUBSING. 



TINCTURES. 



A tincture is a spirit containing medicinal substances in solution — 
that is to say, it is a spirituous solution of such of the active principles 
of vegetables and animals as are soluble in pure alcohol or proof spirit. 
They are made by grinding or bruising the substances of which tinctures 
are to be made, such as roots, leaves, barks, etc., and then placing them in 
the proper amount of either diluted or pure alcohol, letting them stand 
from seven to fourteen days (shaking thoroughly each day) and finally 
filtering through paper. Commonly one ounce of the medicinal substances 
is used to one pint of spirit, though there are some variations as to this. 
As a rule fluid extracts have the same strength ounce for ounce with the 
roots, barks, etc., of which they are made, so that they may generally 
be used instead of the actual substances and facilitate the making of a 
tincture quickly. Ether is sometimes used instead of alcohol, as is also 
ammonia. The following are a few of the tinctures most commonly 
used, together with description as to their making : 

Tincture of Snakeroot — Steep for two weeks three ounces of crushed 
Virginia snakeroot in a quart of diluted alcohol. Express and filter. Good 
for low states of the system, in teaspoonful doses, three times a day. 

Tincture of Rhubarb. — Add to a quart of diluted alcohol three ounces 
of crushed rhubarb and one ounce of crushed cardamom. Steep two 
weeks; express, filter and bottle. 

Tincture of Opium — Add to two pints of diluted alcohol two and a 
half ounces of opium. Steep for a fortnight; express, filter and bottle. 
This is the preparation known as laudanum. The dose should not exceed 
ten to twenty drops. 

Tincture of Lobelia — Add to a pint each of vinegar and alcohol four 
ounces of lobelia. Steep two weeks; draw off and filter. Dose as a 
nauseant, thirty to fifty drops. 

Tincture of Cinnamon. — Add to one pint of diluted alcohol two and 
a half ounces of powdered cinnamon. Steep for two weeks; express and 
filter. Dose, two to four teaspoonfuls. 

Cayenne Pepper Tincture — Steep for two weeks an ounce of powdered 
cayenne pepper in two pints of diluted alcohol. Express, filter and bottle 
for use. 

Tincture of Orange Peel.— Add to one quart of diluted alcohol four 



SYBTTPS. 1017 

ounces of dried orange peel. Steep for a week; express, filter and bottle 
for use. 

Tincture of Cantharides — Steep for a fortnight an ounce of crushed 
Spanish flies in two pints of diluted alcohol. Dose, twenty drops, three 
times a day. 

Tincture of Valerian — Steep for a fortnight four ounces of crushed 
valerian in a quart of aromatic spirits of ammonia. Express and filter. 
Used in nervous diseases in one- or two-drachm doses in sweetened water. 

Tincture of Myrrh. — Steep for two weeks four ounces of crushed 
myrrh and two ounces of capsicum in four pints of alcohol. Express and 
filter. Good externally and as an occasional remedy for flatulence. 

Tincture of Peruvian Bark. — Steep for two weeks twenty ounces of 
diluted alcohol, to which has been added two ounces of red bark, an ounce 
and a half of crushed orange peel, three drachms of Virginia snakeroot 
and one drachm of saffron. Express and filter. A stomach cordial, and 
good in low fevers. Dose, two to four drachms three times a day. 

Tincture of Aconite. — Mix eight ounces of powdered aconite root with 
one pint of alcohol. Express and filter. Same proportions of castor and 
leptandra to alcohol, make their respective tincture. 

Camphor, oil of peppermint, oil of spearmint and asafetida, in pro- 
portions of two ounces each to a pint of alcohol and steeped and treated 
as in tincture of aconite, make their respective tinctures. 

So cardamom, cochineal, Colombo, ergot, galls, hemlock, cubebs, hen- 
bane, lobelia, poke, blood-root, squills, bittersweet and belladonna, in 
proportions of two ounces each to a pint of diluted alcohol, and steeped 
and treated as in cases of tincture of aconite, make their respective 
tinctures. 

SYRUPS. 

Syrups are frequently used in the sick room. A strong solution of 
sugar and water is a simple syrup and when some medicinal has first been 
put in the water it is a compound or medicated syrup. In making medi- 
cated syrups it is preferable to use refined sugar. The following recipes 
will be found useful in making syrups for the sick room : 

Simple Syrup. — Dissolve two and a half pounds of sugar in a pint of 
water. Dissolve sugar by heating, removing any scum. Strain while hot. 
The addition of any medicinal substance to a simple syrup makes a com- 
pound syrup. 



1018 NURSING. 

Syrup of Squills — Add two pounds of refined sugar to one pint of 
vinegar of squills, and proceed as in simple syrup. 

Syrup of Seneka. — Mix four ounces of fluid extract of seneka with one 
pint of water. Dissolve in the liquid one pound of refined sugar and 
proceed as in simple syrup. Useful in colds and coughs, in frequent 
doses of one or two teaspoonfuls. 

Syrup of Rhubarb — Add to six pints of simple syrup, two-and-a-half 
ounces of crushed rhubarb, half ounce each of crushed cloves and cinna- 
mon, two drachms of bruised nutmeg, two pints diluted alcohol. Evapo- 
rate liquid by a gentle heat, to a pint. Excellent for bowel complaint, 
in drachm doses every two hours till it operates. 

Syrup of Lemons. — Boil for ten minutes a pint of lemon juice, strain, 
add two pounds refined sugar and dissolve. When cold, add two-and-a-half 
fluid ounces of alcohol. A fine addition to drinks in fever cases and good 
to disguise the taste of medicines. 

Syrup of Citric Acid. — Add one pint of simple syrup to two, drachms 
of powdered citric acid and four minims oil of lemons ; add another pint 
of simple syrup and dissolve by gentle heat. An agreeable cooling ad- 
dition to fever drinks. 

Syrup of Ginger. — To a quart of simple syrup add two ounces of 
tincture of ginger. Evaporate the alcohol by gentle heat. Added to other 
medicines to improve flavor. Excellent to remove wind from stomach 
and as a stimulant. 

Syrup of Garlic. — Slice and crush six ounces of fresh garlic, add one 
pint of acetic acid and two pounds of sugar. Macerate four days in glass 
vessel. Express and filter the liquor, till a pint has passed. Bottle. A 
teaspoonful will relieve bronchial affections in children under one year 
old. Larger doses according to years. 

Syrup of Wild Cherry. — Steep two and a half pounds coarsely pow- 
dered wild cherry bark in a gallon of water. Strain and dissolve in it by 
heat as much sugar as will make thick syrup. A good tonic and excel- 
lent to mix with medicines for dyspepsia, consumption, and so forth. 

Emetics. — Emetics are medicines administered for the purpose of 
causing vomiting. Generally they are considered as being of two varieties, 
which may be classified as (a) those which produce their effect by being 
absorbed into the blood and thereby act upon the nerve centres, and (b) 
those which act directly on the mucous membranes of the stomach and 
cause vomiting by reflex action. The first class of emetics are slow in 
their operation and are attended by considerable depression of the system 



EMETICS. 1019 

and antecedent nausea, while the latter are prompt in action and their 
depressing effect much less. Formerly emetics were much used in medi- 
cine in the early stages of acute diseases, such as fevers and inflamma- 
tions, with the object of cutting them short, hut their use for such pur- 
poses has practically been discarded and they are seldom used excepting 
in specific cases, such as the following: to empty the stomach in certain 
cases of poisoning, such as narcotics, or where indigestible substances 
are giving rise to disturbances which call for their removal, and to clear 
the air passages of obstructions as in certain cases of bronchitis or croup, 
where the respiratory tubes become filled with morbid material which 
threatens death by asphyxia and which cannot be dislodged by coughing. 
For these purposes class (b) or stimulating emetics are preferable, such 
as sulphate of zinc, sulphate of copper, turpeth mineral, alum, ipecac, 
sanguinaria, mustard, salt, etc. A common household emetic is a tea- 
spoonful of mustard stirred in a glass of lukewarm water. Sometimes a 
couple of tablespoonfuls of table salt in a glass of lukewarm water will 
give results. Emetics in class (a) are frequently administered by the 
rectum or hypodermically when the patient cannot swallow or for other 
reasons it is not desirable to disturb the stomach by direct action. Emetics 
are also sometimes given in class (a) to produce nausea, rather than actual 
vomiting, thereby causing a certain relaxation in the early stages of acute 
inflammation in strong persons, and for this purpose the more depressing 
emetics are used, such as antimony, ipecacuanha, apomorphia, etc. The 
latter are also employed in obstetric practice with view of producing re- 
laxation in cases of protracted labor from uterine and muscular rigidity. 
Emetics should always be administered with great caution, since the act 
of vomiting may be attended with danger where there exists any tendency 
to brain disease such as apoplexy, congestion of the brain, etc., and also 
in cases of inflammation of the stomach, advanced pregnancy, hernia 
(rupture) and other diseases of the internal organs, emetics should be 
avoided. 

KEEPING A CHART AND RECORD. 

A proper sick room chart carefully and accurately kept is of great 
assistance to the physician. The doctor usually is able to spend but a 
few minutes with the patient each day, usually at about the same hour 
each morning or afternoon. He cannot tell just what has happened dur- 
ing the time he has been away excepting by report of someone who has 
watched the case during his absence, yet it is very important that he should 



1020 NURSING. 

know just what has transpired each hour, what the temperature has been, 
what the pulse, what food has been partaken of, what bowel movements 
there have been, and many other things. The nurse cannot trust to her 
memory and, moreover, to recite all details would take up a lot of time. 
A carefully kept chart will tell the physician just what has happened 
while he has been away and will enable him to more ably decide as to 
what course should be pursued in treatment. Almost all drug stores have 
sick room or nursing charts for sale, and the purchase of same will well 
repay. Where these charts cannot be purchased the nurse can easily draw 
a necessary chart, taking as guide the specimen diagrams on the opposite 
page hereto. The date, name of patient and name of physician and when 
he has decided as to the disease write in the name of that also. Each 
time pulse, respiration and temperature are taken record them on the 
chart. The dotted line running across the page at 98.6 indicates the 
normal temperature line. Any variation from this line shows an ir- 
regularity in the system. After recording the figures (expressing frac- 
tions in decimals) make a dot on the chart showing the temperature. 
Then when the temperature next taken make another dot again show- 
ing the temperature and draw a straight line from the previous dot to the 
new one, and so one each time temperature is taken. By using black 
ink for day records and red ink for night records the physician is greatly 
assisted in quickly reading the chart. On separate sheet should be kept 
memoranda of everything occurring during each day and each night, 
including meals and what composed of, discharges and their nature, hours 
of sleep, etc., in short stating in fewest words possible everything as it 
occurs. Put it down at the time. 

That the chart and record be absolutely correct is imperative, as an 
inaccurate report is not only useless, but may prove truly dangerous by 
giving the physician false impressions, while every physician is aided 
and every patient benefited by a true chart and record. 

Moving a Patient. — No one should attempt to lift a sick room patient 
alone. There should at least be two. There are different methods. One 
good way is for the nnrse to pass one arm under the patient's neck in such 
manner that the head will rest on her arm, the nurse's hand being 
passsed under the arm of the patient on the other side ; the nurse's other 
arm is passed over the patient, the hand reaching the middle of the 
patient's back. The assistant, standing on the opposite side from the 
nurse, passes one arm under the lower part of the back and the other 
under the knees, and the nurse and assistant operating in accord with 





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FEVER NURSING. 1021 

each other lift the patient. A patient also may be lifted by the nurse 
taking firm hold of the sheet at the head and the assistant in like manner 
at the foot. The sheet thus forms a sling, and if done carefully and with 
sufficient strength the patient may thus be safely carried. In moving a 
patient from one side of the bed to the other, the nurse may by herself 
safely undertake to do this by placing one arm and hand down the pa- 
tient's back, thus supporting the head and shoulders, the other hand and 
arm being passed over the patient and slipped under the upper part of the 
back — and thus the upper part of the body is moved in the bed. Then 
one of the nurse's hands is placed under the lower part of the back and 
the other under the knees, and thus the lower part of the body is lifted 
over. The patient also may be moved from one side of the bed to the 
other by loosening the draw sheet and pulling it and the patient over 
together, then of course replacing the sheet. 

FEVER NURSING. 

By "fever," as here used, we do not mean merely a high tempera- 
ture. One may have high temperature for a short time as the result of 
an attack of indigestion or other temporary disarrangement of the system, 
while in typhoid and other continued fevers to which we now refer, the 
temperature is not necessarily excessively high, though at times it may 
be, but it goes through a series of ups and downs, now rising, now falling, 
always above normal and probably the risings and fallings being at a 
little higher temperature each day during a certain period of the illness, 
according to the nature of the particular disease. 

In these continued fevers the patient's recovery depends more on 
careful nursing than in probably any other sick-room illness, and that 
the nursing of it may be given all the faithful and untiring care that is 
essential, it is necessary that the nurse herself have very special regard 
to her own health, and that she herself has nourishing food, ample rest 
and sufficient outdoor air and exercise to keep her in good health and 
cheeriness. The nurse who neglects her own health is unable to give 
the best care to her patient, for if she be over-tired or ailing herself she 
cannot be as vigilant as she should with her patient nor can she lighten 
the sick room with that quiet, but contagious cheerfulness which is always 
a potent factor when caring for the sick. The nurse must have her 
hours of rest and recreation and these as far as possible must be away 
from the sick room and from thought of it. This is as much in the 



1022 NURSING. 

interests of the patient as the nurse, oftentimes more so. Where it is 
possible to have two regular nurses, the matter is very simple by a divi- 
sion of hours, but where, as is generally the case, only one trained nurse 
may be had, or only one member of the family able to devote her entire 
attention to the patient, it is necessary that special arrangements be made 
for the regular relief of the nurse, whether she be a trained nurse from 
without or be one of the members of the family. Certain hours when the 
patient is least likely to need special care should be decided upon and 
someone regularly left in charge during those hours with full instructions 
what to do, and the nurse thus be given entire freedom that she may 
come back to her case refreshed and so physically capable of resuming 
untiring watch and care. There should be a free discussion of the matter 
with the attending physician in order that the best hours and best general 
arrangement may be had. 

As illustrative of fever nursing we will take a case of typhoid fever. 
Typhoid fever is caused by poisons produced by myriads of microscopic 
germs in the bowels which live their lives in series of sevens of days. 
It is called an "expectant" fever because it is expected the germs will live 
out their lives in series of seven, fourteen, twenty-one or twenty-eight 
days. The fever seldom runs less than fourteen days ; it rarely exceeds 
twenty-eight days. Once it has started it must run its course, and so once 
it has been fully established that the case is typhoid we must settle down 
to a watchful siege, hoping for the change to convalescence on the four- 
teenth day, and if this passes without crisis then on the twenty-first day, 
and in the meantime, by natural and artificial means, bend our energies 
to preventing the fire of fever from consuming the patient and in keeping 
up the strength and vitality which are essential to his recovery. 

Strict rules apply to the management and care of these fevers (see 
article on typhoid fever and other fevers as per index) and no liberties 
can be taken. Where competent physician is in attendance, obey his in- 
structions religiously. Diet, sponging, attention to urine and stools and 
all the many incidents of proper care should be given careful, incessant 
and unwavering attention. The keeping of exact charts and records is 
matter of especial importance in these fever cases, as they are an index to 
the patient's real condition and invaluable to the physician in his daily 
study of the case. 

Delirium is almost always an accompaniment of continued or ex- 
pectant fevers, especially during high fever, and patients of nervous 
temperament. The patient is restless during sleep and usually keeps up 



Temperature Charts for Various Diseases 

The Time Eruption Appears is Shown by the Black Spots 

SCARLATINA MEASLES 



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FEVER NURSING. 1023 

low mutterings, and on coming out of sleep, but still delirious, fancies all 
kinds of strange things and thinks he sees objects and people about that 
are not actually present. Delirious patients should never be left alone 
for even the shortest while, as they may jump from the bed and out of 
window in a moment's time, or otherwise do themselves harm. Stay close 
by the delirious patient, agree with him in his hallucinations when occa- 
sion demands, soothe him by bathing forehead and other kindly attention 
and strive to gain and retain his confidence in every way, notwithstand- 
ing that for the time he is demented. 

Great care must be given to diet, though for many days this will 
probably be chiefly milk or some prepared liquid food. During the time 
of actual fever the patient will be indifferent to food, but once the crisis 
is over and convalescence commenced there is apt to be such craving for 
food that the patient's appeals may become almost heart rending. Here 
the nurse must be gentle but firm. In typhoid, for instance, five to seven 
days should usually elapse before the patient be given any solid food 
whatever, and then the quantity which may be safely given will be so small 
as to simply aggravate the patient's desire. However, to vary from the 
strict and known rules will be certain to do the patient harm and may 
cause death. Be guided by instructions of attending physician and do 
not permit your kindheartedness to interfere with your known duty. Con- 
sult diet requirements of different fevers in the special articles on these 
fevers (see index at end of book). 

Complications of various kinds are apt to arise in continued fevers, 
such as hyperstatic pneumonia (caused by too long continued lying in one 
position) ; pleurisy (outcome of slight cold or perhaps some undue strain 
on the part of the patient) ; hiccough (a dangerous, but not a frequent 
complication) ; and most commonly of all perforation of the intestines and 
from peritonitis. The safeguard against these dangers is constant vigil- 
ance and a knowledge of what to do at the first symptoms. 

In all continued fevers and especially typhoid it is imperative that 
great care and attention be given to the actions of the bowels and kidneys. 
They must be kept free. Inactivity or constipation means that the outlets 
for poisonous matter are clogged and there is grave danger of serious 
complications. The exact times and natures of stools and of urine should 
be most carefully recorded and the physician's attention especially drawn 
to any and every condition that seems unusual or contrary to natural 
expectation. 

Too much attention cannot be paid to cleanliness and to proper bath- 



1024 NUESING. 

ing (see section regarding cleanliness). During the time of high fever 
it will be found of great advantage and will greatly reduce the fire of 
fever, to give frequent sponge baths with alcohol, some doctors recom- 
mending an alcohol sponge bath every hour during the higher stages of 
fever. Great care must be taken in giving sponge baths, either of alcohol 
or water, that the patient is not exposed to cold or draught and only such 
part should be uncovered as is for the immediate moment being sponged. 
A frequent change of well-aired linen and constant attention that the 
sheets are always smooth and the pillows comfortably arranged are also 
matters of needful care, and all these matters are essential even in the 
care of the lesser fevers. 

Eest and quiet are necessary for the patient. He is not benefited 
and may be harmed by visitors. Even members of the family should 
keep away except where assisting in the care of the sick one. A trained 
nurse from without is generally very careful and insistent in this regard, 
but where one of the family is the nurse there is a danger of leniency 
as to other members of the family; but whoever the nurse, the rules in 
this as in other matters should be strictly enforced. 

It is impossible in this chapter to lay down a complete set of rules as 
to what the nurse should do on all occasions. Other chapters of this 
work should be carefully studied and then the nurse do that which under 
the circumstances she is satisfied is best to do and not in opposition to 
the physician's orders or general instructions of this book. Remember 
that at any and all times emergencies may occur and quick wit, keen 
observation and positive coolness will be requisite, and the greater the 
knowledge of nursing and of disease and its treatment, so much more 
availing will be the nurse's aid. 

NURSING OF SURGICAL CASES. 

Serious surgical cases are to-day almost invariably a matter of hos- 
pital work where nurses especially trained for the requirements are at 
hand. Minor operations, however, are frequently performed at home, 
and occasionally it is necessary to perform a more serious one without 
removing the patient to hospital. It is therefore well to here give a gen- 
eral idea as to special requirements of the nurse in attendance. 

In the first place we would recommend the careful reading of the 
chapter on Surgical Diseases, and of the instructions as to treatment of 
wounds in the chapter on Accidents and Emergencies. 



NURSING OF SURGICAL CASES. 1025 

The acquisition and continuance of disease is dependent upon germs, 
and the curing of disease upon the elimination of germs. A surgically 
clean wound — that is, one into which disease germs have not entered — 
will cure by what is known as first intention, or in other words, by nature. 
But if disease germs have entered the wound then, unless they be killed 
or driven out, complications will soon arise in the form of pus, decom- 
position, or gangrene and blood poisoning. Germs cannot enter the un- 
broken skin, but may enter where there has been the slightest cut or break- 
ing of the skin. Therefore all wounds where the skin has been cut or broken 
must be kept free from infection. A little scratch on the finger which is 
left untreated and unguarded, will place a person in greater danger of 
blood poisoning than the amputation of an arm or leg where surgically 
clean instruments and dressings have been used. In bathing cuts or 
wounds, however slight, the basin or bowl in or from which the part is to 
be bathed must be first thoroughly scalded with boiling water and then 
only water which has been previously boiled and kept free from germs 
used in bathing, and to this water should be added a small quantity of 
carbolic acid, creolin or other germicide. Where no germicide at hand 
a spoonful of salt is the best substitute. All bandages must be antiseptic 
or surgically clean. Antiseptic gauze bandages can now be so cheaply pur- 
chased at all drug stores that there should always be a good supply on 
hand,, but in their absence clean linen or cotton should be boiled, baked or 
soaked in an antiseptic solution before using. It is true that cuts and 
wounds are sometimes dressed with bandages that are not surgically clean, 
even with soiled handkerchiefs and dirty linen, and yet do not become in- 
fected, for even where disease germs exist they may be destroyed by the 
healthy cells and fluids of the blood and tissues, for these always endeavor 
to overcome the intruders, but there always exists grave danger that they 
may not be strong enough and that they may be themselves overcome 
by the disease germs even in the case of the previously most healthy per- 
son. Surgical cleanliness therefore cannot be too strongly insisted upon. 

The sick room patient who is the subject of wound, whether from 
surgical operation or otherwise requires not only all the care of ordinary 
nursing, but attention to the wound, the care of which should be studied 
in the chapters of this work relating especially thereto. Consult Index 
at the end of this book and read the articles there indicated. 



65 



1026 NURSING. 



THE CHILD PATIENT. 



In the chapter of this work especially devoted to the care of children 
there will be found full discussion of the ills of infancy and childhood and 
their treatment, but in the present chapter on the science of caring for 
the sick, it is well to draw attention to the fact that the child requires just 
as careful nursing as the adult and sometimes even greater care. The little 
child or infant cannot tell his wants, yet his needs are just as great as those 
of the grown man or woman. The little child in burning fever needs a 
cooling drink as well as the older patient. We have spoken of the need 
of rest and quiet for the fevered patient, yet how often it happens that no 
thought to quiet is given for the sick baby. Doors are slammed, people 
talk in loud voices and generally there is a carelessness as to the making 
of noise — yet if the baby face be watched, indication may be observed 
that show that the noise and tumult are causing pain. Especial care, too, 
should be given to the temperature of the room and to the covering of the 
child. It must be kept sufficiently warm, yet must not be unduly cov- 
ered. Heavy coverings over a little child may cause incalculable harm 
in different ways — such heavy covering as to prevent free movement of the 
limbs, for instance, may tend to cause deformity. Water bottles with 
properly heated water (not too hot) encased in slip covers, placed about 
the infant and then light covering over the child are more to purpose than 
heavy clothing, and there should be plenty of fresh air. Give all the 
care to a child that you would to a grown person and give especial thought 
to its needs, of which it cannot tell. 

THINGS TO BE AVOIDED. 

Undue Talking. — It is not well to indulge the patient in talking too 
much, and especially is this true of the night. The patient becomes excited 
and passes a restless night. Have it understood that the night is for rest, 
both with the patient and the household. If this be firmly adhered to it 
will redound to the good of both patient and nurse. 

Visitors.-^Jn the vast majority of cases visitors are detrimental to 
the patient's welfare. They mean well, but they almost always more or 
less excite the patient, whose greatest need is quiet and rest. A restless 
night is apt to follow with undue rise of temperature. There are some 
visitors who are exceptions and who have a soothing, calming effect, but 



THE SICK ROOM. 1027 

it is better to exclude all visitors than to run any chances in this regard, 
and under no circumstances should a number of different visitors be 
permitted. 

Too Many Flowers. — There is nothing more cheering in a sick room 
than a few pretty 'flowers, and there are very few patients who are unable 
to enjoy them, but unless great good sense be exercised by the nurse there 
is a danger of more harm than good. Lilies of the valley, violets, roses 
and almost all flowers have more or less heavy odor, which is apt to be- 
come nauseating. Flowers in a sick room should be confined to a few 
simple flowers kept in a vase within sight of the patient, but at some 
distance from him, the water in the vase should be fresh and no one 
set of flowers kept unduly long in the room. It is usually well to leave 
them but for a short time and then take them away, perhaps bringing 
them in again after a reasonable interval. When flowers are sent to a 
patient they should, when his condition permits, be taken to him for 
a brief time, and then removed. But it is often well to keep even knowl- 
edge of their receipt from the patient until he is convalescent, when the 
cards which accompanied the flowers may be shown and there will be real 
pleasure in knowing of the friends who had remembrance. 

Disturbing Influences — Keep the sick room quiet and restful. Keep 
out all news of exciting nature, business matters and everything which 
may disturb. Even trivial matters may cause anxiety or excitement. 

Unclean Articles. — Soiled linen, glasses or utensils of any kind must 
be immediately removed. Nothing but what is absolutely necessary is 
to remain in the sick room. 

Appearance of Being on Guard. — The nurse must ever be on guard — 
always watchful, yet avoid the appearance of it. A patient is apt to be- 
come nervous if he feels he is being constantly watched. It is well much 
of the time to place yourself where the patient cannot see you and knows 
you cannot see him, yet where you can hear the lowest call and where the 
slightest movement will attract you. 

Actions that May Worry. — The nerves of sick people are very sen- 
sitive. Singing, humming, rocking a chair, rattling a paper — a hundred 
and one little things if kept up for any length of time are apt to "get 
on the patient's nerves," and perhaps become almost unbearable, although 
he may try unmurmuringly to put up with them and by his very trying 
bring on exhaustion or other ill. All the actions of a nurse should be of 
a quieting and restful nature and all about the sick room should con- 
form to this idea. 



1028 NURSING. 

Impatience and 111 Temper. — The nurse's position is a very trying one 
at many times and requires the greatest patience. It may be almost im- 
possible at times to retain one's good temper, yet remember that the 
slightest exhibition of ill temper or impatience may have serious effect 
upon the patient's condition. Retain your dignity arid no matter what 
occurs be pleasant, sympathetic and resourceful, yet forceful and unswerv- 
ing in your duty, and through it all bring a love and kindness to bear that 
will bring contentment to your patient. That the patient both like and 
respect the nurse are important factors in his progress toward recovery. 

MASSAGE. 

Massage is a method of treating certain conditions by scientific 
manipulation of muscles, nerves and blood vessels by means of systematic 
rubbing. It is a study by itself and it requires much practice to become 
properly efficient. It has been the subject of much controversy and has 
been so abused by unscrupulous impostors that with many there has grown 
up a prejudice against it. Notwithstanding this, the best physicians of 
the world recognize it as of vast benefit to many patients, and so it is men- 
tioned in this article on nursing. But as it is a subject requiring special 
study and instruction, we would refer the nurse to a special chapter on 
this subject. When the physician advises massage for a sick room patient 
he generally advises the engagement of some one whom he names as pro- 
ficient in the art, or he may give instructions to the nurse as to the way 
to massage the particular part he desires should be so treated. Frequently 
trained nurses have given special study to massage and are capable of 
executing any orders the physician may give in such regard. 

DIET FOR THE SICK. 

Service of Food. — There should be a special set of dishes for the 
patient's exclusive use. In contagious diseases this is imperative. The 
daintier and more attractive these dishes can be the better. Sick people 
are very sensitive to little things and a coarse dish or one that is chipped 
or cracked may take away the relish of a meal. The tray should be cov- 
ever with a clean white traycloth, all linen should be immaculate, fresh 
napkins should be given at every meal if they show any soils, china must 
be spotless, glasses polished and silver shining. No dish should be so full 
that it may spill or slop over in carrying, moreover, the appearance of 



DIET FOE THE SICK. 1029 

much food often destroys appetite. Food that is intended to be hot 
should be served hot, and that which is intended to be cold should be 
served cold. Seasoning is an important detail. High seasoning is not 
to be recommended, but in so far as possible the likings of the patient 
should be considered. All food must be fresh. Great care must be taken 
in regard to such articles as eggs, if there is not the most absolute surety 
as to their freshness they must be opened before entering the sick room. 
Milk and cream must be sweet and should be tested before each serving. 
Do not serve any article about which there is one particle of doubt. Never 
taste foods in the sick room. That should be done outside and anything 
wrong corrected before the food comes to the patient. 

Selecting Foods. — One of the important matters connected with nurs- 
ing is the question of nourishment for the patient. While in most cases 
the physician will give directions in general as to the feeding, it will 
often devolve on the nurse to make selection for the patient of what she 
considers suitable, and not infrequently she will find it necessary to pre- 
pare the food herself. She must decide what combinations are appro- 
priate, and what variety must be introduced, and when the patient tires 
of one food she must exercise her ingenuity often to the utmost to find 
a substitute. Food which is suitable in the morning, or at noon, is often 
improper to give at night, and what will agree under some circumstances 
will manifestly, under other conditions, be wholly inadmissible. As a 
usual thing it is better not to consult the patient about what his meal is 
to be, for if he is asked what he would like he will in all probability say 
that he would rather have nothing, and if told beforehand what he is to 
have, even if he has been wanting it, he will be apt to lose his desire for it. 

The Patient Not to Judge. — Moreover a patient's inclinations are often 
not a safe guide, for he will be as likely as not to choose some article of 
diet altogether unsuitable. For instance, in convalescence from typhoid 
fever it is quite essential to exercise the utmost care in the matter of 
food for a considerable period of time, the ordinary diet being resumed 
only very gradually and tentatively, lest irritation and consequent relapse 
occur. But it is almost invariably the case that long before it would be 
permissible the patient has a strong desire for solid food, often of the 
kind which would not be proper, and an inordinate appetite, which, to 
gratify, would inevitably be detrimental. 

How the Nurse Should Judge. — Accordingly it is better to ascertain 
quietly and gradually the likes and dislikes of a patient, and what ordi- 



1030 NTTESING. 

narily agrees with him best, and with this knowledge to use one's judg- 
ment as to what to provide. 

There are certain articles of diet, however, which are pre-eminently 
suitable for the sick, some under one set of circumstances, some under 
another. Among these are: 

Milk. — The bland, unirritating nature of milk and the fact that it 
furnishes all the elements necessary to sustain life make it ordinarily a 
suitable article of diet for the sick, and unless contra-indicated it is quite 
usual to have it form the basis for the construction of a dietary, and for 
it to enter largely into the composition of the food selected. It is not 
infrequent indeed that it is used alone for many weeks at a time. 

Administration of Milk. — If the taste is objectionable to the patient 
it may be disguised by flavoring with coffee or caramel. By feeding 
through a tube or straw the action of the saliva is secured, and by giving 
it slowly the formation of large curds, impenetrable by the gastric juice, 
is prevented. To counteract the tendency to biliousness, which occurs in 
may people from its use, it is customary to add a small pinch oi bicar- 
bonate of soda, or from a third to a half of lime water, soda water, apolli- 
naris or vichy. At times it is more easily digested if boiled or scalded 
and diluted; in diarrhoea boiled milk often has a salutary effect. 

Steady Milk Diet. — An exclusive milk diet is often resorted to in cases 
of heart, kidney and stomach diseases, and under these circumstances it 
is generally first skimmed. Dr. Thomas G. Morton is accustomed to 
having it administered every hour and a half from 7 A. M. to 10 P. M., 
beginning with three ounces or six tablespoonfuls, and increasing the 
amount one-half ounce with each dose until from two to six quarts are 
taken daily. This diet is continued for a month or six weeks, when a few 
easily digested articles are allowed, and a suitable dietary is gradually 
constructed. On a milk diet the patient at first feels weak, and soon 
develops a disgust for the milk, but this is usually overcome before ai 
great while, and a desire is often established for a continuance of the milk 
even after convalescence. It is usually necessary to administer suitable 
laxatives to overcome the constipation which the milk causes. 

Whey. — This is a watery, somewhat turbid liquid resulting from the 
removal of the .curd of milk after coagulation. It contains a fair propor- 
tion of the nutritive constituents of the milk, which may be increased by 
expressing as much of the fluid from the curd as possible. Sometimes it 
is used as a vehicle for the administration of other nutriment, as beef 
juice, yolk of egg, etc. 



DIET FOR THE SICK. 1031 

Preparation of Whey — Whey may be prepared in several ways. To 
a pint of lukewarm whole milk is added a teaspoonful of essence of 
pepsin, or of liquid rennet, and stirred only long enough to mix.' After 
cooling and coagulation, the product is stirred with a fork, and the whey 
strained off. Or to a pint of boiling bilk add two teaspoonfuls of lemon 
juice and strain. Wine whey is made by bringing to the boiling point a 
pint of milk and adding two wineglassfuls of sherry wine. As it boils up 
again remove from the fire and strain. 

Junket. — Make the same as the first formula for whey, with essence 
of pepsin or liquid rennet, but do not stir. Eat with sugar and cream. 
If desired, flavor with a little nutmeg and extract of vanilla. Tablets are 
furnished in the stores for the sake of convenience for making junket. 

Buttermilk — Fresh buttermilk can be used in many cases where milk 
disagrees, largely because of the formation of finely subdivided curds. 

Koumiss. — For the same reason koumiss is often valuable under 
similar circumstances. Containing as it does carbonic acid gas it is grate- 
ful to the irritable stomach, while the small amount of alcohol present 
furnishes slight stimulation. To prepare it take an eighth of a cake of 
Fleishman's compressed yeast — fresh — and a tablespoonful of white sugar. 
Dissolve in a little warm water. Pour into a quart champagne bottle 
and fill to the base of the neck with fresh milk. Tie cork securely, lay 
on its side in a cool but not cold place for two or three days, shaking 
occasionally. If it is desired to hasten the process of fermentation, it 
may be kept for twelve hours at a temperature of about 70 degrees, 
although the slower method makes a smoother and pleasanter preparation. 
A champagne tap must be used to draw it off. Some prefer it when two 
days old, others when it is somewhat more acid in taste, at the age of three 
days. Kefyr and matzoon are similar to it. 

Peptonized Milk. — To a pint of lukewarm milk diluted with one- 
fourth its bulk of water add fifteen grains of bicarbonate of soda and five 
grains of Fairchild's Extract of Pancreas. Keep in a warm place for 
twenty minutes. Then place against the ice to check further peptoniza- 
tion. This milk is partially predigested and can often be taken when 
milk cannot. 

Sterilized Milk. — To sterilize milk without a special apparatus for the 
purpose it should be placed in infants' nursing bottles, which should be 
lightly corked with absorbent cotton. These should be placed in a kettle 
of cold water, with their bases kept from the bottom of the kettle by a 
folded towel or other contrivance. The water should be boiled for twenty 



1032 NURSING. 

minutes, the cotton removed and replaced by tightly-fitting corks and the 
bottles be allowed to cool gradually. Strictly speaking, milk thus pre- 
pared is "Pasteurized," the process of sterilization being simply a pro- 
longation of this, for about twice the length of time. Pasteurized milk is 
more easily digested than sterilized milk. Both are used for feeding in- 
valids and especially infants. 

Modified Milk — This is a combination of milk, cream, water, lime- 
water and sugar of milk in such proportions as the age and strength of the 
infant for which it is prescribed seem to indicate. A useful and con- 
venient way to employ this for home use is by means of the "materna" ap- 
paratus, which is a graduated glass presenting eight panels, each one being 
marked in such a way as to show how much of a particular constituent of 
the modified milk is to be used for a specified age. 

There are also combinations of milk with other articles which will be 
considered among the miscellaneous formulae given later on. 

Animal Broths. — These often form a suitable means of giving nourish- 
ment to the sick. Unless prepared with great care they do not contain 
the amount of nutrition for which they ordinarily receive credit, for if too 
high a heat is used the albuminous principles are coagulated and the 
virtues of the preparation decreased. 

Beef Essence — A piece of lean, juicy beef is minced and placed in a 
wide-mouthed jar, which is tightly corked and set in a kettle of cold water. 
This is then allowed to boil moderately for three or four hours, when the 
essence is expressed and seasoned. A tablespoonful may be given every 
two hours. - 

Beef Tea. — Cut in small pieces a pound of lean, juicy beef. Cover 
with cold water for an hour or more. Simmer gently for three hours at a 
temperature not above 160 degrees; strain and season. The finished 
product shoud measure one pint ; if less, sufficient water may be added to 
equal that amount. 

Beef Juice — Pieces of lean, juicy beef the size of a walnut are toasted 
for a moment over a hot fire and the juice expressed by means of a lemon 
squeezer or a specially-designed press. Season with salt and give a table- 
spoonful every two hours either warm or mixed with pounded ice. 

Scraped Beef. — Lean, raw meat is scraped fine and the pulp pressed 
through a coarse sieve. This may advantageously be added to the beef 
tea or beef essence. 

Mutton Broth. — Add two quarts of cold water to two pounds of lean 
mutton; boil very gently for two hours and season. A little barley or rice 



DIET FOR THE SICK. 1033 

may be added. The broth should be allowed to cool and all the fat 
skimmed off. 

Chicken Broth. — A chicken, or, if large, a half chicken, after being 
skinned and cut up, is boiled gently in a quart of water for an hour, sea- 
soned and strained through a colander. 

In cases where solid nourishment is permissible the following kinds of 
animal food are suitable : 

Beef Steak. — A piece of thick, lean sirloin or tenderloin steak should 
be broiled quickly over a clear coal fire, the exterior only being cooked, 
while the interior is kept rare and juicy. 

Lamb Chops. — Lean rib or loin chops are suitable. They should be 
broiled until well done. 

Chicken. — Tender chicken, carefully broiled, is a suitable food for 
the sick. 

Squab. — Young pigeon or squab, broiled, is considered a delicacy and 
is nutritious and appetizing. 

Sweet Breads. — In some cases these may be eaten and are highly ap- 
preciated. They should be parboiled and then carefully broiled, with a 
little butter rubbed over the surface. 

Oysters'. — When in season oysters taken raw are nourishing and easily 
digested. Cooked they are less digestible, though permissible in some 
cases. 

Oyster Broth. — Slowly simmer for ten minutes a pint of oysters in a 
half pint each of water and milk ; season to taste and strain. 

Clam Broth. — Equal quantities of clam juice and boiling water are 
seasoned with salt. Clam juice and clam broth are often retained in 
great irritability of the stomach. 

Eggs — Beaten light these are most digestible. One of the most 
frequent ways of giving them is in the form of eggnog. 

Eggnog. — The white and yolk of an egg are beaten separately, very 
light; they are now stirred together, sweetened and salted, and to these 
are added a small amount of brandy, sherry or port wine, a little nutmeg 
and an ounce of milk. 

Boiled Eggs — Cooked eggs should be soft, as the albumen or white is 
otherwise hard and indigestible. Boiled for three and a half minutes or 
less they are, however, suitable. It is still better to put them into boiling 
water, remove them from the stove and allow them to stand in the hot 
water for seven minutes. 

Powdered Yolk. — If eggs are boiled for an hour or more and cooled 



1034 NUBSING. 

the yolks may be mashed into powder, which, with a little salt, is agree- 
able, nourishing and digestible. It may be taken plain or mixed with 
milk, whey or broth. 

Egg Water. — In cases of extreme gastro-intestinal irritability the 
whites of two eggs stirred into a half pint of cold water, and sweetened or 
salted, may be given as a drink. 

Vegetable Sick Foods. — Pre-eminent among the vegetable forms of 
aliment are the cereals, which in recent years have been so largely popu- 
larized by the introduction of scores of palatable, nutritious and digestible 
preparations. Many of these are already cooked, while others are pre- 
digested as well, so that they require little time or trouble in serving. A 
judicious selection from among these affords variety in taste and com- 
position. 

Wheat Foods. — These take the lead in nitrogenous constituents, fol- 
lowed closely by rye, barley, oats and corn; oats, corn and barley are 
richest in fats ; rice contains chiefly starch ; while oats contain the greatest 
amount of indigestible cellulose. This, however, in the finer preparations 
is largely removed. Of the wheat preparations, the following may be 
mentioned, rolled, cracked, crushed and granulated wheat, called by many 
names, according to where or by whom it is prepared, vitos, wheat 
germs, germea, wheatlet, wheatena, cream of wheat, shredded wheat, and 
so forth. Gluten flour is supplied for the use of diabetics and those who 
cannot well take starch ; and farina, a material similar to cornstarch, for 
the use by itself or in combination with other substances. 

From the other cereals similar preparations to those made from 
wheat are manufactured. 

Following are the formulae for preparing some of the foods in com- 
mon use for the nourishment of the sick: 

Milk Toast. — Remove the crust from two small slices of baker's 
bread, a day or two old; toast carefully, and cover with a half pint of 
scalded milk previously salted. 

Boston Cream Toast. — Prepare as above, but thicken milk with a 
heaping teaspoonful of flour mixed with the same amount of butter ; these 
are to be carefully stirred into the hot milk and brought to boil. 

Toast Water. — Cover well toasted, not burned, bread, with boiling 
water; set aside till cool, strain and salt or sweeten to taste. 

Panada — Cover split crackers or slices of toast with boiling water, 
previously sprinkled with sugar, salt and, if desired, a little nutmeg. 
Simmer gently until tke product is like jelly. Serve while warm. 



DIET FOR THE SICK. 1035 

Flour Gruel. — Mix a tablespoonful of flour with enough milk to make 
a smooth paste; add a quart of boiling milk; boil for a half hour in a 
double boiler; salt. 

Flour Ball. — Make a ball of a pint of flour which has been moistened 
with four tablespoonfuls of water ; tie tightly in a cloth ; dampen the out- 
side of the cloth and sprinkle with flour ; boil hard for ten hours. Remove 
the cloth and dry the ball for ten hours in an oven. Grate two teaspoon- 
fuls of flour from the ball, mix into a paste with cold water and stir into a 
cup of boiling milk. 

Farina Gruel. — Stir two tablespoonfuls of farina into a quart of 
water; boil until thick; add a pint of milk, salt and boil fifteen minutes 
longer. Serve with sugar and cream. 

Arrow-Root Gruel. — Mix into a paste two teaspoonfuls of arrow-root 
with a little water ; stir into a pint of boiling water or milk. Sweeten and 
boil for three minutes. 

Oatmeal Gruel. — Boil two tablespoonfuls of oatmeal in a pint of water 
until smooth. Salt and strain. 

Wine Jelly. — Pour two ounces of cold water on one-half ounce of 
granulated gelatine, and six ounces of sugar. Soak for fifteen minutes 
and stir into ten ounces of boiling water until dissolved. Add four 
ounces of sherry wine, strain through a jelly bag or coarse toweling and 
cool. 

Iceland or Irish-Moss Jelly. — Thoroughly wash a handful of the moss 
and soak for one hour in a very little water. Stir into a quart of boiling 
water and simmer, until it is dissolved. Sweeten and flavor, strain and 
cool. Serve with cream. 

Flaxseed Tea. — Pour a quart of boiling water onto four tablespoonfuls 
of whole flaxseed and steep for three or four hours. The juice of two 
lemons may be added, and sugar if desired. 

Barley Water Wash two ounces of barley ; boil for live minutes and 

pour off the water. Add two quarts of water and boil down to a quart. 
Salt or sugar may be added. This is often employed to dilute milk. 

Puree of Celery. — Cut into small pieces enough of the stalks of celery 
to fill a pint measure. Stew in a quart of water until tender. Salt, thicken 
with a little arrow-root and add a cup of milk. Boil for two or three 
minutes, stirring constantly. 

Puree of Asparagus. — Proceed as for puree of celery, reserving the 
tips and discarding the stalks, after they are cooked. . 

Puree of Tapioca. — To a half pint of boiling water or milk, gradually 



1036 NURSING. 

stir in a tablespoonful of instanteous tapioca. Add salt, and boil, with 
constant stirring until it begins to thicken. 

Milk and Albumen. — Shake in a bottle for five minutes the whites of 
two eggs and two ounces of lime-water; add a pint of milk, sugar and 
sherry wine to taste, and shake five minutes more. Give a wineglassful 
every two hours. 

Cocoa. — Dissolve a teaspoonful of Phillip's Digestible Cocoa in a 
little cold milk. Add to this a coffee cupful of hot milk. 

Predigested Foods — Attention has already been directed to the pep- 
tonizing of milk; the same process may be applied to gruels made from 
oatmeal, or other cereals, and to beef tea, thus artificially digesting them 
before they are taken. Peptonized meat preparations have the disad- 
vantage of a disagreeable odor and taste, but they are highly nutritions. 

Extracts of Malt. — These are also employed in predigesting cereals, 
Maltine, diastoid, diastase and extract of malt are some of the prep- 
arations which may be used in this connection. One of the successful 
applications of modern pharmaceutical skill is that exhibited in the manu- 
facture of these artificially digested roods, many of which supply in con- 
centrated form ready for absorption and assimilation the most important 
elements of nutrition. 

PREVENTING THE SPREAD OF CONTAGIOUS DISEASES, 

Diphtheria, scarlet fever, measles, typhoid fever, typhus fever, yellow 
fever, chicken-pox, small-pox, syphilis, cholera, erysipelas and mumps are 
the diseases which are usually recognized as being contagious, or capable 
of being transmitted from one person to another, either directly or in- 
directly, and to these may be added consumption in the sense that the 
expectorations of the consumptive are permitted to dry and become dust, 
such dust may communicate consumption to those who inhale it. It would 
be well to include epidemic influenza or "the grippe" in the list. On 
the occurrence of any of these diseases special care should be taken to pre- 
vent their spread. Select a room at the top of the house that is capable 
of the most perfect ventilation. There should be no carpets and nothing 
but the simplest and absolutely essential furniture. The room should be 
thoroughly cleaned before the patient enters and once he is placed in the 
room jill others of the household excepting the nurse should be kept out. 
The nurse should have as little communication with the household as 
possible ; her meals and everything to supply her needs and those of the 



CONTAGIOUS DISEASES. 1037 

patient should be placed on a table outside the door. The door should 
be kept closed, and a sheet kept constantly wet with disinfectant should 
be hung over the doorway outside. 

Contagious Diseases, Disinfection of. — This is a matter of vital im- 
portance. When inefficiently done it is a source of great danger in that 
it gives a false sense of safety. The purpose of course is to destroy 
germs. While occupied by the patient the most efficacious disinfectants 
for the sick room are fresh air and scrupulous cleanliness. In the matter 
of infected articles, such things as scraps of food and everything else that 
it is not necessary to keep should be immediately burned, while other 
things should be thoroughly disinfected by boiling for one hour in water. 
The disinfection may be made more rapid by the addition of a little 
washing soda to the water. Articles which for any reason cannot be 
boiled, and which are not greasy, may be disinfected by soaking for an 
hour in a solution made by dissolving three ounces of pure (not crude) 
carbolic acid in a gallon of water. In removing Jbedclothing, under- 
clothing, handkerchiefs, etc., from the sick room they should be put in a 
soiled clothes bag, pillow case or sheet which has been previously soaked 
in the carbolic acid solution. Then without handling they should be 
dumped altogether into boiling water and boiled for an hour. They 
may then be washed in the ordinary way. Knives, forks, spoons and 
dishes should be washed with the carbolic solution and boiled half an 
hour. All discharges from the patient, including those from the mouth 
and nose, should either be destroyed by fire or subjected at once to the 
carbolic acid solution or other disinfectant. With consumptives, ex- 
pectoration should be made into pasteboard boxes, which must be burned 
before the expectorations become dry. Bedpans and like utensils should 
be washed with the carbolic solution, and some of it left in the utensil. 

Waterclosets, drains, cesspools, sewers, cellars, privies, yards and 
stables may be disinfected by a free use of chloride of lime, which should 
be used every day. 

The New York City Board of Health prescribes the following rules 
for disinfecting a room after removal of a patient who has had a con- 
tagious disease: 

"All cracks and crevices in room to be disinfected must be sealed 
or calked to prevent the escape of the gases and one of the following dis- 
infectants used for the room disinfection in the quantities named: 

"Sulphur, 4 pounds for every 1,000 cubic feet of air ; eight hours' 
exposure. 

i 



1038 NURSING. 

"Formalin, six ounces for every 1,000 cubic feet of air space; four 
hours' exposure. 

"Paraform, 1,000 grains for every 1,000 cubic feet of air space ; six 
hours' exposure. 

"The following disinfecting solutions may be used for goods which 
are afterward to be washed : 

"Carbolic acid, 2 to 5 per cent. 

"Bichloride of mercury, 1-1,000. (This, however, causes a per- 
manent discoloration.) 

"After disinfection of rooms, the carpets, rugs, mattresses, pillows, 
etc., must be removed by the Department for disinfection by steam, and 
the rooms should then be thoroughly aired and cleaned with soap and 
water." 

Sulphur and paraform candles may be purchased at any drug store. 

Blankets, bedding, clothes and other articles must be exposed to the 
fumes, and should be so hung as to be loose and free for circulation of the 
fumes. All closed doors, bureau drawers and the like must be open 
during fumigation. 

After disinfection the room should be most thoroughly cleared, wash- 
ing everything possible with hot soap and water or some standard dis- 
infectant, and this should be followed by repainting and repapering or 
whitewashing. 

CONVALESCENCE. 

The care of the convalescent comes within the knowledge which all 
nurses should have, and is so important that we here follow with a special 
chapter devoted to the subject. 

SPECIAL DIETS FOR THE SICK E00M. 

As this is matter of great importance a special chapter is devoted to 
the subject and immediately follows that on Convalescence. 



PART II OF BOOK VII 

Treats of the convalescent, giving diets and valu- 
able tonics and instructions about the care necessary 
for a speedy return to health. 



After Chronic Illness 1045 

Air, Change of 1055 

Arrangement of Room 1054 

Avoid Excitement 1056 

Baths 1051 

Blood, The 1056 

Blood Corpuscles 1046 

Books 1054 

Care During Convalescence 1043 

Chamber Arrangement 1054 

Change of Air and Scene 1055 

Chronic Cases, Recovery of 1045 

Chronic Illness, After 1045 

Circulation and Heart 1046 

Clothing 1051 

Complications of Convalescence ....1049 

Constipation 1054 

Convalescence 1043 

Care During 1043 

Causation of 1043 

Circulation in 1046 

Commencement of 1044 

Complications of 1049 

Definition of 1043 

Encouraging Signs in 1045 

Food of 1052 

Nourishment for 1052 

Of Old People 1048 

Pallor of 1046 

Protective Treatment 1050 

Sign of 1044 

Symptoms of 1044 

Termination by Crisis 1044 

Termination by Lysis 1044 

Treatment of 1050 

Copious Perspirations 1053 

Corpuscles 1046 

Red Blood 1046 



Crisis, Termination by 1044 

Diet 1053 

Progressive 1053 

Digestion 1047 

Disease, Overbalancing 1043 

Encouraging Signs 1045 

Excitement, Avoidance of 1056 

Exposure 1049 

Failure of Response 1043 

Feeding, Improper 1049 

First Walks 1055 

Flowers 1054 

Flushing and Pallor 1046 

Gradual Exercise 1049 

Hair and Skin 1047 

Heart and Circulation 1046 

Hunger 1045 

Hypophosphites 1056 

Importance of Obedience 1043 

Improper Feeding 1049 

Lysis, Termination by 1044 

Massage 1051 

Medical Treatment 1053 

Mental Powers 1048 

Disturbance in Childhood 1048 

Loss of, in Adults 1048 

Muscular Movement 1048 

Muscles 1048 

Need of Oxygen 1047 

Obedience, Importance of 1043 

Over-exertion 1049 

Overbalancing Disease 1043 

Oxygen, Need of 1047 

Pallor and Flushing 1046 

Patient, Surroundings of 1054 

Perspirations, Copious 1053 

Powers, Mental 1048 

Progressive Diet 1053 



66 



1041 



1042 



INDEX TO PART II OF BOOK VII. 



Recovery in Chronic Cases 1045 

Recuperative Force 1044 

Red Blood Corpuscles 1046 

Respiration 1046 

Response, Failure of 1043 

Scene, Change of 1055 

Sexual Powers 1047 

Signs, Encouraging 1045 

Signs of Convalescence 1044 



Skin and Hair 1047 

Sleep 1048 

Society 1055 

Surroundings of Patient 1054 

Symptoms of Convalescence 1044 

Urine 1047, 1053 

Ventilation 1051 

Visiting 1054 

Walks, First 1055 



THE SICK ROOM IN THE HOME 



PAET II. 
CARE DURING CONVALESCENCE. 

Definition. — The word convalescence is derived from the Latin con- 
valescere, meaning "to grow strong." It is the period of recovery after 
disease, the state midway between the final cessation of the disease and 
complete restoration to health. Although it is applicable to the periods 
of improvement in the course of chronic ailments, yet it is generally used 
in connection with the acute or self-limited diseases. 

Importance of Obedience. — Since convalescence is the termination to 
which proper treatment, nursing and strict obedience to all the instruc- 
tions contained thus far in this volume would naturally lead, except in 
cases of chronic, incurable diseases and old age, for which no cure has as 
yet been discovered, it may appropriately conclude the sections on pre- 
ventive and curative medicine — substantiating the 'prognosis, or the pre- 
dictions as previously set forth. 

CAUSE. 

Overbalancing Disease — When disease fastens itself upon the human 
organism the outcome or result depends entirely upon the resisting power 
of the different tissues and organs. If tolerance is maintained and the 
several functions are not arrested, the diseases will be overbalanced by the 
vitality and resisting power of the body. 

Failure of Response. — But if the different tissues and organs do not 
respond to the increased tax made upon them ; if they grow progressively 
weaker, the disease will constantly find additional means of spreading and 
ultimately the forces of the body are arrested and death ensues. 

The Causation. — The causation of convalescence is, therefore, the 
response of living tissue to injury, the rallying of the vital forces, which 
overpower the disease and its primary cause, whether it be due to the 
countless micro-organisms, to neglect, exposure, or the many unknown 
factors, 

(1043) 



1044 CARE DURING CONVALESCENCE. 

Sign of Convalescence. — Just how convalescence is established we do 
not know, just how or when the resistance first exerts itself is a mystery, 
yet that it is a fact is evident, for in some diseases convalescence can 
be noticed almost from the moment it begins. 

Termination by Lysis. — Iu certain diseases there is resolution by 
gradual subsidence, the fever growing less and less each day, until normal 
temperature is reached; while the strength increases and the faculties 
brighten. After the fever has entirely subsided the improvement is much 
faster and convalescence is rapid, although very often a long time is 
required to bring the patient back to his usual health. This is called 
termination by lysis. 

Termination by Crisis. — In other affections, as pneumonia, the turning 
point to health is pronounced and plainly evident. Very often the change 
can be noticed inside of a very few moments, and within twenty-four hours 
convalescence is established; recovery following rapidly. This is styled 
termination by crisis. 

Recuperative Force. — But in both cases the termination is due to the 
recuperative power being stronger and more vigorous than the cause of 
the disease — and it is therefore simply a question of the stronger over- 
coming the weaker. 

Recovery in Certain Diseases. — As will be seen further on, under the 
paragraphs dealing with the convalescence of the special affections, there 
are many diseases which run a certain, definite course, both as to length, 
severity and convalescence. In these diseases, one familiar with the 
science of medicine can form a very accurate opinion as to the initiation 
of recovery, and foretell with a fair degree of accuracy the duration of 
the convalescence. This information is gained by comparing the records 
and statistics of many thousands of cases, using the average as a basis and 
applying the particular patient's symptoms and conditions with it. 

SYMPTOMS OF CONVALESCENCE. 

Convalescence presents some very different characters according as 
it succeeds to acute or chronic affections — in the former case it is clearly 
defined and noticeable, even to a superficial observer. 

Its Commencement. — This is often marked by critical phenomena, and 
always by the cessation of local pain or general symptoms of the disease. 
To the patient himself it announces its welcome advent by a feeling of 
ease and comfort previously longed for in vain; whilst to the physician 



Symptoms of convalescence 1045 

it makes itself known by reliable characteristics — such as a natural and 
peaceful expression of the countenance, vivacity and clearness of the 
glance, susceptibility, and, as it were, curiosity of the senses, an agreeable 
change in the disposition, and a tendency to gayety, a prolonged and re- 
freshing sleep and a greater mobility of the circulation. 

The Encouraging Signs. — These do not all make their appearance 
simultaneously, but generally follow each other in groups at short inter- 
vals, often merging together. 

Almost always the first phenomena of returning health develop 
themselves amidst the fading evidences of illness, but occasionally we 
observe in individuals of vigorous constitution transitions from disease to 
convalescence occur with marvelous rapidity. 

Recovery in Chronic Cases. — In recovery from chronic maladies the 
physician is not often called upon to assist at such kaleidoscopic changes 
from disease to health. The functions of the organism do not re-establish 
themselves with the same promptitude, nor in the same almost simulta- 
neous manner. They become regulated, as it were, one by one, in con- 
sequence of careful and individual attention, and even when restored to 
their physiological type they are wanting for a long time in force and 
endurance. 

After Chronic Illness. — The loss of adipose is often not repaired until 
after months or even years of convalescence, and the countenance fre- 
quently retains for a great while the imprint of the sufferings which have 
been endured, while after the acute diseases, such as the fevers, the 
acquirement of flesh is usually rapid, often increasing the weight above 
the normal limit. 

Hunger. — If we consider the symptoms of convalescence a little 
more closely we will find that hunger is one of the first and most im- 
portant manifestations of returning health after an acute disease. The 
appetite for food is sharp, and renews itself after a very brief period; 
sometimes it is even voracious. 

Eating becomes in many cases the great, perhaps the sole, aim of the 
convalescent; and when he happens to be of an age when growth is not 
yet terminated, and when, consequently, assimilation is normally active, 
he is apt to seek the gratification of this voracity with arguments and 
supplications which render it very difficult for the physician or nurse to 
enforce a proper regulation of the diet. 

In military hospitals it is often necessary to resist the tears and most 



1046 CAEE DURING CONVALESCENCE. 

vehement prayers of convalescents in order to preserve them from dan- 
gerous and fatal consequences of their own excesses. 

Heart and Circulation. — As hunger is the demand on the part of the 
attenuated tissues for more nourishment, so is the strengthened circula- 
tion due to the need of the body for more oxygen and less carbonic acid 
gas. 

Circulation in Convalescence. — During convalescence the circulation 
presents a singular impressionability — the pulse is often slower than in 
health, falling sometimes as low as forty, or even thirty-five beats per 
minute ; but it is very excitable and is accelerated by the slightest cause. 
The simple act of changing the position or attitude will increase its rate 
greatly, while the approach of a stranger, especially the physician, the 
slightest worry or mental excitement, will at once increase the pulse rate. 

Pallor and Flushing — The increased mobility or the circulation gives 
rise to ultimate pallor and flushing of the face upon the slightest cause. 
A delicate softening of the skin and transient perspiration are also due 
to the easily-influenced circulation and the low muscular power. - 

The Pallor. — The pallor of convalescence arises, not by the empti- 
ness of the blood-vessels, as was formerly believed, but from the dimi- 
nution in the quantity of red blood corpuscles; in consequence of the 
prolonged abstinence from the proper amount of food or its malassimila- 
tion. 

Blood Corpuscles. — This diminution is determined by the ingenious 
hsematimeter of Hayem and ISTachet, by which the number of corpuscles 
in a given amount of blood are counted — from which it is easy to com- 
pute the percentage in the entire arterial system. A cubic millimeter of 
normal blood contains about five million red blood corpuscles, yet in con- 
valescence we often find as low as two million corpuscles in the same 
quantity. 

Red Blood Corpuscles. — These are the carriers of oxygen to the dif- 
ferent organs and tissues of the body; consequently when we find the 
carrying power so greatly diminished we can readily understand the many 
symptoms of an impoverished circulation. One of the best examples seen 
of this is in the excessive sensitiveness to cold due to lessened oxidation. 
Again we find vertigo and dizziness due to anemia or imperfect blood 
supply of the brain, and palpitation of the heart. 

Respiration is not affected during repose and quietude, but slight 
muscular effort causes fatigue and shortness of breath; this is especially 



Symptoms of convalescence. 1047 

noticeable after ascending a short staircase, and is caused by impoverished 
blood, together with some slight febrile action. 

Need of Oxygen — For as muscular activity is destructive to the body 
it is necessary that carbonic acid gas (C 2 ), the product of such de- 
struction, be carried away, and that oxygen be returned to the tissues iu 
order that they may recover from the loss. The convalescent's blood is 
not as able to perfectly carry out this function as the blood of a healthy 
individual, hence the lungs are required to put forth extra respiratory 
efforts, and shortness of breath results. 

Digestion. — Constipation is the rule rather than the exception in con- 
valescence, and is due to the enforced quietude, the diminished secretions 
from fever, the febrile reaction and the lessened food supply. The tongue 
which has been coated, or hard and baked, as the case may be, gradually 
clears off becoming soft and moist as the bowels are regulated. And 
disturbance of the stomach, as nausea and vomiting, discomfort after- 
eating, and so forth, ceases under proper diet, and the extreme thirst 
disappears. The digestive symptoms will be mentioned more fully fur- 
ther on, under the special diseases. 

Urine. — The urine during convalescence becomes more abundant 
(usually from forty to fifty ounces in twenty-four hours) and less fully 
charged with uric acid than in health. It ceases to present the dense, 
high-colored and strongly odorous character met with in disease, and if it 
has contained albumen or sugar this will disappear, unless the acute dis- 
ease has developed into a chronic one. 

If, during the course of the disease, there has been an involuntary 
voidance of the urine, the desire to urinate frequently and the inability 
to perfectly control the urine will be felt for some time during con- 
valescence. This, however, will return to normal as the patient regains 
health and strength. 

Sexual Powers. — In females the menstrual discharges are re-estab- 
lished during convalescence, and in many cases the genital organs show 
marked activity — married women becoming pregnant soon after conva- 
lescence. In the male convalescing from acute diseases, there is generally 
an energetic stimulation of the sexual functions. After convalescence 
from chronic diseases, middle-aged patients frequently suffer a loss of 
sexual appetite and emotions.. Cases of sexual weakness, discharges, and 
so forth, following acute diseases, are generally transient and leave no 
untoward effects. 

Skin and Hair The outer layer of the skin, or the epidermis, the 



1048 CARE DURING CONVALESCENCE. 

hair and the eyebrows, are frequently shed during convalescence ; but this 
loss is as a rule only temporary. 

Muscles. — The muscles after sickness are more or less emaciated and 
flabby; this varies greatly after different diseases; some acute diseases 
causing a very rapid loss of flesh, while others are more like chronic ail- 
ments, in that the emaciation is slow and progressive. The muscles 
of the abdomen are usually soft and flabby, while the long muscles of 
the legs and arms lose their firmness and are easily separated one from 
another. The muscular tissue of the several organs are also affected, 
being unfiltrated with fat, decidedly inactive and subject to tissue change. 

Muscular Movement — Muscular movement, for a long time, fails in 
that energy and precision which marks a state of complete health, and 
all the organs display an inability to react against, or to withstand, any of 
the innumerable outside influences with which mankind is surrounded, as 
they would normally do. 

Sleep. — The sleep of convalescence is sound and refreshing, losing 
the disturbed character which it had during illness and becoming calm 
and tranquil. As there is perfect rest, both physically and mentally, dur- 
ing normal slumber, the convalescent should be allowed a large portion 
of the day in which to sleep undisturbed. 

Mental Powers. — The mental powers, both of perception and reason- 
ing, gradually return during convalescence, but for a long time patients 
have little endurance, becoming easily fatigued and exhausted after mental 
exercise. After a severe, acute malady, such as typhoid fever, the in- 
tellectual faculties are often very slow in returning to their original 
integrity, and months or even years may elapse before the patient en- 
joys his full mental vigor. 

Mental Disturbance in Childhood. — In certain acute diseases peculiar 
to childhood, such as scarlet fever, meningitis and diphtheria, there is often 
mental disturbance, and while it takes a long time before the mind re- 
covers its normal state, yet in such cases the outlook is generally favor- 
able. 

Loss of Mental Power in Adults. — In adult patients who are con- 
valescing from nervous disorders, the loss of mental power is serious, and 
the full vigor of the mind is seldom acquired. 

Convalescence of Old People. — In elderly people, a convalescence often 
hastens the physiological loss of mental power — the loss being especially 
appreciable to themselves and their associates, inasmuch, as it is sudden, 
instead of coming on gradually with each succeeding year. 



COMPLICATIONS OF CONVALESCENCE. 1049 

COMPLICATIONS OF CONVALESCENCE. 

How frequently we hear that a certain patient has "had a relapse." 
Yet in the majority of cases, such a relapse is due to some neglect or 
carelessness; and to impress upon the reader the danger of complication 
during convalescence, we take up a few of the most common points in 
connection with it. First, we will consider the causes which can be 
averted in most instances. They are improper feeding, exposure, over- 
exertion. 

Improper Feeding — If the desire for food returns slowly and is ca- 
pricious in its' choice for articles for diet; if the patient is quickly dis- 
gusted and wishes to change his bill of fare daily; if, in eating, he does 
not experience the pleasure which accompanies the satisfaction of a real 
want of the organism, and if, during digestion, acid eructations, flatu- 
lence, flushing of the face and distinct febrile movement occur, con- 
valescence is not yet sufficiently advanced to permit gratification of the 
appetite and diarrhoea is apt to supervene on such indulgence. Should 
it do so, whatever progress toward health has been made by the organism 
is often more than obliterated. 

The Complications which must be watched for in connection with 
the diet are, diarrhoea, vomiting or nausea, acid eructations, belching of 
wind, flushing of the face and fever. When any one of these symptoms 
are noticed, look to the food and see if a reason cannot be found. 

Exposure due to cold draughts, cold moist air, an over-heated or ill- 
ventilated room, poor sanitary conditions, may complicate the disease. 
A patient convalescing from typhoid fever may contract bronchitis or 
pneumonia from atmospheric exposure, and in his weakened condition the 
result is to be feared. A pneumonia may be complicated by typhoid fever 
due to defective sanitation, filthy bed-linen or sick-room vessels. These 
are most important details which must not be overlooked, as proper at- 
tendance to hygiene and dietetics is the sheet-anchor during convalescence. 

Over-Exertion. — A heart weakened by disease is not calculated to 
withstand the sudden demands made upon it by severe exercise. An 
intestine just healing after ulceration is not prepared to undergo the 
straining efforts made at stools while in the erect posture. 

Gradual Exercise. — Consequently in allowing a convalescent to exer- 
cise it must always be remembered just how weak all the organs are, espe- 
cially the one which has been the main seat of disease. It is better to 
keep a patient quiet in bed, in spite of his protestations, than to allow him 



1050 CARE DURING CONVALESCENCE. 

to over-exert. Moderate exercise, gradually increased, will be just as 
acceptable, and the termination is certainly more certain by success. The 
length of time that a patient must be kept in bed after sickness varies with 
the disease, its length and intensity. But generally speaking, a patient 
should not be allowed to get up until the fever and all other symptoms have 
been absent for at least ten days, and then the periods of exercise should be 
gradually increased as strength is regained. 

Complications in Convalescence — Certain diseases have a particular 
disposition toward complication during the convalescent period- — while 
such conditions cannot always be prevented, they can at least be expected 
and preparation made to combat them. In the convalescence of diph- 
theria, for instance, one must constantly be watchful of any nervous symp- 
toms which may arise; paralysis of different portions of the body, espe- 
cially of the heart, is a very common complication and should be treated 
energetically. Scarlet fever is often complicated by acute Bright's disease, 
heart affections and disease of the middle ear. Pneumonia or influenza 
may insidiously lead into consumption, unnoticed, except for ' constant 
watchfulness. In fact, during convalescence, the patient should be kept 
under the closest supervision; the smallest details must be noticed and 
acted upon immediately. By so doing many secondary diseases, both 
chronic and acute, may be aborted in their infancy. 

TREATMENT OF CONVALESCENCE. 

When a malady is terminated, sanitary science, which had previously 
labored in conjunction with therapeutics to extinguish the morbid ten- 
dency, resumes sole charge of the patient and directs the convalescence, 
during which the individual, although no longer sick, is not yet in a state 
of perfect health. In convalescence the functions, although brought to an 
equilibrium, are still wanting in energy and in stability; the entire 
organism, more or less shaken by the attacks to which it has been sub- 
jected, re-establishes slowly, and, as it were, step by step, in its connections 
and its reactions with the external world. 

Hygiene being the pre-eminently powerful agent in the management 
of convalescence the following sanitary rules are worthy of particular 
attention. 

Protective Treatment. — The convalescent should be protected with 
special care against variations in temperature, from the baneful influence 
pf cold air, of currents of air and from the effects of moisture. In the 



Complications of convalescence. 1051 

Condition of his system he is particularly apt to be affected by these agents, 
which may readily bring on a relapse, or some more or less serious com- 
plication. 

Ventilation. — What has just been said does not mean that the patient 
is to be denied plenty of pure air; for as we have shown in preceding 
paragraphs, oxygen is as much a necessity to the human economy as is 
food. A patient should be allowed at least 1,500 cubic feet of air space 
and the air should be changed once in every two hours. To do this re- 
quires some ingenuity if the sick room is not supplied with special ventilat- 
ing apparatus — for the first air should be warm and dry. 

A Simple and Effective Method — This is to admit the fresh, outside 
air into an adjoining hallway or room which can be heated. From this 
room the warm, fresh air may pass into the sick-chamber through an open 
door or window ; the patient's bed being so placed as to be out of any direct 
draught or current of air. 

Clothing. — In order to secure immunity from atmospheric exposure 
it is necessary that warm clothing should be worn — thicker and warmer 
than the clothing usually worn at the corresponding season of the year. 
Wool or silk under-garments are by far the best as they radiate the body 
heat and moisture gradually and are less apt to cause a feeling of chilliness 
after perspiration. If the weather is very warm, light-weight wool gar- 
ments can be procured, which will be but little warmer than cotton or 
linen and at the same time preserve uniform body temperature. 

Baths should be indulged in only near the end of convalescence, when 
health appears to be almost fully established. They should be very short 
and taken at least a half an hour before and two hours after a meal. It 
is well to employ those of a stimulating character, such as salt baths, bran 
baths, baths containing alcohol or whiskey, and so forth. Great pre- 
cautions should be observed against the slightest exposure to draughts 
of air for some time after coming out of the water. After bathing the 
body should be well dried with rough bath-towels, rubbing the skin vigor- 
ously enough to bring a healthy glow to the surface. During conval- 
escence from diseases of the respiratory apparatus baths should be strictly 
forbidden. (The previous remarks do not apply to baths administered 
during the active period of the disease, for the purpose of reducing fever, 
cleanliness, and so forth.) 

Massage is beneficial in most cases of convalescence after they become 
strong enough to withstand the somewhat vigorous manipulations. The 
motions of massage differ in character; beginning with firm stroking with 



1052 CAKE DUBINO CONVALESCENCE. 

the palms of both hands they gradually change to a kneading motion, and 
end with percussion or a rapid tapping of the muscles. 

Massage is generally practiced upon the bared skin, using enough 
fresh cocoanut oil to enable the operators hand to glide easily over it 
and render the skin soft and pliable. The object is to bring fresh blood to 
the muscles and stimulate the tissues to greater activity, and consequently 
is of great value in convalescing cases in which the muscles are soft and 
flabby and the circulation sluggish. 

Food of Convalescence. — The diet must be carefully regulated and the 
following rules rigidly adhered to: In the first place, proportion the 
amount and character of the nourishment, not to the hunger of the 
patient, but to the digestive power of his stomach. Instruct him to eat 
often and but little at a time, to chew the food very thoroughly, not only 
to secure its reduction to small particles, but also its complete admixture 
with the salivary fluids. And lastly, to choose those articles of diet which 
are adapted to the comparative feebleness and sensitiveness of the di- 
gestive organs and as far as possible, also, those which gratify the taste of 
the individual. 

Generous Nourishment. — We must guard, however, against a dispo- 
sition to restrain the patient too much in regard to nourishment, through 
an exaggerated fear of the effects which it may produce. It is essential 
to take into consideration the degree of appetite and the sensations which 
the convalescent experiences during the process of digestion. Also to 
consider how his illness has effected the several digestive organs, for, of 
course, the kind and quantity of nourishment must vary with the nature 
and duration of the illness from which recovery is taking place. 

Examples. — For instance, a patient who is convalescing from typhoid 
fever, which has its seat in the intestine, should not be allowed to eat 
plentifully of foods which receive a large part of their digestion in that 
organ, as fats, starches, and so forth. Xor should a patient who has had 
a congested liver partake of fatty food to any great extent — simply 
because bile is required to digest fats and the disease has to do with a 
lessened supply of bile. 

The Patient Must Diet — Stimulating food given to an intensely 
nervous patient would only aggravate the condition, while a routine diet, 
without change or character, would be torture to one recovering from a 
long, chronic illness. 

In other words the diet must suit the patient, not the patient the 
diet. There are many cases in which physicians and nurses gain more 



COMPLICATIONS OF CONVALESCENCE 1053 

credit with a patient and his friends by a very minute attention to the diet 
during convalescence than by the most skillful treatment of the disease 
throughout its course. 

Diet. — As a general rule a patient may begin with weak chicken or 
mutton broth, free from fat, and boiled rice, which probably represent the 
two great classes of nitrogenied and amylaceous articles of food in their 
most easily assimilated form. Experiments have shown that rice is di- 
gested in less time than any other substance of the kind, only requiring 
one hour. The rice may be substituted by tapioca, sago, or cornstarch, 
made with milk, if these are more palatable, according to the directions 
on a previous page. 

Progressive Diet. — After from two to iour days, if improvement con- 
tinues, administer stronger soups, eggs very slightly boiled, calf's-foot 
jelly, rice-pudding and toasted bread, or stale bread with very little butter. 
In the course of a week the patient may proceed to a mealy roasted white 
potato, a tender mutton chop, or tender loin of beef, and light bread not 
less than twelve hours old, with sweet butter in moderate quantity. 

It is much better and saves time for the invalid to go up the inclined 
plane of diet (never to ascend this hill of difficulty by jumps) a little 
slower than is absolutely necessary, than to advance too rapidly and 
bring on a relapse. 

A Correct Guide. — The surest guide is the condition of the tongue; 
should that unruly member have cleaned off, as it usually does when 
full, frank convalescence sets in, go on carefully and cautiously up the list 
given above to stronger and more nutritious articles of diet. But should 
the tongue put on a coat of fur again, remember it is a sign of repugnance 
to such rich food as it has to help to swallow, and quickly taking the hint, 
put the patient back on liquid diet for a few days longer. 

Medical Treatment — During convalescence the secretions and excre- 
tions must be carefully watched over and any excess or insufficiency be 
corrected as soon as practicable. The patient should be encouraged to 
drink a great deal of water (between meals, and not at meals — this also, 
applies to the healthy individual) for water is an absolute necessity to the 
secretions, which if right will bring health much closer to hand. 

Copious Perspirations, which are very apt to occur from simple relaxa- 
tion of the tissues and integument, may be checked by six or eight grains 
of quinine, or by one-hundredth of a grain of atropia, or by sponging with 
a solution of alum and whiskey before retiring. 

The Urine If the urine is rather scanty the patient should drink 



1054 CARE DURING CONVALESCENCE. 

freely of water, or of some bland fluid, such as flaxseed tea, toast-water 
or gum-arabic water. 

Constipation. — Constipation should be overcome by injections, or by 
tonic laxatives, such as rhubarb, in doses of five or ten grains daily. If 
convalescence is protracted and the patient does not regain strength as 
fast as should be expected a tonic containing iron and strychnia is in- 
dicated. 

Surroundings of the Patient. — Those who have suffered from a pro- 
tracted illness will remember how monotonous it became to lie in bed with 
your vision limited to one side of the room, or to a narrow strip of sky or 
landscape which could be seen through some particular window. You 
soon learned every detail of the room and its furniture ; even the figures 
on the wall-paper took on grotesque forms and seemed perfectly hateful 
to you. 

Chamber Arrangement — Consequently the furnishing of the sick- 
chamber, the arrangement of the bed gives us another topic in connection 
with the treatment of convalescence. While the sick-room should have 
as little furniture in it as possible (especially if the disease be contagious 
or infectious), yet what there is should be arranged with a view to cheer- 
fulness and brightness. 

Flowers. — Flowers or potted plants, brought in from time to time, 
give the patient a change and brightens him up. If possible the position 
of the bed should be changed from one part of the room to another so 
as to give the enforced occupant a new field of vision, especially if it be 
so that he can look out of a window. All these little details make sickness 
more bearable; taking away the gloomy thought goes a very long way 
toward establishing a speedy convalescence. 

Visiting. — During the tedious convalescence which we often watch 
so anxiously after prolonged chronic diseases, or after relapses from more 
acute attacks, visits are capable of accomplishing great good if properly 
managed. Every care should be taken not to depress a patient who is 
slowly recovering, by allusions to unfavorable terminations in cases sim- 
ilar to his own. A sick person does so enjoy hearing good news ; for in- 
stance, of a love and courtship which has a happy ending. Sick persons 
also intensely enjoy hearing of any material good, such as a positive or 
practical success of the right in their own neighborhood or country, or, 
indeed, in any part of the world. 

Books. — They have generally a surfeit of books, principles, precepts 
and theories ; so, instead of advising them about their convalescence, with 



COMPLICATIONS OF CONVALESCENCE. 1055 

advice which they have heard at least fifty times before, tell them of one 
benevolent act which has really succeeded practically — it will be like a 
day's health to them. It is hard for people to understand how intense 
is the craving of invalids, who, with reanimated powers of thinking, are 
still cut off from active participation in the world's work and progress, to 
hear of good, practical action even when they cannot yet partake of it. 

Society. — In many instances there is no better society for a convales- 
cent than that of babies, or of other invalids who are also convalescent; 
but, of course, this association must be carefully managed so that neither 
party will suffer from it, which is perfectly feasible as a rule. If you think 
the air of a sick-room is bad for an infant, of course it is injurious to the 
invalid also; and efforts should be made to remedy the aerial impurity 
without a moment's delay. It enlivens a sick person's whole mental at- 
mosphere to see "the baby," and a very young child, if unspoiled, will 
generally adapt itself wonderfully to the ways of a sick person if the time 
they spend together is not too long. A small pet animal is often an ex- 
cellent companion for a convalescent patient, especially if confinement 
to the house in consequence of unfavorable weather or complications of 
the original disease setting in, is unusually prolonged. A pet bird in a 
cage has sometimes proved the only pleasure, or, indeed, solace of an 
invalid shut up in the same room for weeks, or even months. If such 
a pet can be fed, cleaned and taken care of in every way, and perhaps 
taught some of the little tricks which birds, squirrels and even mice are 
capable of learning, and which prove such a source of pride to the trainer 
and entertainment to visitors, the patient should by all means be en- 
couraged to undertake the task. By such devices many a weary hour has 
been whiled away, and the sick-chamber of lingering convalescence shorn 
of half its almost intolerable weariness. 

First Walks — The first walks or rides should receive special attention, 
the convalescent being warmly clothed, a warm sunshiny day being 
selected, in accordance with the rules given under meteorology, and the 
exposure being at first for only fifteen minutes, or half an hour at the 
furthest. 

Change of Air and Scene After the invalid is strong enough to leave 

the house complete change of air and scene is one of the most poteut con- 
tributors to an entire restoration to health. The patient, who lias re- 
mained for three weeks in nearly the same state, growing neither better 
nor worse, will often wonderfully improve after a few days spent in the 
country or at the seashore. If the period of sickness has been passed in 



1056 CAEE DURING CONVALESCENCE. 

a room where the only view was of the backs of houses or the fronts of 
those forming the opposite side of the street, how grateful and invigorating 
is the sight of green fields, shady groves and sparkling streams at some 
sylvan retreat. By the ocean, too, vitalizing sea breezes frequently exert 
an almost magical power over a frame enfeebled by disease and restore 
to the languid convalescent his wonted vigor with astonishing rapidity. 

Avoid Excitement. — Lastly, try to secure the patient against any 
intense mental emotion or intellectual excitement, which will be almost 
sure to react with unfavorable effect upon his enfeebled physical powers. 

Reconstructive Remedies. — These must be administered in a form 
ready to be taken up by the assimilative functions and transferred to the 
wasted tissues. Chemistry teaches us the exact nature of the elements 
destroyed by disease, and thus gives the clue to rational scientific treat- 
ment. There is need of food structure for muscle, blood, nerve, bone and 
the numerous other tissues. The need is a complex one, and the remedy 
must be, likewise, complex in its chemical nature. It is true that all the 
elements of the tissues have been wasted ; but there is one element which, 
because of its vital importance and wide distribution throughout the econ- 
omy, must be specially provided for — this element is phosphorus. 

A Question. — The question naturally arises : Is it possible to obtain a 
remedy that will meet all the requirements for checking the ravages of 
disease and replacing the structures wasted by the pathologic processes, 
i. e. y for checking destructive metabolism and fostering constructive meta- 
bolism ? 

The Blood. — It is self-evident that before a patient can reach con- 
valescence the germ or virus causing the disease must be removed from the 
system. How shall we combat these germs % We cannot rely on steriliza- 
tion. Happily we have discovered that normal, healthy blood is antago- 
nistic to germ life, while impoverished blood furnishes a favorable nidus 
for their development. 

Hypophosphites. — Experience has demonstrated that the remedy that 
fulfills all the indications for treatment is the Compound Syrup of Hypo- 
phosphites. 

This remedy is based upon the broad philosophic basis of the exact 
needs of the system in diseases characterized by waste of tissue and loss 
of nervous force. 

It should be used in teaspoonful doses, given in a wineglass of water 
before each meal and at bedtime. 



PART III OF BOOK VII 



Treats of Diet in its relation to diseases, giving 
special diets for nearly fifty diseases. 



Acute Diseases, Diet in 1059 

Administration of Broths 1060 

Asthma 1063 

Beneficial Diet in 1063 

Detrimental Diet in 1063 

Beef Tea 1060 

Blood Vessels, Diseases of 1073 

Bright's Disease 1063 

Beneficial Diet in 1063 

Detrimental Diet in 1063 

Broths 1060 

Administration of 1060 

Catarrh, Contagious 1076 

Diet in 1076 

Cerebro- Spinal Fever 1069 

Cerebro-Spinal Typhus 1069 

Chronic Gastritis 1074 

Consumption 1079 

Beneficial Diet in 1079 

Detrimental Diet in 1079 

Congestive Fever 1070 

Constipation 1064 

, Beneficial Diet in 1064 

Detrimental Diet in 1064 

Contagious Catarrh 1076 

Convalescence, Diet in 1061 

Debility 1065 

Beneficial Diet in 1065 

Detrimental Diet in 1065 

Diabetes 1065 

Beneficial Diet in 1066 

Detrimental Diet in 1066 

Diarrhoea 1067 

Beneficial Diet in 1067 

Detrimental Diet in 1067 

Diet in Acute Diseases 1059 

Diets 1061 

Convalescence 1061 

Extra 1062 

Full 1062 

67 105 



Increase of 1061 

Low 1062 

Middle 1062 

Ordinary 1062 

Diphtheria 1066 

Difficulty of Nutrition in 1066 

Milk Diet Required 1066 

Proper Diet 1066 

Stimulants 1067 

Dysentery 1068 

Dyspepsia 1068 

Beneficial Diet in 1068 

Detrimental Diet in 1068 

Eggs 1060 

Enema, Feeding by 1061 

Feeding by Enema 1061 

Fevers 1069 

Benefical Diet in 1069 

Detrimental Diet in 1069 

Foods, Liquid Meat 1060 

Fresh Meat Juices 1060 

Full Diet 1062 

Gastric Indigestion 1074 

Beneficial Diet in 1074 

Detrimental Diet in 1074 

Gout 1072 

Beneficial Diet in 1072 

Detrimental Diet in 1072 

Heart, Diseases of 1073 

Beneficial Diet in 1073 

Detrimental Diet in 1073 

Impotency 1073 

Beneficial Diet in 1073 

Detrimental Diet in 1073 

Indigestion, Gastric 1074 

Indigestion, Intestinal 1076 

Influenza 1076 

Diet in 1076 

Intestinal Indigestion 1076 

La Grippe 1076 



1058 



INDEX TO PART III OF BOOK VII. 



La Grippe, Diet in 1076 

Liquid Meat Foods 1060 

Liquid Peptonoids 1060 

Liver Trouble 1077 

Beneficial Diet in 1077 

Detrimental Diet in 1077 

Low Diet 1062 

Malignant Quinsy 1066 

Measles 1078 

Meningitis 1069 

Middle Diet 1062 

Nervous Affections 1078 

Nourish the Patient 1059 

Obesity 1078 

Beneficial Diet in 1078 

Detrimental Diet in 1078 

Ordinary Diet 1062 

Pernicious Fever 1070 

Pernicious Malarial Fever 1070 

Phthisis 1079 

Beneficial Diet in 1079 

Detrimental Diet in 1079 



Pneumonia 1081 

Diet in 1081 

Pregnancy 1080 

Beneficial Diet in 1080 

Detrimental Diet in 1080 

Preparation of Broths 1060 

Putrid Sore Throat 1066 

Rheumatism 1081 

Beneficial Diet in 1081 

Detrimental Diet in 1081 

Rickets 1081 

Diet in 1081 

Scarlet Fever 1070 

Soup and Broth 1060 

Spotted Fever 1069 

Stimulants 1061 

Typhoid Fever 1070 

Beneficial Diet in 1071 

Detrimental Diet in 1071 

Uric Acid Diathesis 1082 

Beneficial Diet in 1082 

Detrimental Diet in 1082 



THE SICK ROOM IN THE HOME 



PART III. 



SPECIAL DIETS FOR VARIOUS DISEASES. 

Mankind, whether well or ill, must eat to live. We must have food. 
But some foods are more nutritious than others, — some foods are good 
for one person and had for another. It is important therefore for all 
people at all times to have careful regard to diet, hut it is especially so in 
the case of those who are ill, for not only may certain things he taken 
with impunity when one is well, that would he injurious in illness, hut 
different diseases need different diets, and oftentimes a diet that would 
he beneficial to a patient with one disease would prove dangerous, perhaps 
fatal, to the sufferer from some other disease. 

Diet in Acute Diseases. — The proper diet in acute diseases varies some- 
what according to the individual affection, hut is subject to general 
principles which are sufficient guides for most cases. 

When Food is Not Needed. — In acute febrile diseases which have a 
very short duration, from one to three days, it is not necessary that the 
patient take food, as his vitality is strong enough to tide him over. Again, 
during the first day or two of pneumonia, scarlet fever, or similar affec- 
tions, there need be no alarm even if the patient take no food, as his 
strength is sufficient, and often he has absolutely no inclination for food. 

When Food is Needed — But after the fever has been prolonged more 
than one or two days, then, it becomes necessary to nourish the patient, 
even though it be against his will, for the tendency to fatal results in all 
such cases is through exhaustion, and much can be done toward preventing 
a failure of the vital power by proper feeding. 

NOURISH THE PATIENT; DON'T STARVE A FEVER. 

Food in Fevers. — The older writers upon dietetics taught that a fever 
patient was not to be fed, and some modern authors still follow the old 
teaching. However, fever is not a contra-indication to food — to be sure, 
if the stomach is overloaded with coarse food it will only augment the 

1059 



1060 SPECIAL DIETS FOR VARIOUS DISEASES. 

condition, but if proper care is taken in selecting a diet there will be few 
bad results and many good ones. 

LIQUID MEAT FOODS. 

Fresh Meat Juices. — This is the most nutritious of this class, but as a 
rule it is not taken well by the average patient, owing to its insipid flavor. 
It may be added to the patient's milk, or used in making broth, about a 
tablespoonful being given at a time. Beef juice is made by cutting prime, 
lean beef into small pieces and pressing until all the juice is extracted from 
the meat. A little salt added to fresh beef juice makes it more palatable. 

Beef Tea has an undeserved reputation, for it has but little nourish- 
ing property, and to have any effect it must be given in large quantities. 
It is, however, slightly stimulating. 

Liquid Peptonoids are by far the best prepared meat food in typhoid 
fever, containing as they do the active and nourishing principles of beef, 
they are especially adapted to the conditions found in typhoid fever. This 
preparation of beef is manufactured by all reputable pharmaceutical firms, 
and can be procured from any drug store. It should be given in milk, or 
alternated with it, every two or three hours, a teaspoonful to a table- 
spoonful constituting the usual dose. 

Soup and Broth resemble beef tea, in that they contain the extractives 
of meat, but they also contain nutritive substances, but vary greatly 
according to preparation, the lighter forms of soup being spoken of as 
broth. 

Preparation of Broths. — To prepare broth, use young chicken, lean, 
fresh beef, or mutton, without fat, allowing the meat to boil slowly for 
four or five hours (until it falls to pieces), strain, cool and skim off what 
little fat appears. This liquid may then be seasoned and diluted to the 
strength required by the patient. 

Administration of Broths. — As broths are stimulating as well as 
nutritious, they should not be administered to a typhoid patient until the 
third or fourth week, by which time the milk and peptonoid diet will have 
become exceedingly tiresome, and the new nourishment will be relished 
and at the same time adapted to the conditions of that period of the 
disease. 

Eggs may be given cautiously throughout the disease in combination 
with milk as egg-nog, which is made by adding the yolk of an egg to half 
a pint of milk, with a tablespoonful of whiskey, wine or brandy, and then 



DIET OE CONVALESCENCE. 1061 

beating in the white of the egg. This should be given sparingly in any 
delicacy of the stomach. 

Stimulants are given by many physicians throughout the disease, but 
unless the individual case requires stimulation from the beginning it is 
best to defer the administration of alcoholics until the middle of the second 
week, or until the time when the organism requires energetic artificial 
stimulation. 

What Stimulants to Use — Whiskey, brandy and the light wines can 
all be used, either slightly diluted in doses from a teaspoonful to a table- 
spoonful, every two or three hours, or incorporated with the medicine or 
food. As mentioned above, whiskey or brandy can be given in the form 
of egg-nog, or milk-punch, thus exhibiting both the stimulating effects 
of the liquor and the nourishment of the milk and eggs. A light, power- 
fully stimulant beverage is made by the addition of champagne to milk, 
and is especially applicable to a weak stomach. 

Feeding by Enema — In extremely serious cases of typhoid fever, or 
when the stomach will not retain proper nourishment, it is often necessary 
to sustain strength by rectal feeding. For this purpose, strong, black 
coffee, solutions of beef peptonoids, beef tea, beaten eggs and milk, etc., 
are injected well up into the intestine by means of a long rectal tube. In 
this form of feeding a very much larger quantity of food should be used 
than by the mouth. 

Diet of Convalescence. — After the acute symptoms have all subsided 
and the temperature has been normal for ten days or two weeks, the diet 
may gradually be increased. For the first few days boiled rice, corn- 
starch pudding, oat-meal porridge or sago porridge may be given in small 
quantities. This may be followed by a portion of a soft boiled or poached 
egg, or milk toast made from old bread. On the fifth or sixth day a little 
dry toast with a baked apple or potato may be eaten ; this can be followed 
by finely chopped lean beef, broiled, and light bread which is a day or two 
old, with a little fresh butter. 

Increase of Diet. — From this diet gradually increase to a tender piece 
of chop or steak, small quantities of well-cooked green vegetables, and so 
forth, always remembering that the seat of the disease is in the intestine, 
and standing ready to cut the diet down on the appearance of diarrhoea, 
a return of fever or other unfavorable symptom. 

During convalescence it is not usually advisable to continue the use 
of stimulants, although the malt liquors, as ale, porter and malt extract 
are at times beneficial. 



1062 SPECIAL DIETS FOE VARIOUS DISEASES. 

Full or Extra Diet. — Fourteen ounces of bread ; one pint of porter for 
males, half a pint of porter for females; six ounces of dressed meat, 
roasted or boiled, alternately, with eight ounces of potatoes ; half a pound 
of rice pudding three times a week ; half a pint of mutton broth in addition 
on days when boiled meat is given (which is four times a week) ; or, 
occasionally, one pint of strong vegetable soup, with meat and rice pud- 
ding, twice a week; one ounce of butter each day; porridge, gruel and 
barley water as required. 

Middle or Ordinary Diet. — Twelve ounces of bread; half a pint of 
porter; four ounces of dressed meat roasted and boiled, alternately, with 
eight ounces of potatoes ; half a pound of rice pudding three times a week ; 
half a pint of mutton broth in addition on days when boiled meat is given 
(which is four times a week) ; or, occasionally, one pint of strong vege- 
table soup with meat and rice pudding, twice a week; with the full diet 
allowance of bread; one ounce of butter each day; porridge, gruel and 
barley water as required. 

Low Diet. — Ten ounces of bread ; half a pint of beef tea, mutton broth, 
rice, arrowroot, or sago, when specially ordered; three-quarters of an 
ounce of butter ; gruel and barley water as required. Wines and spirits, 
if used, must be mentioned each time the physician or surgeon attends. 

It is to be observed that even with those who are well exact diet 
should vary with different people according to their temperament and 
occupation. A person of nervous temperament may not indulge in seasoned 
foods with the same impunity that one of phlegmatic temperament, and 
the diet of a person of sedentary habits is necessarily more restricted 
than that of one who is engaged in the open air or in manual work. 

The following particulars as to foods and drinks that may and may 
not be taken during the period of certain different ills will be found of 
great value in the sick room and in the care and treatment of all who 
are ill. The importance of eating slowly and properly masticating all 
food cannot be too strongly urged, and it is particularly to be desired 
that care and worry should be banished at meal time and cheerfulness 
prevail. After eating, even with the well, it is of great benefit to lie 
down and rest for twenty or thirty minutes. 



DIET IN BRIGHT'S DISEASE. 



1063 



ASTHMA. 



General Rules — The diet should be normal and not stimulating. 



BENEFICIAL. 

Soups. — As desired, but in moderation. 
Fish. — As desired. 

Meats. — As desired. Preferably lean. 
Vegetables. — All kinds. 
Fruits.— 'All kinds. 

Drinks. — Water, cocoa, milk, tea, cof- 
fee. 



DETRIMENTAL. 
Alcohol, irritating spices or sauces. 



BRIGHT'S DISEASE. 

General Rules — When acute symptoms are present diet should be 
small in amount, very bland and preferably liquid, viz : milk. In the sub- 
acute or chronic form, a more liberal diet is needed to preserve proper 
nutrition and strength. Large amounts of liquids should not be taken 
continuously for more than a few days at a time, especially if the heart 
is weak or dropsy is present. Avoid all high seasoning. 



BENEFICIAL. 

Soups. — Weak broths with rice or bar- 
ley, thin vegetable soups. 

Fish. — Fresh fish, boiled or broiled, 
raw oysters, raw clams. 

Meats. — Beef, mutton, lamb, poultry, 
all sparingly. 

Farinaceous. — Hominy, oatmeal, wheat- 
en grits, rice, with milk or cream spar- 
ingly, stale bread, whole wheat bread, 
toast, milk toast, biscuits, macaroni. 

Vegetables. — Potatoes, peas, beans, 
spinach, cabbage, cauliflower, tomatoes, 
onions, lettuce, watercress, mushrooms. 

Desserts. — Rice and milk puddings, 
stewed apples, stewed pears, berries. 

Fruits. — Ripe apples, pears, grapes, 
berries. 

Fluids. — Pure water (restricted) pep- 
tonised milk, fresh buttermilk, Bulgarian 
sour milk, milk with hot water, equal 
parts, whey, weak tea and weak coffee 
(restricted), toast water, unfermented 
grape juice and fruit juices (restricted). 



DETRIMENTAL 

Strong meat broths and extracts, fried 
fish, pork, corned beef, heavy bread, 
batter cakes, asparagus, celery, hashes, 
stews, gravies, strong condiments, such 
as curry, pepper, mustard, radish, etc., 
cakes, pastry, ice cream, malt or spir- 
ituous liquors, cranberries, fruits with 
kernels. 



1064 



SPECIAL DIETS FOR VARIOUS DISEASES. 



CONSTIPATION. 

General Rules. — Diet should consist largely of easily digested fats 
and oils, green and fresh cooked vegetables, such as leave a large residue 
in the bowels. Moderate exercise and regularity in habits are important 
adjuncts to treatment. Active cathartic drugs should be avoided. 



BENEFICIAL. 

Soups. — Meat broths, oyster soup. 

Fish. — Boiled fresh fish of all kinds, 
raw oysters. 

Meats. — Almost any fresh tender meat, 
poultry, all in moderation. 

Farinaceous. — Oatmeal, wheaten grits, 
mush, hominy, whole wheat bread, corn 
bread, graham bread, brown bread, rye 
bread, bran biscuit or muffins. 

Vegetables. — Boiled onions, brussels 
sprouts, spinach, cauliflower, potato, 
asparagus, green corn, green peas, string 
beans, salads, with oil. 

Desserts. — Stewed prunes, figs, baked 
apples with cream, ripe peaches, pears, 
oranges, apples, melons, grapes, huckle- 
berries (the blue seedless kind), cherries, 
raisins, honey, plain puddings, fig-pud- 
dings, apple charlotte. 

Fluids. — Plenty of pure water, cold or 
hot, black coffee, cocoa, new cider, but- 
termilk, Bulgarian sour milk, orange 
juice, unfermented grape juice. 



DETRIMENTAL 

Salt, smoked, potted or preserved fish 
or meats, liver, eggs, new bread, pud- 
dings of rice or sago, pastry, milk, 
sweets, tea, nuts, cheese, pineapple, spir- 
ituous liquors. 



Above all other means for removing constipation are those hygenic 
applications derived from the natural stimulus of the intestinal move- 
ments — food. If there is no contra-indications, those foods which leave 
a considerable residuum — as Graham flour, bran, rye and corn bread, 
groats, oatmeal, cracked wheat and oats, and so forth — can be used with 
advantage; fresh vegetables as lettuce, spinach, celery, onions, the various 
vegetables known as greens, and so forth, and fruits as apples, dried 
peaches, figs, dates, tamarinds, prunes, and so forth. 

A large draught of plain or carbonated water should be taken before 
breakfast. The alkaline mineral waters, as Saratoga, Pullna or Hunyadi, 



DIET IN DIABETES. 



1065 



taken in this way usually give excellent results. As a sedentary life 
induces constipation, it follows that sufficient exercise must be enjoined 
in all such cases. 

Consumption — See Phthisis. 



DEBILITY. 



General Rules. — 

BENEFICIAL. 

Soups. — Any broth thickened with 
farinaceous material, chicken or beef 
soup containing chopped meat, rich 
vegetable soups, whole beef tea. 

Fish. — All fresh fish, boiled or broiled, 
raw oysters. 

Meats. — Beef, mutton, chicken, boiled 
ham, lamb chops or cutlets, broiled 
bacon, tender juicy steak, hamburger 
steak. 

Eggs. — Soft boiled, poached, scrambled, 
raw with sherry wine. 

Farinaceous. — Cracked wheat, rolled 
oats, corn meal mush, sago, tapioca, 
hominy, barley, macaroni, vermicelli, 
rolls, biscuits, cakes, whole wheat bread, 
corn bread, milk toast, dry toast, brown 
bread. 

Vegetables. — Nearly all, perfectly fresh 
and well cooked. 

Desserts. — Custards, egg-and-milk, rice 
or apple puddings, baked apples, fruit- 
jams, jellies, cocoa-junket, marmalade, 
sweet fruits, calf's-foot jelly. 

Fluids. — Cocoa, chocolate, milk — hot, 
cold, or peptonised, Laibose, Bulgarian 
sour milk, pure water, plain or aerated, 
Panopepton on cracked ice. 



DETRIMENTAL 



Hashes, stews, cooked oysters or clams, 
pork, veal, thin soups, turkey, salt meats 
except ham and bacon, cabbage, cucum- 
bers, turnips, carrots, squash, spices, 
pickles, vinegar, pies, pastry, bananas, 
pineapples. 



DIABETES. 

General Rules. — Avoid all sugars and reduce starches to a minimum. 
Increase the amount of meats and especially oils and fats. Substitute 
saccharin for sugar. 



1066 



SPECIAL DIETS FOR VARIOUS DISEASES. 



BENEFICIAL. 

Soups. — Soups or broths of beef, 
chicken, mutton, veal, oysters, clams, 
terrapin or turtle (not thickened with 
any farinaceous substances), beef tea. 

Fish. — Shell fish and all kinds of fish, 
fresh, salted, dried, pickled, or other- 
wise preserved (no dressing containing 
flour). 

Eggs. — In any way most acceptable. 

Meats. — Fat beef, mutton, ham or 
bacon, poultry, sweetbreads, calf's head, 
sausage, kidneys, pig's feet, tongue, tripe, 
(all cooked free of flour, potatoes, 
bread, or crackers). 

Farinaceous. — Gluten porridge, gluten 
bread, gluten gems, gluten biscuits, glu- 
ten wafers, gluten griddle cakes, almond 
bread or cakes, bran bread or cakes. 

Vegetables. — String beans, spinach, 
beet-tops, chicory, kale, lettuce plain or 
dressed with oil and vinegar, cucumbers, 
onions, tomatoes, mushrooms, asparagus, 
oyster plant, celery, dandelions, cresses, 
radishes, pickles, olives. 

Deserts. — Custards, jellies, creams (all 
without sugar) ; walnuts, almonds, fil- 
berts, Brazil nuts, cocoanuts, pecans. 

Fluids. — Tea or coffee (without sug- 
ar), pure water, peptonised milk, Bul- 
garian sour milk, lemonade, seltzer water 
with lemon juice (no sugar). 



DETRIMENTAL 

Liver, sugars, sweets or starches of 
any kind, wheaten bread or biscuits, 
corn bread, oatmeal, barley, rice, rye 
bread, arrowroot, sago, macaroni, tapi- 
oca, vermicelli, potatoes, parsnips, beets, 
turnips, peas, carrots, melons, fruits, 
puddings, pastry, pies, ices, honey, jams, 
sweet or sparkling wines, cordials, cider, 
porter, lager, chestnuts, peanuts. 



DIPHTHERIA. 

Putrid Sore Throat. Malignant Quinsy. 

Milk Diet Required. — The diet should be concentrated and highly 
nutritious from the onset, embracing the necessary variety of alimentary 
principles. Milk meets preeminently these requirements. 

Difficulty of Nutrition A serious difficulty in the treatment often 

arises from the invincible repugnance to nutriment, and sometimes from 
the persistence of vomiting. Owing to the difficulty of alimentation in 
such cases, and sometimes a want of appreciation of its importance, death 
takes place from innutrition. 

Items of Proper Diet. — Milk, eggs, broth, peptonoids, beef juice or 
essence, peptonized oysters, eggnog or milk-punch should be given at 



DIET IN DIARRHCEA. 



1067 



intervals of every two. or three hours. If swallowing is so difficult as to 
prevent the patient from taking a proper amount of food, resort must be 
had to nutritious enemata. The following is a suitable formula: 

Milk 1 ounce 

Whiskey y 2 ounce 

Egg 1 ounce 

Add a little salt, beat up and warm. 

Stimulants. — Stimulants should be used boldly from the start, guiding 
the dose by the effects. It is surprising to observe the large amount 
which can be taken even by the tenderest subject, without bad results. 
Usually a child of two years requires from thirty to sixty drops of whiskey 
or brandy every two or three hours ; an adult, from two to three teaspoon- 
fuls every three hours. However, this amount can be greatly increased 
if necessary. It is a mistaken idea to wait until symptoms of debility 
appear in diphtheria before using alcoholic stimulants. 



DIARRHCEA. 

General Rules. — Diet should be mainly liquids and during an acute 
attack all food should be stopped for about twelve hours. Avoid foods that 
ferment easily or that leave an undigested residue, thus causing intestinal 
irritation. Take food in small quantities at frequent intervals. 



BENEFICIAL. 

Soups. — Milk soup well boiled, clam 
juice, beef tea. 

Meats. — Scraped fresh beef or mutton 
well broiled, sweetbread, beef juice from 
freshly broiled steak (all sparingly). 

Eggs. — Lightly boiled or poached on 
dry toast, boiled white of egg. 

Farinaceous. — Rice, sago, macaroni, 
tapioca, arrowroot, dry toast, milk toast, 
toasted crackers. 

Desserts. — Milk-puddings, plain, with 
sago, rice, tapioca or arrowroot (no 
sugar). 

Fluids. — Tea, toast water, boiled pep- 
tonised milk, Panopepton, Panopepton 
and whey. 



DETRIMENTAL 

Oatmeal, wheaten grits, fresh breads, 
rich soups, vegetables, fried foods, fish, 
salt meats, lamb, veal, pork, brown or 
graham bread, fruits, nuts, pies, pastry, 
ice cream, ice water, sugar, sweets, cus- 
tards, malt liquors, sweet wines, iced 
drinks. 



1068 



SPECIAL DIETS FOR VARIOUS DISEASES. 



DYSENTERY. 

As in this disease the nutrition suffers severely the correct diet is 
important from the beginning. If the stomach is irritable, milk, with 
one-fourth lime-water, is the best food. If there is but little nausea, 
and especially if the digestion remains good, the patient can take milk, 
eggs, beef juice (which is particularly adapted to this condition), ice 
cream, boiled custard, oyster soup, mutton^ chicken and beef broth, and 
similar articles. But solids leaving much residuum, and especially coarse 
articles, are highly objectionable. 

DYSPEPSIA. 

General Rules. — Eat slowly and masticate thoroughly. Avoid all 
stimulants and culinary delicacies, iced or very hot drinks; no sweets 
and no acids. 



BENEFICIAL. 

Soups. — Clear thin soups of beef, mut- 
ton, or oysters. 

Fish. — Oysters raw, fresh boiled or 
broiled bass, white fish, shad, cod, trout, 
no rich sauces. 

Meats. — Broiled tender steak or chop, 
roasted or boiled beef, lamb, mutton, 
chicken, calf's head, sweetbread, broiled 
chopped meat. 

Eggs. — Boiled, poached, raw, any way 
that agrees. 

Farinaceous. — Cracked wheat, hominy, 
rolled oats, rice, sago, tapioca, crackers, 
dry toast, stale bread, corn bread, whole 
wheat bread, graham bread, unsweet- 
ened rusk or zwieback, macaroni. 

Vegetables. — -Potato (sparingly), spin- 
ach, sweet corn, green peas, string beans, 
asparagus, stewed celery, well-boiled 
onions, lettuce. Vegetables sometimes 
best made into purees, thoroughly 
cooked, then passed through colander or 
sieve. Cream, fresh butter, best olive 
oil, may be used with farinaceous or 
vegetable foods, if agreeable. 

Desserts. — Rice, tapioca, or farina 
pudding, junket (directions on back of 



DETRIMENTAL 
Rich soups or chowders, veal, pork 
hashes, stews, turkey, gravies, fried 
foods, liver, kidney; pickled, potted, 
corned or cured meats ; salted, smoked 
or preserved fish ; goose, duck, sausage, 
crabs, lobster, salmon, pies, pastry, can- 
dies, ice cream, cheese, nuts, ice water, 
strong condiments, pickles, malt or spir- 
ituous liquors. 



DIET IN FEVER, 



106£ 



BENEFICIAL. 

slip), custards, apple snow, baked and 
stewed apples and pears, ripe fruits. 
Fruits usually best taken in morning or 
early part of day, not after a full meal, 
oranges, grape fruit, etc. 

Fluids. — Hot water before meals. At 
meals, one cup weak tea, coffee, cocoa, 
milk and hot water equal parts, one glass 
pure cool water, sipped toward end of 
meal. Milk, plain or peptonised, butter- 
milk, Bulgarian sour milk, whey, whey 
and unfermented grape juice, Ponopep- 
ton and whey, Panopepton on cracked 
ice. 



DETRIMENTAL 



FEVERS. 

General Rules — A nourishing diet for the strength of the patient 
must be kept up, but solids are not permissible and in liquid and semi- 
liquid foods care is necessary that they are easy of digestion. 



BENEFICIAL. 

Foods. — Soups, clear, or thickened 
with some well cooked farinaceous sub- 
stance, mutton, clam or chicken broth, 
beef tea, peptonised milk, Laibose, Bul- 
garian sour milk, Panopepton with 
cracked ice, Panopepton with whey. 

Fluids. — Pure cold water, toast water, 
lemon or orange juice in cold water, 
jelly water, cold whey, all in small quan- 
tities, sipped slowly. 



DETRIMENTAL 

Any solid or vegetable food or fruit, 
until so directed by the physician in 
charge. 



FEVER, CEREBROSPINAL. 

Cerebro-Spinal Typhus, Meningitis, Spotted Fever. 

Generous Diet Needed. — This disease may be very rapid in its course 
and terminate in from four to seven days, or again, it may continue for 
six or eight weeks, according to the length of its stages and their particular 
conduct. Consequently a generous and sustaining diet must be inau- 
gurated from the onset. 

Items of Diet — Milk, eggs, beef juice, liquid peptonoids, mutton 
broth, and so forth, should be given every three hours, day and night, to 
avoid paroxysms of weakness in the early morning. Very often food can- 



1070 SPECIAL DIETS FOR VARIOUS DISEASES. 

not be taken by the mouth, in such cases nutritious enemata should be 
used as in typhoid fever. The alcoholic stimulants: whiskey, brandy, 
wine, and so forth, should be given freely every few hours. 

FEVER, PERNICIOUS. 

Pernicious Malarial Fever. Congestive Fever. 
Full Diet Needed. — The diet in pernicious malarial fever should be 
full ; plenty of meat, milk and eggs. During the attacks it should be cut 
down to liquid food, often repeated. In the gastro-enteric variety of 
the disease the diet should be the same as in acute dysentery. 

FEVER, SCARLET. 

A Supporting Diet Needed — As the disease runs a rapid, definite 
course, the diet must be supporting and nourishing from the start ; milk, 
beef peptonoids and eggs fulfilling the indications. Alcoholic stimulants 
are indicated in proportion to the frequency and feebleness of the pulse, 
together with general prostration. Alcoholics are to be given with dis- 
crimination, however, their precise effects being noticed. The malignant 
type of the disease requires that stimulants should be used freely. In 
children, wine-whey, milk-punch and egg-nog are eligible forms for their 
administration. 

Water Diet. — If the urine is scanty and high colored, the patient 
should be permitted to drink of water very freely, also milk and lime- 
water and cream-of-tartar lemonade, in order to promote proper renal 
secretions. 

FEVER, TYPHOID. 

General Rules — All foods given in protracted febrile states should be 
in liquid form. This is especially true in typhoid fever, in which disease 
it should be continued until ten days or two weeks after the temperature 
has returned to normal. 

Of all liquid foods, milk is by far the best and most serviceable in 
typhoid fever. It is taken, if not with relish, at least with less reluctance 
than other articles, and it has the great advantage of embracing in proper 
combination all the ailmentary principles required for nutrition. 

Care should be taken that the milk is of a good quality and comes 
from healtky cows. In preparing it for the patient it is often necessary 



DIET IN FEVER. 



1071 



that it be iced in order to make it more palatable, or, if it is thought to be 
questionable in quality, it should be sterilized or boiled. 

Should the stomach reject milk when taken as it comes from the 
dairy it may be diluted with ice-water, lime-water or barley-water. Again, 
if the regurgitated milk shows signs of non-digestion, it should be artifically 
digested with peptonizing powder (which can be procured at any phar- 
macy) before administering to the patient. 

One or two ounces of milk should be taken every three hours during 
the day, and at night not more than four hours should elapse without 
food and stimulants being administered. While sleep is essential, yet a 
patient is not harmed by the partial awakening which is sufficient for 
the administration of a milk-punch. Again, a careful nurse can give 
food at frequent intervals without awakening him. 

During convalescence, commencing the third day after disappearance 
of all fever, the diet must become varied, utmost effort being made to 
build the patient up with most nourishing food. The first day or two 
give only milk and broths, with perhaps a little beef juice twice during 
day. The next day a little stale bread may be added to this and a cup 
of cocoa may be given. The third day custard may be given or a soft 
boiled egg and each day thereafter the diet may be slightly increased. By 
the seventh day breast of broiled chicken may be given and by the tenth 
day the diet may become general. Throughout convalescence peptonized 
milk should be given three or four times between meals and a glass of 
sherry or burgundy. 

General Rules. — Avoid eating rich or highly seasoned foods, but take 
good nourishment to keep up the general strength. Avoid exercise and 
sexual excitement. 



BENEFICIAL. 

Soups. — Clear soups, oyster soup. 

Fish. — All kinds, if boiled. 

Meats. — Lamb, mutton, chicken. Meats 
should be either boiled or broiled and 
eaten sparingly. 

Farinaceous. — Graham bread, brown 
bread, bran bread, corn bread, rye bread ; 
whole wheat bread ; oatmeal porridge, 
cereals. 

Vegetables. — Spinach, brussels sprouts ; 
asparagus, string beans, lettuce, celery. 

Drinks. — Lemonade, milk, unferment- 
ed grape juice, pure water, one glass 
laxative early each morning. 



DETRIMENTAL 

Soups. — Clam chowder, nor rich meat 
soups. 

Fish. — Smoked fish, lobster, crabs, 
clams. 

Meats. — Pork, veal, beef, smoked 
meats, salt meats. 

Farinaceous. — White bread ; rolls, grid- 
dle cakes, cheese, custard pies, cakes, 
hot biscuits. 

Vegetables. — Cabbage, tomatoes, tur- 
nips, carrots, baked beans. 

Drinks. — Ales, porters, wines, tea, cof- 
fee, cocoa, ginger ale, nor any other 
alcoholic or stimulating beverages. 



1072 



SPECIAL DIETS FOR VARIOUS DISEASES. 



GOUT. 

General Rules. — Restrict the use of starches and meat. Pure water 
should be taken freely, but not to excess. Alcohol and sweets should be 
entirely interdicted. 



DETRIMENTAL 

Cakes, sweets, pork, veal, fried meats, 
cooked oysters, salted, dried, potted or 
preserved fish or meats (except fat 
bacon or ham), crabs, lobster, sweet- 
breads, kidneys, hard boiled eggs, rich 
made dishes, gravies, raw tomatoes, rhu- 
barb, pies, pastry, tea. 

Absolutely forbidden. — Malt liquors, 
sweet wines, champagne. 



BENEFICIAL. 

Soups. — Clear soups, vegetable soup, 
clam and oyster broths. 

Fish. — Fresh fish, raw oysters. 

Eggs. — In moderation, preferably soft 
boiled or poached. 

Meats. — (Once a day only, principally 
white meat.) Chicken, ham, bacon, 
sweetbreads, mutton, lamb, very little 
beef. 

Farinaceous. — Whole wheat, corn or 
brown bread, dry toast, milk toast, 
zweiback, rye (stale only), crackers, 
hominy, cereals without sugar. 

Vegetables. — Potatoes (small quantities 
only), spinach, green peas, cabbage (well 
boiled), green vegetables, salads, string 
beans. 

Desserts. — Fresh or cooked fruits, ices, 
rice pudding, baked apples (very little 
sugar), cheese, nuts or almonds. 

Beverages. — Water plentifully, plain 
soda, milk, buttermilk, coffee, lemonade 
(no sugar). 



Gouty. — Gouty patients may, for the purpose of dietetic discussion, be 
arranged in three classes : first, those who are robust and vigorous ; second, 
those who with a distinct feebleness of constitution and sluggishness of 
habit have a marked tendency to the accumulation of fat; third, those 
whose nutrition and general vital forces are habitually on a low level. 

In robust gouty persons it is essential that the quantity of food be 
lessened ; such persons should be taught to habitually rise from the table 
with the appetite not entirely satisfied. In the second class of patients 
some control over the appetite is not rarely imperative, while in the third 
class of patients it is often equally essential to administer food beyond the 
cravings of the stomach. 

What to Avoid. — There are certain articles of food which should be 
denied to all gouty subjects. First of these is cane sugar, acid fruits, 
including the tomatoes and strawberries, are also to be avoided by all 



DIET IN IMPOTENCY. 



1073 



gouty subjects, while non-acid fruits, if ripe, are almost invariably of great 
service and should be taken freely. The harm done by acid fruits is 
largely due to their irritating effects upon the organs of digestion. 

HEART AND BLOOD VESSELS.— DISEASES OF. 

General Rules.- — Food should not be taken at short intervals as diges- 
tion is slow. Allow an interval of five hours between meals. All meals 
should be moderate in amount and sugars and starches restricted, especially 
if there is a tendency to flatulence. 



BENEFICIAL. 

Soups. — (In moderate amounts.) Clear 
vegetable soup, purees and milk soups. 

Fish. — Fresh of all kinds, raw oysters 
and clams. 

Meats. — Beef, mutton, chicken, quail, 
partridge, grouse, lamb. 

Eggs. — Soft boiled or poached. 

Farinaceous. — Toast, crust of bread, 
zweiback, crackers, beaten biscuits. 

Vegetables. — Peas, string beans, spin- 
ach, lettuce, baked potatoes in small 
amounts. 

Desserts. — Fresh fruits, baked apples, 
pineapple, custards, gelatines. 

Beverages. — Milk, buttermilk, weak 
tea (with little sugar), coffee (small 
cup, clear), light dry wines. 



DETRIMENTAL 

Fried foods, candy, pastries, much cof- 
fee or tea, batter cakes, waffles, hot 
breads, sweet wines and much spirituous 
or malt liquors. 



IMPOTENCY. 



BENEFICIAL. 



Soups. — Beef, mutton, oyster. 

Fish. — Codfish, halibut, bass, blue, 
white, shad, shad roe, lobster and crab, 
sardines, trout, mackerel, caviar, sal- 
mon. 

Meats. — Beef, lamb, mutton, chicken, 
turkey, game, fresh lean ham, bacon, 
tripe, sweetbreads. 

Eggs. — Soft boiled, poached or raw. 

Farinaceous. — Gluten, gocham, whole 
wheat and brown bread, oatmeal, barley, 
shredded wheat, peas, beans, hominy. 

Vegetables. — Spinach, cauliflower, as- 

68 



DETRIMENTAL 



Soups. — Chowder, nor rich soups and 
spiced gravies. 

Fish. — Eels, clams, all fried fish. 

Meats. — Pork, veal, liver, goose, can- 
ned and potted meats, fried meats, 
sausages. 

Eggs. — Fried nor hard boiled. 

Farinaceous. — White bread, rolls, hot 
biscuits, wheat griddle cakes. 

Vegetables. — Cabbage, turnips, carrots, 
parsnips, melon, lettuce, pumpkins, mush- 
rooms, rhubarb. 



1074 



SPECIAL DIETS FOE VARIOUS DISEASES. 



BENEFICIAL. 

paragus, celery, potatoes (preferably 
baked), green peas, string beans, cu- 
cumbers, onions. 

Desserts. — Rice puddings, cheese, or- 
anges, olives, custards, figs, raisins, pea- 
nuts, walnuts, Brazil, pecan, hickory and 
other nuts. 

Drinks. — Milk, cocoa, tea, coffee, malt- 
ed milk. 



DETRIMENTAL 

Desserts. — Strawberries, blackberries, 
raspberries, currants, cherries, pies. 

Drinks. — Beer, ale, porter, whiskey, 
gin, brandy, buttermilk, sour wines, 
vinegar, all alcoholic drinks. 



INDIGESTION, GASTRIC (Chronic Gastritis). 

General Rules. Small meals taken at regular intervals. Masticate 
thoroughly, eat slowly and avoid overloading the stomach. A limited 
amount of fluid with meals. 



BENEFICIAL. 

Soups. — Small quantity. Clear soups 
of beef, mutton, oysters. A little vermi- 
celli, barley, rice or tapioca may be 
boiled with these. 

Fish. — Raw oysters, weak fish, white 
fish, shad, perch, trout, smelt, fresh 
mackerel, whiting. 

Meats. — Meat-juice, roasted or broiled 
beef (scraped or chopped), mutton, 
chicken, venison, fresh tongue, sweet- 
breads, lamb chops, squab, roast part- 
ridge, woodcock, plover, turkey (white 
meat). 

Eggs. — Raw, soft boiled, baked, poach- 
ed, plain omelette, or combined with 
chicken or oysters. 

Farinaceous. — Bread at least one day 
old, brown bread, toast, rye, gluten and 
Graham bread, zweiback, crackers, cream 
crackers, cracked wheat, rice, sago, tap- 
ioca, arrowroot, corn meal, hominy, 
wheaten grits, Graham grits, vermicelli, 
rolled oats. 

Vegetables. — Best made into puree by 
passing through a colander or mashing. 
Greens, spinach, French beans, green 
peas, asparagus, celery, potatoes (but 
little), preferably baked or mashed. 

Dessert. — Cooked fruits, rice, tapioca, 
Indian and farina puddings, custards, 



DETRIMENTAL 

Rich soups and chowders, fried foods, 
hot or fresh bread, griddle cakes, dough- 
nuts, veal, pork, liver, kidneys, hashes, 
stews, pickled and corned meats, pre- 
served and potted meats, goose, duck, 
sausage, salmon, salt mackerel, bluefish, 
sturgeon, eels, shrimps, sardines, lobsters, 
crabs, cabbage, cauliflower, celery, rad- 
ishes, cold slaw, cucumbers, parsnips, 
egg plant, turnips, carrots, squash, oyster 
plant, sweet potatoes, beets, tomatoes, 
corn, pastry, pies, made dishes, nuts, 
dates, jams, dried and candied fruits, 
candies, cheese, strong tea, ice water, 
malt liquors, sweet and effervescent 
wines and spirituous liquors. 



DIET IN INDIGESTION. 



1075 



BENEFICIAL. 

rice, snow, rennet, gelatin creams, blanc 
mange, baked and stewed apples and 
pears, grapes and ripe fruits, if fresh. 
No rich sauces. 

Beverages. — Drinks should mostly be 
taken near the end of and between 
meals. Hot water before meals, milk, 
lime-water, weak tea (one-half ounce to 
the pint), koumiss, weak cocoa, pepto- 
nized cocoa and milk, buttermilk, malted 
milk. 

Mineral Waters. — French Lick (Pluto, 
Natural or Concentrated), Carlsbad, 
Vichy, Kissingen, Apollinaris, Poland 
Spring. 



DETRIMENTAL 



INDIGESTION, GASTRIC (With Diminished Secretion). 

General Rules. — Food should be small in bulk ; very little fluid with 
meals. Lie down and rest after each meal. Articles enumerated should 
be taken in small quantities at a time, at frequent intervals. The com- 
parative digestibility of animal and vegetable foods must be determined 
by experience and the diet regulated accordingly. 



BENEFICIAL. 

Soups. — Between meals. Beef, chicken, 

Fish. — Fresh only, boiled, broiled or 
baked; oysters. 

Eggs. — Raw, soft boiled or poached. 

Fats. — Very little butter or cream. No 
cooked fats. 

Meats. — Preferably scraped or chopped 
beef, mutton, lamb, broiled or roasted 
chicken, tongue, sweetbreads, thin crisp 
bacon, cold boiled ham. 

Vegetables. — Spinach, carrots, soft 
boiled turnips, asparagus, rice. 

Farinaceous. — Stale bread only, dry 
toast, zweiback, crackers. Cereals should 
be thoroughly cooked and eaten with 
salt and cream, no sugar. 

Desserts. — Small quantities only. Boil- 
ed or baked custards, rice, tapioca and 
sago puddings, jellies, compotes of ap- 
ples and pears. 

Beverages. — Limited quantities between 
meals. Water (not iced), milk, cocoa, 
coffee, tea, light dry wines. 



DETRIMENTAL 

Soups and drinks, with meals. All 
articles of coarse texture that contain 
indigestible parts like tendons, skin, 
stems, husks, pips, seeds, etc. Carbon- 
ated and alcoholic beverages, very acid, 
very sweet or very salt foods, salads, 
freshly baked bread or cakes. 



1076 



SPECIAL DIETS FOR VARIOUS DISEASES. 



INDIGESTION, INTESTINAL. 

General Rules. — Diet should contain a predominance of animal foods, 
e. g., milk, eggs, fish, poultry, etc., avoiding especially sweets, insufficiently 
cooked starches, vegetables and fruits of the coarser varieties. Avoid all 
foods which occasion distress shortly after eating. 



BENEFICIAL. 

Soups. — Thin and containing little fat 
or vegetables. 

Meats. — Lean meat of beef, mutton, 
lamb, also partridge, squab, chicken, 
turkey (white meat), calf's brains, sweet- 
breads (no sauces or dressings). 

Fish. — 'Shell fish, trout, pike, sole, cod- 
fish, haddock, sardines, salmon. 

Eggs. — Raw, soft boiled (up to three 
minutes). 

Fats. — Good butter and cream in mod- 
eration. 

Vegetables (very little). — Cauliflower, 
asparagus, baked or mashed potatoes, 
fresh green peas (if tender). 

Farinaceous. — Toast, wheat bread, 
whole wheat, Graham, rye (stale only), 
cereals, as oatmeal, cream of wheat, 
Ralston's, Pettijohn's (thoroughly cook- 
ed), with salt and cream, very little 
sugar. 

Dessert. — Oranges, grape fruit, baked 
apples, stewed prunes, wine jelly, pud- 
dings (small amounts). 

Beverages. — Water (especially an hour 
or two after meals), milk, buttermilk, 
koumiss, light, white or red wines, cocoa, 
weak tea, very little coffee. 



DETRIMENTAL 

Fat meat or fish, sausage, meat sauces 
and dressings, boiled or fried meats, 
smoked meats, chipped beef, fritters, 
cakes, pan cakes, fresh bread, pastries, 
onions, carrots, turnips, tomatoes, cab- 
bage, corn, salads, ice cream and water 
ices, cold drinks, whiskey and brandy, 
heavy wines, strong coffee or tea, strong 
condiments. 



INFLUENZA. 

La Grippe. Contagious Catarrh. 

Diet Required. — Food consisting of milk and eggs should be admin- 
istered at frequent intervals and in most cases, especially in elderly 
individuals, alcoholic stimulants should he given. When the pulse is 
soft and the stomach irritable, champagne will be found to be a most 
serviceable remedy. 



DIET IN INFLUENZA. 



1077 



Diet in Convalescence — The prostration and loss of strength is very 
great after an attack of influenza, even though the duration has been 
short; and convalescence must be watched with much care. The diet 
should be increased as soon as possible to thick soups, rare beef and mutton 
and the easily digested vegetables. Malt liquors, porter, ale, stout, and 
so forth, are often indicated. 

The rapid increase of consumption since the advent of influenza, a 
few years since, is very significant: convalescing patients should receive 
the most nourishing food, in order to fortify the organism against any 
tendency to chronic complications. 

LIVER TROUBLE. 
General Rules. — A bland mixed diet containing no alcoholic beverages, 
a minimum of fat, a small amount of animal food, plenty of fresh fruits, 
vegetables, milk, cereals, starches and a small amount of sweets. Spices 
and condiments should be excluded. 



BENEFICIAL. 

Soups. — Thin vegetable soups with a 
little bread or cracker, light broths, 
oyster broth. 

Fish. — Boiled fresh cod, bass, sole or 
white fish, raw oysters, soft part. 

Meats. — Tender lean mutton, lamb, 
chicken, sweetbread, all sparingly. 

Farinaceous. — Oatmeal, hominy, tap- 
ioca, sago, arrowroot, all well-cooked, 
whole wheat bread, graham bread, dry 
toast, crackers, zweiback, all sparingly. 

Vegetables. — Nearly all fresh vege- 
tables, well-baked or boiled potato once 
a day, dandelions, green salads with 
French dressing. 

Desserts. — Plain milk puddings of tap- 
ioca, sago, arrowroot, junket, custards, 
stewed fruits, baked apples, stewed 
prunes if constipation. 

Fruits. — Fresh ripe oranges, grape- 
fruit, peaches, pears, grapes, strawber- 
ries, if agreeable, ripe tender plums. 

Fluids. — Weak tea or coffee (without 
sugar or cream), hot water, pure water, 
plain or aerated, lemonade (with little 
sugar), milk, diluted or peptonised, but- 
termilk, Bulgarian sour milk, whey, or- 
ange juice. 



DETRIMENTAL 

Strong soups, concentrated meat ex- 
tracts, rich made dishes of any kind, hot 
breads, preserved fish or meats, curries, 
pies, pastry, cakes, peppers, spices, mus- 
tards radish, horse-radish, raw onions, 
fats, sugar, herrings, eels, salmon, mack- 
erel, sweets, creams, dried fruits, nuts, 
watercress, celery, malt liquors, sweet 
wines, champagne. 



1078 



SPECIAL DIETS FOR VAEIOUS DISEASES. 



MEASLES. 

The diet needs nothing more than actual mention. Milk constitutes 
the chief article of diet, especially if there is a trace of albumen in the 
urine. Iced drinks, calf's-foot jelly, custards, rice and tapioca puddings 
are very acceptable to the little patient, and can be given in moderation. 
Stimulants are seldom required. 



NERVOUS AFFECTIONS. 

Nervous prostration; nervous exhaustion. The question of feeding 
is one of great importance, and requires the utmost care and attention ; the 
end to attain is to feed the patient as much as can be digested, but not to 
overfeed and derange the digestion. 

Food should be given at intervals of two or three hours, and must 
be both light and nutritious. It should, at least at first, consist largely 
of milk, except in those rare cases in which this fluid does really disagree 
with the stomach and is not merely thought to do so. The milk should 
be skimmed or given in the form of koumiss. 

Beef juice, or other concentrated meat essences are valuable as stimu- 
lants, and may be used as the basis of soups. Various farinaceous articles 
of food may be added to them ; if an egg be broken into the concentrated 
bouillon or beef essence just as it ceases boiling, a nutritious and palatable 
dish is obtained. When constipation exists, oatmeal porridge, Graham 
bread and fresh or dried fruits may be allowed if they are readily digested 
by the patient. 

OBESITY. 

General Rules. — Avoid starches, sugars and much fat. Eeduce liquids 
to two or three pints daily and take very little with meals. The whole 
diet should be reduced to the minimum needed to maintain good nutrition 
and strength. 



BENEFICIAL. 

Soup. — Small cup bouillon or clear 
soup at dinner. 

fish. — Fresh fi^h except those con- 
A taining much fatty matter, preferably 
boiled. 



DETRIMENTAL 

Soups, except as above, salmon, blue- 
fish, eels, salt fish, pork, veal, sausage, 
made dishes, fats, potatoes, macaroni, 
oatmeal, hominy, spices, rice, beets, car- 
rots, turnips, parsnips, puddings, pies, 



DIET IN CONSUMPTION. 



1079 



Meats. — Lean beef, mutton or lamb, 
chicken, all sparingly. 

Eggs. — Boiled or poached on toast. 

Farinaceous. — Stale bread, dry toast, 
sparingly. 

Vegetables. — Spinach, asparagus, cauli- 
flower, onions, white cabbage, celery, 
tomatoes, radishes, olives, lettuce, cresses. 

Desserts. — Jellies made with gelatin. 

Fruits. — Fresh ripe fruits — acid fruits 
preferable. 

Fluids. — At meals one cup tea or cof- 
fee, without milk, cream or sugar, or 
one glass pure water sipped at end of 
meal. Hot water freely between meals. 



pastry, cakes, sugars, sweets, milk, cream, 
malt or spirituous liquors, beers, sweet 
wines, champagne. 



PHTHISIS (Consumption) 



General Rules. — 



BENEFICIAL. 

Soups. — Turtle soup, oyster soup, clam 
or chicken broth, puree of barley, rice," 
peas, beans, cream of celery or tomato, 
whole beef tea, peptonised milk gruel. 

Fish. — All kinds of fresh fish, boiled, 
broiled or baked, oysters and clams raw 
(soft portions), also roasted or steamed 
or broiled. 

Meats. — Rare roast beef or mutton, 
lamb chops, tender steaks, hamburger 
steak (rare), ham, fat bacon, sweet- 
bread, poultry, raw pulped mutton or 
beef (scraped, pounded, put through 
sieve), or meat juice from slightly 
broiled steak. 

Eggs. — Raw, soft-boiled, poached, any 
way acceptable except fried or hard 
boiled. 

Farinaceous. — Oatmeal, wheaten grits, 
cornmeal mush, hominy, rice, with milk 
or cream, whole wheat bread, corn bread, 
milk toast, biscuits, muffins, gems, etc. 

Vegetables. — Nearly all if non-irritat- 
ing, potatoes, baked, boiled, creamed, 
fresh green peas, beans, spinach, onions, 
asparagus, tomatoes, all well-cooked, 
preferably steamed to avoid loss of salts 
in boiling, lettuce, celery. Cream butter, 



DETRIMENTAL 

Fried foods, salt fish, hashes, gravies, 
highly seasoned dishes, veal, pork, car- 
rots, parsnips, cabbage, beets, turnips, 
cucumbers, macaroni, spaghetti, sweets, 
pies, pastry, sweet wines. 



1080 



SPECIAL DIETS FOR VARIOUS DISEASES. 



best olive oil may be used freely if 
agreeable. 

Desserts. — Farina, sago, tapioca, plain 
or as simple puddings, floating islands, 
custards, baked or stewed apples with 
fresh cream, rice with cream, cooked 
fruits. 

Fruits. — Fresh ripe fruits as desserts, 
or taken in morning or early part of 
the day, oranges, grapes, peaches, pears, 
etc. 

Fluids. — Fresh milk, freely, sipped 
slowly, taken plain, peptonised, with 
cream added, with carbonated water, but- 
termilk, Bulgarian sour milk, cocoa, tea, 
coffee, lemonade, orange juice, pure 
water, Panopepton, Panopepton and 
whey, Laibose. 



PREGNANCY. 



General Rules. — 



BENEFICIAL. 

Soups. — Broths of mutton, chicken, 
oysters and clams, fish, when it agrees, 
raw oysters, raw clams. 

Meats. — Beef, mutton, chicken, game, 
eggs, butter, fat, sweetbreads, ham. 

Breadstuifs, etc. — Good wheat bread, 
corn bread, oatmeal, wheaten grits, rice. 

Vegetables and Fruits. — Baked pota- 
toes, spinach, macaroni, greens, cresses, 
celery, green peas, lettuce, asparagus, 
green corn, oranges, grapes, stewed fruit. 

Drinks. — Water freely, cocoa, milk, 
tea, coffee. 

Desserts. — None but the plainest. 

Nursing Women. — During the first 
three or four days after delivery the 
diet should consist of liquid food made 
of cereal grains, with a small allowance 
of animal broths. After the bowels have 
been thoroughly opened, begin to resume 
the normal diet. Allow tender beef, 
mutton, chicken or game once a day, 
with baked potatoes and green vege- 
tables. Wine, jelly, blanc mange and 
simple custards should constitute the 
desserts. At the end of ten days the 



DETRIMENTAL 

Pork, veal, indigestible meats, stews, 
gravies, made dishes, rich desserts, pas- 
tries, etc., coffee, stimulants, acid fruits. 



DIET IN RHEUMATISM. 



1081 



regular meals should be given, consist- 
ing of the most nutritious and digestible 
substances. Cocoa and chocolate may 
be used. 



PNEUMONIA. 

Food must be carefully administered from the beginning without 
waiting for depression to come on. Beef juice, milk, milk-punch, egg- 
nogg, wine-whey, mutton or chicken broth, liquid peptonoids should be 
given systematically every three hours. In weak subjects stimulants 
are necessary from the onset. 

RICKETS. 

Good cow's milk, diluted by one-third to one-fourth of lime-water 
is the most suitable food. In older children the food should contain 
-an abundance of animal fat, nitrogenous principles, and salt. The quantity 
of animal fat should amount to at least one-fourth of all the solid food 
taken, the nitrogenous food to one-third, and the starches to one-third. 
The fat is best administered in the form of cream or rich milk, but if 
this cannot be obtained cod-liver oil may be substituted. Raw or beef 
cooked very rare is one of the best articles of food in this disease for 
older children. 

RHEUMATISM. 
General Rules. — Avoid eating much meat. Drink plenty of water. 



BENEFICIAL. 

Soups. — Light broths in small quanti- 
ties, of mutton, chicken, beef, oyster or 
clam broth, preferably without the 
oysters or clams. 

Fish. — Fresh fish (whiter kinds), 
boiled, raw oysters, clams. 

Eggs. — Soft-boiled, poached. 

Meats. — The lighter kinds, chicken, 
sweetbread, calf's head, tripe, fat bacon, 
boiled ham, all sparingly. 

Farinaceous. — Whole wheat, corn or 
brown bread, arrowroot, rice, dry toast, 
milk toast. 

Vegetables. — The more digestible kinds, 
well-baked potato, well-cooked spinach, 
stewed celery, green peas, cabbage (well- 
boiled), lettuce. 



DETRIMENTAL 

Pork, veal, turkey, goose, duck, fried 
fish or meats, cooked oysters or clams, 
salted, dried, potted or preserved fish or 
meats (except fat bacon or ham), crabs, 
salmon, lobster, rich made dishes, gravies, 
meat extracts, tomatoes, beans, aspara- 
gus, mushrooms, candies, rich puddings, 
pies, pastry, nuts, cheese, coffee, cider, 
malt liquors, wines. 



1082 



SPECIAL DIETS FOR VARIOUS DISEASES. 



Desserts. — Simple puddings of rice or 
arrowroot with milk (no sugar), junket. 

Fruits. — Fresh ripe fruits, stewed 
fruits without sugar. 

Fluids. — Tea (without sugar), butter- 
milk, pure water, plain, or with lemon 
or lime juice, milk between meals, plain 
or peptonised, Bulgarian sour milk. 

URIC ACID 

Lithemia, Reno 

General Rules. — 

BENEFICIAL. 

Soups. — Light soups from bone or 
bone marrow, clear vegetable broths. 

Fish. — The whiter kinds of fresh fish, 
boiled, broiled, baked, soft portions of 
oysters and clams, all restricted. 

Meats. — Beef steak freed from fat and 
connective tissue, fresh beef, lamb, mut- 
ton, chicken, boiled, broiled, roasted, 
bacon, all restricted. 

Eggs. — Soft boiled, poached, prepared 
with milk, cream, butter or with cheese. 

Farinaceous. — Cracked wheat, oat- 
meal, hominy, rice, sago, with milk or 
cream, macaroni, whole wheat, rye or 
graham bread, crackers, dry toast, butter 
sparingly. 

Vegetables. — Nearly all fresh vege- 
tables, peas, beans, spinach, cabbage, 
cauliflower, onion thoroughly boiled, as- 
paragus, potato, celery, lettuce, light sal- 
ads with oil and vinegar or lemon juice. 

Desserts. — Light plain puddings, light 
fruit puddings, or with sauces of fruit 
juice, rice, sago and milk, junket, stewed 
fruits, baked apples, fresh ripe fruits 
(sometimes better taken in early part of 
day), nuts, almonds, figs, dates, honey, 
jelly, fresh cheese. 

Fluids. — Tea, coffee, cocoa, all restrict- 
ed, milk, plain, peptonised, skimmed, or 
with carbonic waters, buttermilk, Bul- 
garian sour milk, cream, toast water, 
pure water, cold or hot, fruit juices 
(unfermented), from grapes, apples, 
raspberries. Alkaline mineral waters, 
waters containing potassium or lithium 
salts, calcium carbonate, etc., as directed 
by physicians. 



DIATHESIS. 
-Vesical Calculi. 

DETRIMENTAL. 
Liver, sweetbread, veal, pork, goose, 
duck, turkey, dried, potted or preserved 
fish or meat, crabs, lobster, salmon, rich 
soups, meat broths, meat extracts, meat 
gravies, fried food, pastry, hot breads, 
confectionery, sweet potatoes, mush- 
rooms, pickles, mustard, pepper, paprika, 
curry, horse-radish, parsley, rich pud- 
dings, heavy cheese, malt liquors, sweet 
wines, champagne. 



VEGETABLE DIET 



A vegetable diet, or vegetarian diet, in the the true sense of the word, is one 
that not only does not include meat, but does not even include such animal 
products as milk, butter, cheese and eggs. Even in the strict application of the 
term, such a diet commonly includes not only vegetables but all cereals, fruits, 
nuts and green food. As a matter of actual practice, however, such restrictions in 
diet are seldom observed and the "vegetarians" usually restrict themselves only in 
avoiding flesh, fish and fowl. In many instances they really depend very largely 
upon the use of eggs, milk and milk products to take the place of meat, and 
especially to supply the protein which gives meat its chief value. 

There is no question that life, health and strength can be maintained on a 
meatless diet, and it is interesting to note that millions of people, especially in 
Asia, actually do live on a vegetarian diet, either exclusively or nearly so. The 
vegetarian diet is naturally a clean diet, and when satisfactorily balanced so as to 
supply all of the food elements required by the body is frequently found to be con- 
ducive to endurance. Many athletes have shown superior powers of endurance 
when on this diet, including Marathon runners, professional boxers and wrestlers, 
but at the same time it cannot be said that a vegetarian diet is always to be 
advised for the average man, inasmuch as it is most important that one should 
have a thorough knowledge of food values in order to make such a selection of 
foods as will provide perfect nutrition. Those who lose strength or weight on a 
vegetarian diet usually do so because they do not know how to find substitutes 
for meat. 

The chief defect of a strict vegetable or vegetarian diet is its comparative lack 
of protein, which, of course, is supplied liberally by the meat and fish in the 
ordinary diet. (See Table of Pood Values, page 1215.) Most vegetables contain 
a large percentage of water and considerable starch, but very little or no protein. 
They are valuable, however, for the ash or organic mineral salts which they con- 
tain. Fruits also contain very little protein. A diet of vegetables and fruits 
alone, therefore, would be inadequate to sustain life and energy for any length of 
time. The grains, however, especially wheat, rye and oats, contain a fair per- 
centage of protein, and one can practically live on these alone, if necessary, 
though such a diet would be monotonous and probably less conducive to energy 
than a mixed diet that includes a good variety. Cereals, however, naturally form 
an important part of a vegetarian diet, although it appears that in the case of 
white flour a considerable part of the protein of the wheat has been lost in the 
process of milling. 

Nuts are rich in both protein and fats and therefore make a splendid sub- 
stitute for meat. Like fruits, they are eaten uncooked or in their "natural" 
state. Some vegetarian theorists even advocate a "back to nature" life, in which 
one would be supposed to live on an exclusive diet of nuts and fruits. In some 
cases, however, nuts are found hard to digest, especially if the digestion is weak. 

Among the vegetables an exception to the rule is found in the legumes, 

1083 



1084 VEGETABLE DIET. 

including peas, beans and lentils. These have a high percentage of protein, espe- 
cially in their ripened or dried condition, and make a very good substitute for 
meat. The familiar baked beans, therefore, have a real strength building value. 
Peanuts should properly be classed with the legumes, for they do not strictly 
belong to the family of nuts. 

It will be seen from the above that a strict vegetarian diet offers a compara- 
tively limited supply of protein, which may be regarded as the building material 
for the muscles and various other tissues of the body, but does supply freely the 
energy and heat-producing elements, particularly the carbohydrates, starch and 
sugar. Most vegetarians, therefore, use eggs, milk and cheese to a considerable 
extent to supply the protein. If properly balanced in this way this diet is usually 
satisfactory. One may, of course, secure sufficient protein on a strict vegetarian 
diet by using plenty of nuts, beans, peas and lentils and the products of whole 
wheat, rye and oats. According to the best opinion on the subject, however, the 
animal proteins are more easily digested and assimilated. One secures energy from 
the animal foods with less expenditure of energy in the process of digestion. 

There are certain conditions in which a vegetarian diet is especially valuable, 
though it is usually best to follow any strict diet of this kind for only a limited 
time. Where there is rheumatism, disease of the thyroid gland, Bright's disease, or 
any other disorder due to excessive accumulations of uric acid or difficulty in the 
assimilation of protein it is well to use very little or no meat. A strict diet of 
fruit or of vegetables in such cases may frequently be found to have good results. 

Vegetables and fruits are especially valuable for their supply of the mineral 
salts. These are needed only in small quantities, but in these quantities they are 
absolutely essential and when the diet is deficient in this respect serious conditions 
arise. It is now held by many investigators that such diseases as scurvy, beri-beri 
and pellagra are chiefly due to starvation in respect to these particular elements, 
and are curable by the free use of fresh vegetables and fruits containing these 
organic salts in abundance. Green salads are extremely valuable on this account. 
In order to preserve the mineral salts in the cooking of vegetables it is important 
that the water should not be thrown away, for the salts are largely dissolved in the 
boiling water and then lost in the process of draining. Very little water should 
be used in cooking, boiling slowly or steaming, and this liquid should be served 
with the vegetables. 

All foods should be used, as nearly as possible, in their natural form in order 
to secure these organic salts. Whole wheat flour should be used instead of white 
flour; unpolished, natural rice instead of polished rice; brown sugar in place of 
white sugar. The refinement of food, while making it more attractive in appear- 
ance, invariably robs it of much of its nutritious character. When using a vege- 
tarian diet it is especially important to consider these requirements. 



PART IV OF BOOK VII 

Tells how to care for the aged, giving diets, exer- 
cises and palliative remedies for many minor ills to 
which they are peculiarly subject. 



Accidents, Eye 1097 

Acidity, Counteracting 1093 

Aged, The 1089 

Best Foods for 1091 

Clothing for 1094 

Foods for 1092 

Organs in 1089 

Rules for the Care of 1091 

Ancestry, Healthy 1087 

Artificial Food 1093 

Attention to Feet 1098 

Avoid Worrying 1089 

Baldness 1100 

Brushing the Hair 1099 

Bunions 1 104 

Care of the Aged 1087 

Care of the Ear 1098 

Care of the Eyes 1095 

Care of the Feet 1 102 

Care of the Hair 1099 

Ca»e of the Mouth 1 102 

Care of the Skin 1098 

Care of the Teeth 1 101 

Causes of Old Age 1090 

Chalky Matter, Proportion of 1090 

Chilblain 1104 

Children of Criminals 1088 

Cleansing the Ear 1098 

Cleansing the Hair 1099 

Clothing for the Aged 1094 

Condiments, Use of 1093 

Consumption, Inherited 1087 

Contagious Eye Diseases 1097 

Corns 1 103 

Cosmetics 1099 

Counteracting Acidity 1093 

Criminals, Children of 1088 

Crimping the Hair 1 100 

Death, Natural 1095 

Digestible Form of Fat 1093 

Ear, Care of * 1098 



Effects of Overeating 1090 

Eye, The 1095 

Accidents 1097 

Care of 1095 

Diseases, Contagious ■ 1097 

Glasses, Use of 1097 

Removing Cinders from 1097 

Face Shine, Removing 1099 

Fat, Digestible form of ....1093 

Feet, Attention to 1098 

Feet, Care of 1 102 

Fibrin Blockades Life 1090 

Foods and Chalky Matter 1090 

Foods for the Aged 1092 

Frost-bite 1 104 

Good Sight, How to Preserve .... 1096 

Grayness of Hair 1 100 

Hair, The 1099 

Brushing the 1099 

Care of 1099 

Cleansing of 1099 

Crimping 1 100 

Grayness 1 100 

Invigorators 1 100 

Health, The 1087 

Preservation of 1087 

Healthy Ancestry 1087 

Immoderation, Effects of 1087 

Ingrowing Toe-nails 1 103 

Inherited Consumption 1087 

Life, Prolonging of 1089 

Liquid Tonic 1092 

Maintenance Diet 1094 

Medical Care 1094 

Moderation 1087 

Mouth, Care of 1102 

Mouth Wash 1 102 

Natural Death 1095 

Nature Hint 1092 

Near-sightedness 1095 

Old Age, Causes of 1090 



1085 



1086 



INDEX TO PART IV OF BOOK VII 



Overeating, Effects of 1090 

Organs in Old Age 1089 

Preservation of Health 1087 

Prolonging Life 1089 

Recreation, Value of 1088 

Removing Cinders from Eye 1097 

Salts, How to Dissolve 1091 

Scalp, Attention to 1099 

Shoes 1 102 

Skin, Care of 1098 

Soap, Use of on Skin 1099 

Spectacles, Use of 1097 

Sports, Value of 1088 



Sweetenings 1093 

Teeth, Care of 1101 

The Aged 1089 

Three Diet Rules 1092 

Toe-nails, Ingrowing 1103 

Tooth Powder Formula 1 102 

Value of Recreation 1088 

Value of Sports 1088 

Wash for Hair 1101 

Washing the Skin 1098 

Weak Sight 1095 

Wines, Cautious Use of 1094 



THE SICK ROOM IN THE HOME 



PART IV. 
HEALTH AND CARE OF THE AGED. 

Preservation of Health — The preservation of health is sought by all 
wise persons, and the sweeping advances made by medicine in the past 
century, together with the better understanding of the masses, makes it 
possible to lessen disease, to minimize its evil effects, and to preserve the 
separate organs from involvement. 

Patients Must Assist. — An educated physician has wonderful powers, 
but he can use but half his knowledge if he has no assistance from the 
patient or the patient's family. The physician recommends certain foods 
and advises against certain habits. An intelligent man will follow this 
advice to the letter. As regards many conditions, the reader can find 
ample advice in these pages. ' 

Moderation. — All through life one word sums up the rule which all 
should heed. That word is moderation. 

Temperance is almost a synonym. 

Be temperate in food as well as in drink; in exercise and in work; 
even in sleep and rest, moderation is the word. 

Effects of Immoderation. — Too much meat, too much pastry, too much 
tea or coffee, too little sleep, too heavy work and the blood is surcharged 
with deleterious material which is deposited in the various organs and 
tissues of the body and premature old age comes on, or the organs fail to 
functionate, and death comes years ahead of its' time. Even in acute 
illnesses which are determined in their course in the first few days of the 
disease, constitution plays a most important part. This constitution may 
be inherited — a cause for congratulation — or it may be acquired. 

Healthy Ancestry. — To obtain a good physique one should have 
healthy ancestors. For this purpose — to insure as healthy an ancestry as 
possible to coming generations- — the most intelligent men of our times are 
agitating the passage and enforcement of laws prohibiting the marriage 
of the physically or mentally unsound. 

Inherited Consumption — Consumptives should not marry, or if they 
marry, should not create or bear children to inherit the weakened consti- 
tions and to look forward to the same early and revolting death that their 
parents have had. 

Care in Inherited Consumption. — If, on the other hand, such a family 

(1087) 



1088 CAEE OF THE AGED. 

history has preceded one's advent into this world, attention to every detail 
in the development of the body and to maintaining that condition of health 
which results, will usually lengthen the days and the reward will be worth 
all the struggle and effort. Climate, an outside life, temperance in all 
things, and the careful trial and development of the weakened parts of 
the body are essential to improvement. 

Criminals Should not Have Children. — That criminals should not create 
offspring is most widely accepted. How to prevent this is the question that 
has excited discussion for several decades among learned men. That the 
vast majority of our criminals are the children of other criminals is 
acknowledged. 

Children of Criminals. — A large number of their children are epileptics 
or idiots. With this horde of "misfits" in the community, there is a con- 
stant drag backward on the wheels of progress. Emasculation is the 
remedy most certain, and is offered by the most enlightened and advanced 
men in the world, but few among the masses are prepared to accept so 
severe a measure. Many people fail even in this day to realize that duty 
to mankind is above duty to individual man. 

Cleansing the World of Disease. — The above paragraphs — on consump- 
tion and on criminals — are but hints to the thinking, and if followed to 
their natural conclusion will demonstrate the necessity of cleansing the 
world of disease by allowing those who are afflicted to live out their lives 
as comfortably and as happily as they can, only prohibiting them from 
perpetuating their kind, which they should have no desire to do anyway 
if they realize the sort of offspring that will surely be given them. 

Care in Different Stages of Life. — In the third decade of life many 
excesses in work or in dissipation may be indulged in without any im- 
mediate ill resulting, but the fourth or at latest the fifth decade will show 
that all excesses must be paid for to the full. I do not mean to encourage 
laziness, for activity in business and in pleasure are as useful as can be. 

Value of Recreation. — Vacations are a help and should be spent away 
from one's work and among new and novel scenes. Recreation from work 
and worry helps to lengthen one's days. Brain workers especially must 
throw off completely all thoughts of their work at frequent intervals and 
refresh their minds, and thus their bodies, with new or entirely different 
occupations. The return to work will reveal an increased power and 
interest. 

Value of Sports. — Golf, hunting, fishing, and the various simpler sports 
arc- of value to a mature man or woman, acting both mentally and physi- 



THE AGED. 1089 

cally toward the well-being of the individual. No one should consider 
themselves old so long as they can possibly enjoy the milder sports of life. 
Some men are young at seventy — yes, even at eighty — while some are old 
at sixty. "A man is as old as his arteries/' says someone, and it is true 
that some men are older at thirty than others are at fifty. 

Avoid Worrying. — Don't worry. It ages yourself and all your friends. 
A woman who thinks herself a compact bundle of symptoms looks old, is 
old, but unfortunately does not die soon enough to allow her friends to 
enjoy a little youth. 

THE AGED. 

Prolonging Life — In older times the alchemists claimed to have dis- 
covered the elixir of life. They said that old age might be retarded and 
life greatly prolonged by means of an elixir having the power of prevent- 
ing or suspending physical decay. 

The possibility of prolonging life has in all ages been noticed by great 
thinkers. 

The Organs in Old Age. — The latest scientific knowledge in regard to 
this subject may be stated as follows : The principal characteristics of old 
age, as demonstrated by anatomical research, are a deposition of fibrinous, 
gelatinous, and earthy material in the system. Every organ of the body, 
during old age, is especially prone to ossific deposits. The earthy deposits 
have been found to consist primarily of phosphates and carbonates of lime 
combined with other calcareous salts. 

Bone Hardening in Old Age. — Man begins in a gelatinous and ends in 
an osseous or bony condition. From the cradle to the grave a gradual 
process of ossification is undoubtedly present; but after passing middle 
age the ossific tendency becomes more markedly developed until it finally 
ushers in senile decrepitude. These earthy deposits during old age mate- 
rially interfere with the due performance of function by the organs ; hence 
we find imperfect circulation in the aged; the heart gradually becomes 
ossified; the large blood-vessels blocked up with calcareous matter, and 
nutrition hindered. 

Changes Which Produce Old Age. — "If repair was always equal to 
waste, life would only terminate by accident." It is the opinion of eminent 
scientists that the majority of all who pass sixty-five years suffer more or 
less from these ossific deposits. Therefore, bearing these facts in mind, 
it is plain that the real change which produces old age is, in truth, nothing 
more nor less than a slow but steady accumulation of calcareous matter 
69 



1090 CARE OF THE AGED. 

throughout the system ; and it is owing to these deposits that the structure 
of every organ is altered, elasticity thus giving way to senile rigidity. 
Blockage of various organs is thus commenced, and sooner or later a vital 
part becomes involved, and death of necessity follows. The idea that old 
age was brought about simply, or at all, by a decline of the vital principle, 
has long since been discarded by scientists, and the true cause found to be 
that of gradual disintegration of the tissues because of the inadequate 
supply of blood. 

The feebleness of old age, therefore, being due to nothing more nor 
less than ossific deposits, it is well for a moment to look for the causes and 
influences leading to the condition described. 

THE CAUSES OF OLD AGE AND THEIE AVOIDANCE. 

The two principal causes of old age are, first, fibrinous and gelatinous 
substances; and second, calcareous deposits. According to recent re- 
searches, the origin of the first, the fibrinous and gelatinous., may un- 
doubtedly be traced to the destruction of atmospheric oxygen. ^ 

Fibrin Blockades Life. — Although unquestionably fibrin nourishes the 
organs of our body, yet it becomes at times, as we reach the cool and shady 
walks in the evening of life, accumulated in redundant quantity, blockad- 
ing the streams of life as do the chilling winds of winter the mountain 
rivulets. 

Proportion of Chalky Matter. — The calcareous deposits are proved to 
be caused by gradual deposition from the water which forms so large a 
part (70 per cent.) of the human system, and to be introduced by means 
of food. 

Foods and Chalky Matter. — As a matter of fact, everything we eat 
does contain these calcareous matters to a greater or less degree. The 
cereals are found most rich in them ; so bread itself, the so-called staff of 
life, except in great moderation, most assuredly favors the deposition of 
these salts in the system. The more nitrogenous our food, the greater its 
percentage of calcareous matter ; thus a diet composed principally of fruit, 
from its lack of nitrogen, is best adapted for preventing or suspending 
ossification. 

Effects of Overeating. — Moderation in eating, then, must ever be of 
ureal value as an agent for retarding the advent of senile decay. Large 
eaters more rapidly bring on ossific deposits by taking in more than is 



FOOD IN OLD AGE. 1091 

utilized or excreted, naturally resulting in blockading the vessels and 
destroying their normal functions. 

Best Foods for the Aged. — According to the best authorities, the fol- 
lowing seem to be the best articles of food as containing the least of earthy 
salts: Fruit, fish, poultry, flesh of young mutton and beef; because, as 
before stated, they are much less nitrogenous. Fluids, as part of the diet, 
are of special import. All well and spring water contains considerable of 
the earthy salts, and should therefore be avoided and cistern water used in 
its stead, because water is the most universal solvent known. 

How to Dissolve Salts. — Therefore, if when taken into the system clear 
of foreign matter, it is to that extent the better prepared to dissolve and 
take up those earthy salts and convey them out of the system. The addi- 
tion of fifteen or twenty drops of dilute phosphoric acid to the glass of 
water, and drunk three times a day, will add to the solubility of these 
earthy salts. 

RULES FOR THE CARE OF THE AGED. 

1. The aged should not endeavor to perform the feats of agility, 
strength, endurance, and "of digestion," which were once their pride, 
especially during the extreme heat of summer. 

2. The aged should avoid torpor of the bowels and constipation. 
Straining at stool may cause apoplexy. 

3. Do not give up all mental and bodily work. 

4. In the chill of any evening, or of early autumn, the aged need fire. 
Many an otherwise long life is cut short from neglect of this rule, by an 
attack of some form of lung inflammation. 

5. Life can be prolonged, without a doubt, by a proper change of 
climate and of scene. The flickering flame of life can be protected from 
going out by a careful hand. 

6. All warnings of weakness, or oncoming sickness, or decay, should 
at once be noticed by the aged, and due precaution and proper treatment 
instituted at once. 

FOOD IN OLD AGE. 

What Food to Avoid. — We eat to live or should eat to that purpose, 
and as one grows old there is all the greater demand from Mother Nature 
that we adhere to this rule. Sir H. Thompson, in his book on Diet in Ke- 
lation to Age and Activity, says that if a man past his half century of life 
"continues to consume the same abundant breakfasts, substantial lunches 
and heavy dinners which at the summit of his power he could dispose of 



1092 CARE OF THE AGED. 

almost with impunity, he will in time either accumulate fat or become 
acquainted with gout or rheumatism, or show signs of unhealthy deposit 
of some kind in some part of the body-processes which must inevitably 

empoison, undermine, or shorten his remaining term of life 

The typical man of eighty or ninety years is lean and spare and lives on 
slender rations." 

Three Diet Rules — Prof. W. Gilman Thompson, M.D., of New York, 
in his classic work on dietetics gives three rules to be observed in the 
dietetic treatment of old age. These are: 

"1. To diminish the total quantity of food ingested. 

"2. To give food at frequent intervals in small amounts. 

"3. To give only digestible food, which does not produce too large 
a residue of waste mater, either in the intestinal canal or in the form of 
excrementitious material in the blood." 

A Nature Hint — Meats and tough vegetables are to be avoided and 
Mother Nature gives us a hint of this by taking away our teeth. This does 
not mean that the aged are to be kept on a fluid diet, for mastication is of 
use in promoting the salivary flow. 

Liquid Tonic. — "Malt liquors are very good for the aged, and a 
moderate amount of alcohol acts as a tonic and supplies them with needed 
energy for digestion and other functions." 

Minced Foods. — Yeo's suggestions as to diet in the aged are worthy 
of quoting in full : 

"Of animal foods best suited for this time of life the following may 
be mentioned. \Yhen the organs of mastication are altogether inefficient 
these foods should be minced or pounded into a paste or otherwise finely 
subdivided : 

List of Foods for the Aged. — "1. Young and tender chicken and game 
and other meats. 

"2. Potted chicken, game and other meats, sweetbread. 

"3. White fish, as soles, whiting, smelts, flounders, and so forth. Best 
when broiled. 

"4. Bacon, grilled ; eggs lightly cooked or beaten up with milk, and 
so forth. 

"5. Nutritious soups, such as chicken purees, or fish purees, beef tea, 
mutton and chicken broths. 

"6. Milk in all forms, when easily digested. 

"7. Beef tea and milk supply the needed mineral substances, and the 
former is an excellent slimulant. 



FOOD IX OLD AGE. 1093 

# 

"8. The addition to milk of an equal quantity of Vichy water, warm, 
or of warm water, will often help to make it agree. 

Vegetable Food. — "1. Of vegetable foods the following are all suit- 
able. 

"2. Bread and milk made with the crumbs of stale bread and with- 
out any lumps. 

"3. Porridge and oatmeal gruel. 

"4. Puddings of ground rice, tapioca, arrow-root, sago macaroni with 
milk or eggs and flavored with some warm spices, or served with fruit 
juice or jelly; bread and butter, at least a day old; rusks for soaking in 
tea, or milk, or water. 

Artificial Foods. — "1. Artificial foods, consisting of predigested 
starches. The digestive ferments are scantily provided by the digestive 
organs at this age, and soluble carbohydrates are valuable for maintaining 
the body heat. 

"2. All farinaceous foods should be submitted to a high temperature 
for some time so as to render the starch granules more easy of digestion. 
"3. Vegetable purees of all kinds may be taken in moderation — e. g., 
potatoes, carrots, spinach and other succulent vegetables. 

"4. It is important that the use of potatoes and fresh vegetables 
should not be neglected; otherwise a scorbutic state of the body may be 
engendered. 

"5. Stewed celery and stewed Spanish or Portugal onions. 
"6. Stewed or baked fruits and fruit jellies and the pulp of perfectly 
ripe raw fruits in small quantity. 

Counteracting Acidity. — a The acidity of certain stewed fruits may be 
advantageously neutralized by the addition of a little bicarbonate of soda 
so as to avoid the use of a large quantity of cane sugar to sweeten it, as 
this is apt to cause gastric fermentation and acidity. In stewing fruit 
about as much soda as will cover a shilling should be added to each pound 
of fruit. 

Use of Condiments. — "Aged persons often require their foods to be 
accompanied with some kind of condiment, which promotes their diges- 
tion and prevents flatulence. 

"Caviare and the roes of smoked and salted herrings are of this 
nature. 

Sweetenings. — "For sweetening food milk sugar is much less prone 
to excite acid fermentation than cane sugar. 

Digestible Form of Fat. — "A verv digestible form of fat, when it is 



1094 CARE OF THE AGED. 

needed, is cream mixed with an equal quantity of hot water and about ten 
drops of sal volatile to each fluid ounce." 

General Diet Required. — It is but fair to all concerned that I submit 
the teachings of Dr. J. Boy-Teissier, of Marseilles, who, in the most 
recent and complete work on this subject, handles the theme and the 
patient in a different manner entirely. As to diet, he says: "I do not 
think that a special diet is necessary. We must not forget that the normal 
old man is not a patient ; all the functions of the adult exist also in the old 
man, only in a diminished degree ; the functions are the same, but their 
activity only is lessened. . . . We must regulate the quantity of 

food and adapt it to the degree of senilization It is useless 

and even dangerous in the case of old people to try to maintain the strength 
at high point by means of alimentation. 

A Diet of Maintenance. — "In a general way, having no longer an 
active life to lead, the old man has need merely of a diet of maintenance 
. . . watch . . . over the performance of the excretory func- 
tions ; as long as the weight does not vary, and as long as the urea repre- 
sents the quantity of nitrogen contained in the food we may regard it as 
certain that there is a perfect equilibrium and that the alimentation of 
the old man is sufficient." 

Cautious Use of Wines. — Boy-Teissier does not subscribe to the saying 
that wine is the milk of the aged, but advises great caution in its use. 

The Aged Should not House Themselves. — This same author advocates 
plenty of fresh air for the normal old man. So many old people house 
themselves up and shut out from their blood the pure air which they need 
even more in their old age than when younger. If diseases of the lungs 
forbid exposure, heed should be given, but the normal old person should 
have fresh air, and also all the sunshine he can get. 

Clothing of the Aged — The clothing should not be heavy, but rather 
light. It should, however, be warm and comfortable. Bundling should 
be avoided in the latter days as in all the other days of life. The 
warmest place in the chimney has always been reserved for the grand- 
parent, but this is a mistaken kindness, for it only increases his tendency 
to inaction. 

Muscular Exercise — To counterbalance this tendency to inaction, 
which means a retarding of the combustion of the products of nutrition, 
muscular exercise should be insisted upon. Care should be had lest this 
be overdone, but the old man should be forced to exercise. 

Medical Care. — I have written here of normal old age, and it is the 



CARE OF THE EYES. 1095 

old age we all look forward to. Few attain it and those who grow old 
with some organs of the body more advanced in the aging process than 
others, find that they need almost constant medical supervision to help 
them live longer and to be more comfortable while they live. 

Natural Death. — " Above all modes of dying is that which we must 
call natural death, physiological death, that which necessarily and happily 
terminates existence. This death is gentle and calm, for it is free from 
all painful manifestations; it is, therefore, desirable, and all our efforts 
ought to be directed to its attainment. We should try to have it accepted 
as a happy event. ... I have not to occupy myself with the value 
of life. Most commonly, I believe, it is worth only what we make it worth. 

When Death is Welcome. — "But after having seen that all the vital 
phenomena have fulfilled their evolution, we may justly believe that this 
final act, that which is accomplished naturally, without our having had 
any responsibility in its hastening or retardation, that which terminates 
the series of organic acts, ought to be regarded as welcome." — Boy- 
Teissier. 

CARE OF THE EYES. 

To take proper care of the eyes is to do all we can to avoid such dis- 
eases as are avoidable. To do this we should know something about the 
eye and its diseases, descriptions of which have been given in Book IV — ■ 
Part IV. 

Near-Sightedness — Boys often discover their near-sightedness by find- 
ing that their playmates can read signs and see clocks and faces at much 
greater distances than they can. Near-sightedness is a growing defect 
among young people and may be corrected in part by looking at distant 
objects in the heaven or on the ocean. 

Weak Sight — Fatigue of the eyes during or after the use of them is 
the first symptom of weak sight. This is more noticeable at first after 
reading, writing or sewing in the evening ; soon the same fatigue is noticed 
after similar occupation in daytime. In time this fatigue comes on im- 
mediately after attempting to read or sew, and, if work is continued, pain 
and confusion of vision follow; letters run together, lines are blurred and 
indistinct. Weak sight is simply a disorder of the muscular apparatus of 
the eyes. 

There are four striking symptoms by which we may judge that the 
eyes are being injured : 

1, Redness of the eyelids and eyeballs. 



1096 CARE OF THE AGED. 

2. Pain in the eyes. 

3. Indistinct or imperfect vision. 

4. Frontal or other headaches. 

In health the muscles act in perfect harmony, but if these muscles are 
overworked, fatigued or sensitive they do not act harmoniously, and weak 
sight is the result. 

Never Use Imperfect Light. — Never use an imperfect light. What is 
an imperfect light ? 

1. Deficient amount of light, as in the early morning or twilight, 
or an artificial light far distant, or a very small artificial light, or light far 
from a window which is too small for the room and for a dark day. When 
the light is such as to render it difficult to see the work or print before us 
a proper regard for the preservation of vision will compel the immediate 
stopping of the work. 

2. Light may be imperfect from its' unsteadiness. It is this quality 
that renders the electric light harmful to vision. Gas light often exhibits 
a degree of flickering very trying to the eyes. 

3. The light may be steady but the car or carriage in which we are 
seated may move. The attempt to read in the cars is a fruitful source of 
injury to the eyes. 

4. The practice of reading while in a reclining position upon a 
lounge or in a bed causes the light to enter the eye at such an angle as to 
require an undue amount of effort in order to see distinctly for a long time. 
Such a position should always be avoided. 

When possible the light should fall upon the printed page or upon 
our work from the left side of the body and from behind the shoulders. 

How to Preserve Good Sight — 1. Act as if the eyesight were of more 
importance than any other thing on earth. 

2. Have your child's eyes carefully examined by an expert before 
it is given specific tasks to perform calling for the full exercise of healthy 
eyes. If the eyes are found defective then grade the tasks according to 
the nature of the defect. 

3. Never use the eyes when such use causes pain in these organs or in 
the head. 

4. Never use the eyes when imperfectly supplied with blood, as be- 
fore breakfast, when exhausted after a severe illness, and so forth. 

5. Never use the eyes for close work in an imperfect light. 

6. Avoid the excessive use of alcohol and tobacco. 

7. Heed the warning given by redness of the eyelids and of the whites 



CARE OF THE EYES. 1097 

of the eyes ; by pain in or about the eye ; by the continuance of indistinct 
vision for any considerable time. 

8. Regard the eyes as part of a very complex system of apparatuses, 
the best health of all being absolutely needful for the best health of each. 

9. Remember that we do not see with the eye, but with the brain. 
Hence after the brain is exhausted it is impossible to really see. 

Use of Spectacles and Eye-Glasses. — Weak sight is very often due to 
defective form of the eyeball itself, it being too flat, too full, or of irreg- 
ular form. In cases of defective eyeballs, beside following the advice 
given above, the imperfect shape must be neutralized by the scientific 
adaptation, of spectacles. It is quite wrong to depend upon your own 
judgment in this matter or to procure your glasses from a traveling ped- 
dler of spectacles. For elderly people, spectacles are usually preferred to 
eyeglasses, except for occasional use. For long use spectacles are more 
comfortable. 

Blue or smoked glasses in weak sight, when there is much dread of 
light. Their use should be confined chiefly to wear in bright sunlight on 
the snow, sand or water. For reading, colored glasses should not be too 
dark in tint, as too much exertion is required to see clearly through them. 

Contagious Eye Diseases. — It should be borne in mind that diseases of 
the lids or eyes attended with a pus discharge are contagious. Those suf- 
fering with such a disease should be kept apart from others and great at- 
tention should be paid to cleanliness. Towels and washing material should 
not be used in common. 

Common Eye Accidents. — Those who work where splinters of metal 
or stone are liable to strike the eye should wear spectacles at their work. 
Spectacles of ordinary glass are a good protection against cinders in travel- 
ing. Eye-stones are nothing but smoothly-worn pebbles. It is not best to 
use them. It is not common-sense treatment to cure an irritable eye, suf- 
fering from a foreign body, by placing another foreign body therein. 

Kemoving Cinders — A cinder or other foreign body may often be dis- 
placed by quietly and steadily looking downward at your feet, letting the 
tears that form wash out the irritating substance. If the foreign body 
sticks on the ball it sometimes can be readily wiped off with a piece of 
paper twisted to a lamp-lighter shape or the free end of a common match. 
If it does not come off easily professional aid must be secured as great 
harm may be done the beautiful, transparent front of the eye by the use 
of sharp instruments in unskilled hands. 

If quick-lime or mortar has fallen into the eyes, the best plan is to 



1098 CARE OF THE AGED. 

drop in some olive oil at once. The eye then may be washed out with 
warm water to wash away all the particles of lime. This can be best done 
with a small syringe. If acid has gotten into the eyes use milk and water 
at once and in the same manner. 

CARE OF THE EAR. 

Prime Rules. — 1. Act as if hearing were of more importance than any 
other thing on earth. 

2. Refrain from use of the ear when it causes pain, choosing quiet 
places and deadening sound by the use of cotton plugs. 

3. Avoid all such injuries to the ears as result from slapping, pulling, 
and very loud and sudden noises. 

4. Keep out of the external ear all things smaller than the forefinger, 
or stiffer than a towel or handkerchief. 

5. Keep out of the ear all oils, all soaps, all cold water and everything 
else recommended by kind but mistaken friends ; especially never ap- 
ply a poultice to the ear for the relief of pain. Dry heat will do all that 
moist heat can do to relieve and be free from the danger of absolutely, de- 
stroying the drum of the ear. 

Cleansing the Ear. — In health, the deeper parts of the ear can be left 
to take care of themselves. The orifice of the canal is to be cleansed in 
precisely the same manner as any other depressed portion of the surface 
of the body — that is, with a wet sponge or cloth. 

CARE OF THE SKIN. 

Every-day Washing — Every-day washing should be the rule the year 
round, but particularly so in summer. Ablution of the person sufficient 
for cleanliness may easily be made to act also as a proper stimulant by 
using a rapid sponge bath, followed by quick rubbing for a few moments 
with a towel of such texture as can be borne without irritation. The skin 
will not bear the frictions of a lintish towel so well in summer as in winter. 
Invalids should avoid chilling the body ; simple and generally healthful as 
bathing is, it cannot be trifled with. Many a good man or woman has un- 
wittingly committed suicide with water. 

Daily Attention to Feet. — If the person is very feeble and very sensi- 
tive to the application of water such an one can attend to one part of the 
body one flay and another the next. It is well, however, to give daily at- 
tention to the feet. The feet perform a large part of our bodily labor, and 



CARE OF THE HAIR. 1099 

the excretion from them is so great that particular care should he taken 
to keep them clean. Warm sponging followed by friction is more suitable 
for cleansing the skin of dirt and for the delicate invalid and child. 

Use of Soap. — The amount of soap used in the toilet depends upon the 
delicacy of the skin and the exposure to which it has been subjected. 
Those who have oily skins depending upon well-developed and active oil- 
glands require much more soap than those having harsh and dry skins 
lacking in oily secretion. 

Cautious Use of Soap. — Daily application of soap to the face is not 
necessary unless one is exposed to considerable dust and dirt. Hot water 
and a coarse washrag with thorough rubbing and followed by cold water 
and more thorough rubbing will stimulate the skin and make it healthier 
than the excessive use of soap to remove invisible dirt. Many cases of 
"black-heads" and postular eruptions of the face have been benefited by 
stopping the use of soap on the face. 

Removing Face-Shine. — Clean fine white velvet is an elegant substi- 
tute for powders to remove the shine on the face. Chamois skin is used for 
the same purpose. 

Cosmetics. — Cosmetics are substances applied to the skin, hair, teeth, 
nails, and so forth, to improve their appearance. None of them are essen- 
tial to health; the great majority are positively harmful. Health and 
strength give the beauty that is appreciated by all men and women of 
refinement. 

CARE OF THE HAIR. 

Attention to the Scalp. — The preservation of the hair depends upon a 
number of things, and chief of these is the condition of the scalp which is 
the soil in this case. The scalp should be thick and movable and massage 
will help to develop this part of the body as it does other parts. So 
shampooing does double duty, cleansing and massaging. The brush does 
the same work in a different way and neither should be neglected. 

Cleansing the Hair. — Cleanliness is the first requisite in the manage- 
ment of the hair. There is no danger that the scalp will be washed too 
often. Shampooing should be done as often as the hair is dirty. At least 
once a month the head should be thoroughly washed and the hairs cleaned 
down to their roots. Any good soap may be used, but there is not one that 
is purer than the white castile. Tincture of green soap is a reliable and 
satisfactory soap. 

Brushing the Hair The hair should bo brushed several times a day. 



1100 CARE OF THE AGED. 

at least in the morning and evening, and for several minutes at each time, 
until there is a feeling of warmth in the scalp. Adults should use a stiff 
brust and children or those with thin hair or a tender scalp a soft brush. 
Never brush hard enough to make the head sore. 

Good Combs. — Combs should be preferably coarse and used to disen- 
tangle the hair, not to cleanse it. The teeth should be well made and not 
ragged, as they will then tear and pull out the hair. Never try to comb 
dandruff out of the hair. It should be brushed out or washed out. 

Crimping. — Crimping the hair causes it to break and crack. This 
may be a matter of considerable importance in elderly women in whom 
the hair is beginning to fall and thin out, for this will hasten the fall and 
cause more or less baldness. 

Grayness. — Women usually preserve the color of the hair longer than 
men. Fair hair falls out sooner than black, but does not become gray so 
soon. Premature grayness of the hair is often produced by debility, 
anxiety or severe illness. 

Baldness. — If from any cause the hair papilla becomes diseased or 
debilitated it either ceases to produce the hair or each successive hair be- 
comes shorter, finer and more brief in its life, until, finally, atrophy of the 
hair follicles occurs and the hair is dead. Under ordinary circumstances 
the hair of the head begins to thin out between the ages of thirty and 
forty and this thinning proceeds slowly but steadily during the rest of the 
individual's life. Those who are affected with dandruff should pay imme- 
diate attention to the condition, otherwise the hair will begin to fall out 
and baldness result. Baldness can occur without the occurrence of 
dandruff, and, again, the hair remains thick and strong in some persons 
whose heads are full of dandruff. The baldness occurring in connection 
with fevers, skin diseases of the scalp, and so forth, is only temporary; 
the bulbs are not destroyed and the hair is again reproduced. In elderly 
persons, after sickness, the hair may not return to its full former con- 
dition. 

Hair Invigorators, — When the falling of the hair has been caused by 
some fever or other illness the remedies used for relief are stimulants — 
something to increase the blood supply to the scalp. These are called 
hair invigorators. We would caution the reader against the use of all 
patent, advertised hair remedies. A simple and harmless "invigorator" 
is as follows: 



CARE OF THE TEETH. 1101 

Formula for a Good Hair Invigorator. — 

Cologne water 2 ounces 

Tincture of cantharides 2 drachms 

Oil of lavender io drops 

Oil of rosemary io drops 

Use once or twice a day. If it makes the scalp a little sore, discontinue its 
use for a short time. 

To Cleanse Hair of Dandruff.— Hub in well the yolk of an egg. Wash 
out with castile soap, rinse with cold water and dry well. The egg com- 
bines with the grease and dirt and gives the scalp a thorough cleansing. 

A Good Wash for the Hair. — 

Vinegar 2 ounces 

Salt of tartar 2 drachms 

Spirits of lavender % ounce 

Spirits of rosemary I ounce 

Spirits of nutmeg % ounce 

Essence of almonds I drachm 

Essence of violets i drachm 

Pure spring water 20 ounces 

Mix and bottle for use. This makes, as well, a cool and refreshing perfume. 

CABE OF THE TEETH. 

Attention to the teeth should begin early in life, even during the 
period of first teeth. Decay of the "milk" teeth should be prevented and 
filling is just as important as with the permanent set. The temporary 
teeth must be removed in due time if they do not fall out themselves, and 
the permanent ones must be trained to fill their places. The teeth should 
be cleansed fiYe times a day — morning, bedtime and after each meal. A 
soft brush is better than a stiff one so as not to wound the gums. The best 
dentrifice is water ; sometimes a little prepared chalk or white castile soap 
may be used. The too frequent use of powders containing cuttlefish bone 
or charcoal will injure the enamel of the teeth. "When the gums are 
tender and tend to bleed add a few drops of tincture of myrrh to the water. 
Avoid all patent tooth powders and washes. It is a good rule to visit the 
dentist once each season to find out the exact condition of these important 
organs. Never lose a tooth if art can save it. The shape of the jaw and 
face is altered by the removal of teeth. When, by reason of a collection 
of tartar on the teeth a powder is desired for its removal, the following 
will be found useful and agreeable : 



1102 CARE OF THE AGED. 

Tooth Powder. — 

Powdered sugar 2 drachms 

Precipitate of chalk 2 ounces 

Orris root 2 drachms 

Bicarbonate soda 1 drachm 

Mix and flavor with oil of rose or oil of teaberry. 

Care of the Mouth. — After the teeth have been cleansed, a valuable 
addition to the toilet is a mild and pleasant antiseptic month wash, which 
sweetens the mouth and by its action on disease-producing organisms puri- 
fies the mucous lining and acts against the decomposition of the food debris 
which the most careful attention to the teeth cannot completely remove. 

Antiseptic Mouth Wash 

R. — Boric acid 10 grains 

Resorcin 4 grains 

Salol 2 grains 

Thymol % grain 

Glycerine % drachm 

Pure water 2 ounces 

Care of the Feet. — The feet are subject to many diseases, but the most 
common ones — ingrowing nails, corns and bunions — are due to neglect of 
a few simple rules which nearly all adults know. Fashion decrees that 
certain shapes must be worn, and the poor foot, willing to toil and bear, 
is pressed and pulled out of shape by misshaped shoes. 

Shoes. — 1. Should be neither too large nor too small. They should 
fit snugly but comfortably all parts of the foot. 

2. The heels should be placed well back under the human heel. 

3. The soles should be reasonably thick. In winter heavy soles have 
many advantages that are apparent. 

4. Patent leather and other forms of non-porous leather are injurious 
as they prevent the dissipation of natural sweat. The retention of this 
sweat increases the tendency to soft corns and to sore feet. 

5. Slippers and low shoes are to be worn only in warm weather. 
They expose the blood at the ankles and so encourage colds. 

The toe-nails should be cut regularly and carefully. Overshoes 
should always be worn in wet weather. Ladies often go without them in 
rlamp weather, relying upon the thickness of the soles of their shoes, and 
thus expose themselvos to risks. A sheet of India-rubber is sometimes 
pla o(>(\ brtween the layers of leather in the soles of shoes, or felt or 



CARE OF THE FEET. 1103 

cork soles are placed within the shoe. There is no objection to these, pro- 
viding they do not supplant the rubber overshoes. 

Ingrowing Toe-Nails — Causes — Tight shoes and the cutting of the 
nails square are the causes. A tight sock may also be at fault. The skin 
is pressed over the sharp edge of the nail and ulceration results. The edge 
of the nail may become thickened or proud flesh may spring up at the point 
of ulceration. 

Treatment. — "In mild or trivial cases the trimming or clipping of the 
free margin of the nail, scraping of the dorsal surface Avith a bit of glass 
or with a knife, so as to reduce its thickness and to produce a tendency to 
curling upward and backward of its lateral margins and the removal of 
any cuticle accumulated under the ingrowing edges of the nail are all that 
is required to give relief and prevent further progress. Pressure must be 
avoided. When ulceration has occurred a minute roll of lint shreddings 
should be neatly packed beneath the tender overhanging skin and ingrow- 
ing edge. Strapping is then applied so as to retain the lint and drag upon 
the overhanging integument and keep it pulled away from contact with 
the ingrowing edge. The lint may be removed in a few days and the space 
filled with boric acid, iodoform, lead nitrate, alum or zinc oxide." 

In severe cases avulsion of half or all the nail is required. This is a 
sure cure and a favorite with many physicians. * 

Corns. — A common corn is caused by friction or irritation of the skin 
from tight, loose or otherwise ill-fitting shoes, hard, stiff leather, large 
wrinkles over the joints, high heels that pitch the foot forward and keep it 
constantly bearing against the leather over the toes, and shoes narrow at 
the toes. In such cases the skin thickens and hardens to protect itself from 
injury in just the same way that it does upon the hands or other parts of 
the body exposed to rough contact. 

Treatment. — Ordinary hard corns, when young, may be removed by 
scraping up the callous skin about the borders and prying out carefully 
with a penknife. It must be remembered for the successful treatment of 
corns proper foot covering must be worn. The shoes must be soft and of 
proper fit. Only such means can effect a radical cure. Corn cures and 
plasters are but a vexation if the laws of hygiene are not obeyed. The 
important part of treating corns is to relieve the pressure. Persons ill 
with a long fever, confined to their beds, have found their corns gone on 
getting from bed. 

If the corn is between the toes the sole should be extra wide so that 
cotton may be put between the toes to keep them apart. Dr. Holler 



1104 CARE OF THE AGED. 

(quoted in the Therapeutic Gazette) advises that the foot be soaked in 
hot water for fifteen minutes before bedtime, this followed by an applica- 
tion of salycilic acid in collodion, one part to three. This is repeated for 
five or six nights, each time removing all dead tissues with a knife after 
bathing. A drop of castor oil well rubbed in every night helps greatly. 

Bunions. — Cause. — The great cause of bunions is the wearing of short 
and narrow-toed shoes, making a constant tendency to enlarge^^viden and 
project the joint of the great toe. Bunions may prove a menace to life, 
especially in those past middle life. Eepeated inflammations may finally 
go on to suppuration and this leave an ulcer which is most tedious to heal. 
This ulcer in those past middle age is liable to lead to erysipelas and senile 
gangrene. Amputation of this part of the foot has been necessary in 
some cases. 

Treatment. — This is usually soothing. The deformity can seldom be 
overcome. Comfortable shoes are the things to be considered. When 
the bunion first appears and is characterized by simple thickening and a 
sensation to the examining finger as of fluid in a sack (which is just what 
is present), the bunion may be treated with flying blisters, tincture of 
iodine or strapping with mercurial ointment. If inflammation exists it 
should be treated as inflammation is treated elsewhere. 

Chilblain or Frost-Bite — Chilblains may be defined as an inflamma- 
tion of the skin and underlying tissues due to cold. Anemic persons and 
tkose who are weakened from hunger or fatigue are more liable than 
their more fortunate fellows. 

Symptoms. — First, redness accompanied by hypersensitiveness of the 
parts and tingling. This is soon followed by purplish lividity and dimin- 
ished sensibility. Blanching with numbness supervenes. Next coagula- 
tion takes place and is characterized by the parts becoming hard, white, 
absolutely insensible. In very severe cases gangrene follows. The parts 
shrivel up and blacken. An inflammatory line of demarcation shows 
itself later. 

Treatment. — In the stage of redness friction with a towel soaked in 
ice-water or with ice or snow should be resorted to until the congestion 
disappears, when the parts should be wrapped in cotton wool. The patient 
should not be taken into a warm room until after reaction has taken 
place. 

Tonic treatment is indicated in nearly all cases and should consist of 
cod-liver oil, quinine or some such general tonic. 

For the itching the following have been recommended : 

Tincture of iodine; soap liniment or diluted turpentine. 



PART I OF BOOK VIII 

Treats of Sexology, giving much information which 
is valuable to young men and women entering upon 
or contemplating marriage. 



Affinity 1 107 

Afterbirth, The 1 125 

Association 1 107 

Auxiliary Remedies 1 125 

Barren Periods, Table of n 12 

Birth in Absence of Physician .. ..1125 

Care of the Passions 11 12 

Childbed, Easy 1 124 

Childbirth, Pain in 1124 

Conception, Period of 1109 

Conception, Table of 1112 

Control of Sex of Child mi 

Cord, Navel 1 125 

Courtship 1 107 

Length of 1 107 

Easy Childbed 1 124 

Emotion and Secretion 11 10 

Engagement 1 107 

Female Child Desired 1112 

Form, Physical 1 109 

Function of the Ovary 11 10 

Gestation, Period of 1 120 

111 Health and Marriage 1108 

Infant, The 1126 

Length of Gestation 1120 

Lessening Pain in Childbirth 1124 

Longevity and Marriage 1108 

Male Child Desired 1112 

Marriage and Longevity 1108 



Marriage Estate 1 107 

Marriageable Age 1 107 

Mental Association mi 

Mental Condition 1 107 

Money and Marriage 1 108 

Mutuality 1 108 

Navel Cord 1 125 

Necessity for Rest 1126 

Ovary, Function of 1 1 10 

Pain in Childbirth 1124 

Remedy Against 1125 

Rules for Avoiding 1124 

Passions, The 1112 

Period of Conception 1 109 

Period of Gestation 1 120 

Physical Characteristics 1108 

Physical Forms . . 1 109 

Pregnancy Table 1121 

Religion 1 108 

Remedy Against Pain 1 125 

Rest, Necessity for 1126 

Rules for Avoiding Pain 1124 

Secretion and Emotion 1110 

Sexology 1 107 

Sex of the Child, Control of mi 

Table of Barren Periods 1112 

Table of Conception 1112 

Table of Pregnancy 1121 

Tastes 1 108 



70 



1105 



"TWILIGHT SLEEP 55 

OR, THE SCOPOLAMIN TREATMENT IN CHILDBIRTH 



"Dammerschlaf" or "Twilight Sleep" is the term given to a method of painless 
childbirth, discovered and perfected at the Frauenklinik at Freiburg, Germany, 
by Drs. Bernhard Kronig and Carl J. Gause, and accomplished through the use 
of scopolamin and morphine. 

Credit for pioneer work along this line must be given to Sir James Young 
Simpson, a London physician, who in 1847 brought about the first spontaneous 
birth under artificial painlessness through the inhalation of sulphuric ether. 
Later he used chloroform, confining Queen Victoria in this manner in 1853. While 
chloroform is now extensively used in obstetrics where instruments are required, 
it is used only by a limited number of physicians to produce a partial anaesthesia, 
and thus give a measure of relief from pain, but without entirely preventing a 
natural childbirth. 

Various other experiments have been made for producing a limited degree 
of narcosis in order to secure painlessness in confinement, though the Freiburg 
method, or "Dammerschlaf," seems to have been most successful. In France a 
new method was brought to light in 1914, about the time the great war broke out, 
in which antalgesine is used, discovered by a chemist, Georges Paulin, and later 
taken up by Ribemont-Dessaignes, head of Beaujon Maternity. In America the 
so-called "laughing-gas," or nitrous oxide and oxygen, has been used with some 
success in various experiments, together with a dozen other anaesthetics. 

The scopolamin-morphine method was first used at Freiburg in 1903. Later 
scopolamin was combined with nacrophin, another opium derivation. The result 
is a condition of semi-narcosis, sufficent to obliterate or ease the pain, but without 
producing complete insensibility, and without preventing the muscular contrac- 
tions that are essential in natural childbirth. In other words, the condition 
induced is aptly expressed by the term "twilight sleep." The chief characteristic 
is the loss of memory, even though the patient is conscious. The success of the 
treatment depends very largely upon the technique employed and upon the skillful 
adjustment or regulation of the successive doses of the drug. Many physicians 
have severely condemned the "twilight sleep," but those who defend its use 
claim that unsatisfactory results are due entirely to faulty technique. 

The most serious criticism bears on the alleged tendency of the treatment 
to affect the child injuriously, possibly causing asphyxiation, even though favor- 
able to the mother. It is said that "blue babies" are likely to result, through the 
failure of the foramen ovale in the walls of the heart to close properly with the 
change in the child's circulation, which normally takes place when respiration 
begins. In Freiburg, however, little trouble of this kind seems to have been 
encountered, and after a number of years the death rate of babies born at the 
Frauenklinik was cut from 3.4% to 1.3%. Success is achieved in about 80% of 
all cases. 

Two special advantages are claimed for the "twilight sleep," namely, the 
avoidance of the use of instruments in a majority of cases and the rapid recovery 
which seems to be made possible through the lack of the nervous shock and 
mental strain which ordinarily attends natural childbirth. It is claimed that 
painless childbirth will mean an increase in the birth rate, inasmuch as women 
will no longer dread the ordeal. The "twilight sleep" treatment seems especially 
suited to the requirements of nervous women. 

1106 



Book VIII 



SEXOLOGY 

PAET I. 



COURTSHIP AND MATRIMONY. 

Courtship — The object of courtship should be to study dispositions 
and affinities, also mental and physical conditions. Falling in love first 
and then courting is substituting blindness for sight, folly for discretion. 

Association. — Both young men and women should mingle freely 
in a social way before entering on courtship, for genuine courtship im- 
plies more or less direction of attention to a single person, and therefore 
a measure of social exclusion. 

Length of Courtship. — Courtship should never be hasty. It should 
be prolonged until both parties are satisfied of the mutual existence of 
the qualities which will conduce to conjugal happiness. 

Engagement. — Engagements should, as a rule, be brief. The spec- 
tacle of engaged couples trying each other's patience for years by delay- 
ing marriage is a pitiable one. The contract entered into becomes a 
mortgage without interest. 

Affinity — Affinity differs from love. It may exist in the marriage 
estate, and be productive of comfort and happiness in the absence of the 
sentiment of love. Yet it cannot be said that the converse of this ever, 
or, at least, frequently is true. Affinity rests on a variety of causes. 

Mental Condition — Mental affinity is necessary to married happi- 
ness. An ignorant man or woman should not mate with one of educa- 
tion, or vice versa. It cannot be said that such a union is devoid of 
all certainty as to happiness, but the chances for unhappiness are too 
great to risk. 

Marriageable Age. — In temperate climates the proper marriageable 
age is not reached before maturity, when nature has completed and 
perfected the organic structure ; that is to say, marriage may be entered 

1107 



1108 SEXOLOGY. 

upon with propriety at from twenty to twenty-five years of age. Earlier 
marriage is likely to entail injury to health and comfort upon the wife; 
while marriage at a late period in life is apt to lead to puny and sickly 
children. Any material disproportion in the ages of man and wife should 
be avoided. 

Marriage and Longevity — It is a definitely ascertained result of 
marriage that it lengthens life, where the estate is entered upon with dis- 
cretion, and conducted in a proper manner. 

Ill Health and Marriage. — The marriage of unhealthy persons is 
liable to lead to distressing consequences. Hereditary transmission of 
diseases enters into the moral as well as physical order of things. This 
is especially true of consumptives and scrofulous people, who, as a rule, 
are prolific. Even if the exact hereditary taint does not pass to the off- 
spring, there is liability to a train of the common diseases which mar com- 
fort and destroy life. 

Money and Marriage. — Marriages of convenience, that is, for money, 
ease or distinction, are to be deprecated. The fortune-hunter, pure and 
simple, is never a disinterested lover, nor a considerate life partner. The 
spirit of mercenariness, which prompts an alliance for convenience, grows 
by what it feeds upon, and is an enemy to conjugal harmony and hap- 
piness. 

Religion. — Likeness in religious sentiment is necessary to conjugal 
happiness. It is not necessary that the man and wife should belong to 
the same church. What is meant is that there should be tolerance of the 
religious views and pious sentiments of each other. The indifferent man 
or woman, the intolerant, the mocking, the profane may speedily wreck 
the happiness, and even health, of a partner, for there is no sentiment 
that lies deeper, or is more sensitive, than that of piety and religion. 

Tastes. — These should be so nearly akin in man and wife as to assure 
adaptability and accord. When a wife sees beauty in an object and a 
husband only ugliness, or when one is tidy and the other careless, there 
are constant grounds for reproachful differences, ending in unhappiness. 

Mutuality — In general, mutuality in the conjugal estate is a sharp- 
ener of love and respect, a helper to the further and fuller exercise of 
whatever ripens and completes manhood and womanhood, and conduces 
to the perfection of the estate. 

Physical Characteristics Affinity, adaptability and all characteris- 
tics of a mental, moral and sentimental nature, which are generally 
recognized as essential to married happiness, do not necessarily include 



THE PERIOD OF CONCEPTION. 1109 

physical likenesses. While two unhealthy people may not marry for 
fear of perpetuating disease in their offspring, such fear may not prevent 
the alliance of a sturdy constitution with a delicate one. Oftentimes 
marriage improves a delicate organization; at least, there is a possibility 
of the robust man or woman so modifying the condition of offspring as 
to eliminate hereditary disease tendencies, and produce a healthy gen- 
eration. 

Physical Forms. — Intercourse in the lower animals and in plants is 
so regulated by experts as to lead to great improvements in the species. 
This is equally possible in mankind. The tendency to over-proportion 
in male or female lines may be corrected by marriage of a large part- 
ner with one of small size. The same is true of complexions. The 
brunette may well marry with the blonde, with the hope of modifying 
parental complexions in offsprings. Some theorists carry this matter 
much further, and say that those having the same color of eyes should 
not marry; and they say the same of the hair. So large-boned people 
should marry those of small bones; beauty should marry homeliness; 
nervous people should marry their opposites; those of strong facial con- 
tour should marry those with less decided physiognomies ; and so on ; all, 
of course, with the hope of curing in their posterity what may pass for 
defects in the parents; or, if not defects, at least so modifying physical 
forms as to produce a more satisfactory form. 

The Final Resolve. — Courtship has made the contemplated partners 
acquainted with one another. They have talked over their aims and 
ambitions. They have plighted troths and sealed a contract. Among 
the Hebrews this was the equivalent of marriage. The final resolve 
should, therefore, be to carry into and through the marriage estate all 
those high agreements which love prompted, hope cherished, and thought- 
ful consideration of the future suggested. 

THE PERIOD OF CONCEPTION. 

Woman's Courage. — Courage is assigned to man — to woman it is due. 
Follow her steps from the time she enters the arena of married life, study 
each line — each shading and its effect — as though an artist with magic 
brush had depicted on canvas the hidden mysteries of life's various phases, 
and the result will be startling to those who have been but casual ob- 
servers in the past. The courage and sublimity of woman's nature is in- 



1110 SEXOLOGY. 

herent, descending through ages, thus becoming a fixed moral quantity 
of woman in her kind. 

Courage Illustrated. — Courage in woman is illustrated by the forti- 
tude with which she bears her children, the cheerfulness with which she 
undertakes their moral and physical training, and the patience and perse- 
verance she shows when called to tend by their sick-bed through the long, 
weary hours, days or weeks of their illness. All parents desire to bring 
into the world good, bright and healthy offspring without pain. Can it be 
accomplished ? 

Propagating Likes. — Sexual emotion is absolutely necessary to con- 
ception. The impress is made at the moment. Every quality of mind or 
body which is dominant then will undoubtedly determine the fate of the 
offspring. How imperatively necessary it is, then, at that moment, to 
permit nothing but the most pleasant fancies to occupy the mind, namely, 
the thought of those actions and things which are most desirable to re- 
appear in children. 

Natural Harmony. — Life itself should be a sober hilarity; all the 
senses should be in harmony with nature, and the heart should be ready 
to respond at the right period with a holy fidelity to the mysterious de- 
mands of the love which unites existences, and in the homes of earth 
educate beings to dwell in heaven. 

WILL THE BABE BE BOY OR GIRX? 

Function of the Ovary. — The ovary is undoubtedly the predominant 
factor in this respect. The only means by which the determination of 
sex can be influenced is by the nutritional processes in the ovary. Dis- 
turbances in the ovary in this line, dating from foetal life, seem to deter- 
mine a preponderance of male ova, while abundant normal nutritional 
processes favor the production of females. 

We have observed, in our experience, the evidence of nutritional dis- 
turbances, as a number of mothers of boys gave birth to girls after symp- 
toms of diabetes were first noticed. 

Emotion and Secretion. — Cases of this kind might be multiplied ad 
libitum, but such instances are not needed to demonstrate that the feel- 
ings infliitmcp fwerv fibre of our frame. The soul pervades every element 
of our bodies, and "in every nerve it thrills with pleasure, or grows mad 
with pain." The direct influence of the immortal agent over the mortal 



CONTROLLING SEX OF CHILD. 1111 

organism is beautifully demonstrated by the effects of emotion on se- 
cretion. 

Mental Association. — Hence, at such a time, how important that only 
the most pleasant and calming recollections should pervade the mind. 
This appetite, which is not essential to the life of the individual, is mainly 
dependent on mental associations for its activity, and should be controlled 
by moral principle. 

CAN PARENTS CONTROL THE SEX OF THE CHILD? 

Interest in the Subject. — The above subject has for a long time deeply 
interested the scientists, not only of Europe, but also our own country, 
and various experiments have been made to endeavor to found the same 
upon fact instead of theory. 

Results of Investigation. — These experiments were at first made in 
the interest of science alone, but the raisers of cattle and horses, seeing an 
increase of gain to themselves, quickly took hold of the subject, and have 
endeavored to reap the advantages therefrom. 

The following results, which have been carefully kept record of, 
elucidate the following: 

1st. That the offspring of a cow or mare, if young, and the male 
older and in good health, was a male. 

2d. If the female is mature in age, healthy and strong, the male 
younger and deficient in copulative strength, the offspring was a female. 

3d. That when both male and female were of mature age and 
healthy, the offspring was about equal, male or female. 

4th. If the female is old and the male young, the offspring will be 
male. 

5th. If the male is old, with the female younger, the offspring will 
be female. 

6th. If female was ill fed or run down by labor, the male well fed 
and in vigor ; offspring, male. 

7th. If the female was well fed and rested, and male ill fed and 
worked ; offspring, female. 

8th. That the offspring would be male or female as regards the man- 
ner in which they were treated, fed, etc. 

Conclusions — From the above we would draw the following conclu- 
sions: Men having physical and procreative propensities similar to an- 
imals, the genital function is first to feel disturbance of the nervous sys- 



1112 - SEXOLOGY. 

tern, as the top of the tree first shows that the roots are not properly 
nourished. The function of generation being the last to be developed has 
nothing directly depending on or issuing from it, it is a twig and not a 
main branch, like the stomach and brain ; it is a periodic function, capable 
of long intervals of inactivity, and the rest of the body cannot only sur- 
vive, but be in good condition for a time at least when this function is 
absolutely dead. 

When a Male Child is Desired — The husband should partake of good 
substantial food. Exercise in open air; indulge in light literature; keep 
up a glow of spirits ; abstain from indulgence for a short time previous to 
the procreative period. During this period the wife should abstain from 
animal foods, living mostly on vegetables and farinaceous articles of diet ; 
exercise daily to almost fatigue, take the following treatment and pass a 
portion of her time with females older than herself. The following pill 
should be taken, one three times daily for several weeks : 

Extract Hyoscyamus % grain. 

Extract Valerian i grain 

Extract Sumbul I grain 

Extract Asafcetida I grain 

When a Female Child is Desired — Exactly the opposite course should 
be pursued — the woman should indulge in the most stimulating food — but 
should not indulge her passions, reserving her whole vigor for the desired 
time. The male should indulge in violent physical exercise to fatigue, 
and morning and night take sitz baths of cold rock-salt water. 

Care of the Passions — Abuse of the passions disturbs all the pro- 
cesses of life ; a brutal kind of vigor in those who are reckless, but a soul 
that condemns its own conduct, is sure to produce disorders of the nervous 
system ; the family of reflex centers, the brain, the stomach, the genital 
system; between these, messengers of evil or of good are ever passing in 
sleeping and in working hours; to touch one is to touch all. 

TABLE OF CONCEPTION AND BARREN PERIODS. 

The following table, showing the possible periods of conception and 
barrenness after the recurrence of each menses, or monthly, will prove 
helpful to married women seeking rational means of regulating pro- 
creative conduct. E stands for beginning of each period — monthly, con- 
ceptional and barren — and E for the ending of the same. 



TABLE OF CONCEPTION. 



1113 



MONTHLIES. 
B. 

Jan I— 

2 — 

3— 

4— 

5— 

..... 6— 

7— 

8— 

9— 

io — 

ii — 

13— 

14— 

i= — 

16— 

17— 

i8— 

19— 

20 — 

21 — 

22 

23— 

24— 

25— 

20— 

27—- 

28— 

29— 

30-Feb 

31—" 



Period of Probable 
Conception. 

B. E. 



Feb. 



Jan 



... 4— 

... 5— 
... 6— 

... 7— 
... 8— 
... 9— 
. . . 10 — 
. ..11 — 
. . . 12 — 
...13— 
... 14— 
...15— 
...16— 
...17— 
...18— 
...19— 



Feb 



2 — 


4 


3— 


5 


4— 


6 


5— 


7 


6— 


8 


7— 


9 


8— 


10 


9— 


11 


10 — 


12 


11 — 


13 


12 — 


14 


13— 


IS 


14— 


16 


15— 


17 


16— 


18 


17— 


19 



16 

17 

18 

19 

20 
21 

22 
23 
24 
25 
26 

27 

28 
29 
30 
31 



Probable Barren 
Period. 



Jan ....17— 

" 18— 



21—' 

....22—' 

...••23-' 

....24—' 

....25-' 

....26—' 

....27-' 
....28—' 
.... 29— 
....30— 
....31— 

1 — 

2 — 

.... 3— 
.... 4— 
.... 5— 
.... 6— 
.... 7— 
.... 8— 
.... 9— 
10 — 



Feb. 



20-Feb. 1 

2 
3 

4 
5 
6 

7 

8 

9 

10 

11 
12 
13 
14 
15 
16 

17 

18 

19 
20 
21 
22 
23 

2/ 

25 

26 

2 

28 



12 — 

13— 

14— 

15— 

10— 
. I7-Mar. I 
. l8— " 2 

10—" ^ 
.20—" A 



22 

23 
24 

25 
26 

27 
28 
29 
30 
31 



...19— 

...20 — 
, . .21 — 
...22 — 
...23— 
...24— 
...25— 
...26— 
. . . 27-Feb 
...28—" 
...29-" 
...30—" 
...31—" 
. . . I — 
" 2 — 

" 3- 

" 4— 

" 5- 

" 6— 

" 7- 

" 8— 

" 9— 

" 10 — 

" 11 — 

" 12 — 

" 13- 

" 14— 

" 15- 

" 16— 

" 17- 

" 18— 

M 19- 

" 20— 

" 21— 

" 22 — 

" 23— 

" 24-Mar. 1 

" 25—" 

" 26—" 

" 27—" 

" 28—" 

Mar 1 — 



Period of Probable Conception. 
B. E. 



Jan 23 — at next monthly 

" 2 4 - (< " 

u 25-" " 

" 26—" " 

« 27 " " " 

" 28—" " 

" 29-" " 

" 30-" " 

u - T It U it 

Feb i—" " 

" 2—" " " 

" 3-" " 

<( . « it u 

4 — 

« c « n t* 

" 6—" " 

« 7 « « « 

K O « " '* 

" .'.'.'..'; 9-- " 

" 10—" " 

a TT tt a « 

" 12—" " 

a 13-" " 

" 14—" " 

u 15-" " 

" 16—" " 

" 17-" " 

" 18—" " 

" 19-" " 

" 20—" " 

" 21- " " 

" 22—" " 

23-" " 

" 24—" " 

" 25-" « 

" 26—" " 



2 — 
3— 
4— 
5— 



Mar 



27— 

28-" 

. 1 — " 

2—" 

. 3—" 

4—" 

5-" 

. 6—" 

• 7-" 
, 8—" 

9~" 
.10—" 
.II—" 



1114 



SEXOLOGY. 



MONTHLIES. 



Period of Probable 
Conception. 

B. E. 



Feb. 



Mar. 



Apr. 



,18- 

19— 
.20 — 

.21 — 



23— 
24— 



2z 
26 

27 
2S 

2/-Mar. 1 
28—" 2 

i— 3 



^0 — 
26— 



8— 

9— 

10 — 

11 — 

12 — 

13— 
14— 

15— 
16— 

17— 
18— 
19— 
.20 — 
21 — 
,22 — 
23— 
24— 
25 — 
.26— 



Feb 21-Mar. 5 



27— 
.28— 
.29— 

.30-Apr. 1 

• 3I-" 2 

• 1— 3 

• 2— a 

• 3— 5 

. 4- e 

• 5 — 7 



Apr 



.22 — 

23— 

.24— 

• 2 5 — 
.26— 



" 28— 

Mar.... 1— 



2 — 
3— 
4— 

5 — 
6— 

8— 

9— 

10 — 

11 — 

12 — 
13— 
M— 
15— 
16— 

17— 
18— 

19— 



20- A p 


r. 1 


21 — " 


2 


22 — " 
23-" 


4 


24—" 

25- " 

26— " 
27— " 

2S— " 


6 

7 
8 
c 


21—" 


IC 


3 r >-" 


II 


31- " 


12 


I — 


1; 


2 — 


1 1 


3— 


If 


4— 


16 


5— 
6— 


17 

i3 


8— 


10 
20 


9— 


21 



Probable Barren 
Period. 
B. 

Mar.... 6— 

7— 

" 8— 

" 9— 

" 11 — 

" 12— 

" J 3— 

" 14— 

" 15— 

" 16— 

" 17- 

" 18— 

" 19- 

" 20 — 

" 21 — 

" 22— 

" 23- 

" 24— 

" 25- 

" 26— 

" 27-Apr. 

" 28—" 

" 29-" 

" 30—" 

" 3I-" 

Apr 1 — 

" 2— 

" 3- 

" 4— 

5 — 

" 6— 

7 — 

" 8— 

" 9— 

" 10— 

" 11 — 

" 13— 

" 14— 

" 15— 

" 16— 

" 17- 

" 18— 

" 19— 

" 20— 

" 21 — 

" 22— 



Period of Probable Conception. 
B. E. 

Mar 12 — at next monthly 

Mar 13—" " 

" 14—" " 

" 15—" " 

" 16—" " 

" 17—" « 

" I9-" " 

" 20—" " 

" 21—" " 

" 22—" " 

" 23—" " 

" 24-" " 

" 25—" " 

" 26—" " 

" 27— " " 

" ......28—" " 

" 29—" " 

" ...A.30-" ' " 

14 31—" " 

Apr 1—" " 

" 2—" " 

" 3-" " 

" 4~" " 

" 5-" " 

" 6— " " 

M 8— " " 

" 9—" 

" 10—" " 

" 11—" " 

" 12— " " " 

" 13—" " 

" 14—" " 

" IS-" " 

" 16—" " 

" I7-" " 

" 18—" " 

" I9-" " 

" 20—" " 

" 21—" " 

22 — 

" 23-" " 

" 24—" " 

" 25-" " 

" 26—" " 

" 27—" " 

" 28—" " 



TABLE OF CONCEPTION. 



1115 



MONTHLIES. 



Apr. 



May 



7— 
8— 

9— 
io — 

12 — 

13— 
14— 
15— 

16— 

17— 
i8— 
io— 

20 — 

21 — 

22 — 

23— 
24— 

25— 

26— 

27— 

28— 



9 

10 

II 

12 

13 
M 

15 

16 

1/ 
18 

19 

20 

2 

22 

23 

24 

25 

26 

27 

28 

29 
30 



29-May I 

30—" 2 



1 — 

2 — 

3— 
4— 

5— 
6— 
7— 
8— 

9— 

10 — 

11 — 

12 — 
13— 
14— 
15— 
16— 

17— 
18- 

19— 

20 — 

21 — 

22 — 

23— 
.24— 



Apr, 



May 



>f Proba 
ception. 
B. 


ble 
E. 


.10 — 


22 


.11 — 


23 


.12 — 


24 


13— 
14— 


25 
26 


15— 
l6— 


27 
28 


17— 29 

18— 30 
19-May I 


20-" 


2 


.21—" 


3 


22—" 


4 


23—" 


5 


24—" 


6 


25-" 
26—" 


7 
8 


27-" 
28—" 


9 
10 


2Q-" 


11 


30—" 


12 


I — 


13 


2 — 


14 


3— 
4— 


15 
16 


5— 
6— 


17 
18 


7— 
8— 


19 
20 


9— 


21 


10 — 


22 


11 — 


23 


12 — 


24 


13— 
14— 


25 
26 


15— 
16— 


27 
28 


17— 


29 


18— 


30 


19— 3i 
20-June 1 
21—" 2 


22 — " 


3 


23—" 


4 


24—" 


e 


25— " 
26—" 


6 


27- " 


8 



Probable Barren 
Period. 

B. E 



Apr 23 — 28 

" 24— 29 

" 25— 30 

" 26-May I 

" 27 — " 2 

" 28-" 3 

" 29—" 4 

" .....30-" 5 

May 1 — 6 

" 2- 7 

" 3— 

" 4— 9 

" 5— 10 

" 6— 11 

" 7- 12 

" 8- 13 

" 9— 14 

" 10— 15 

" 11— 16 

" 12— 17 

" 13- 18 

" 14- 19 

" 15— 20 

" 16— 21 

" 17 — 22 

" 18— 23 

" 19— 24 

" 20 — 25 

" 21 — 26 

" 22 — 27 

" 23- 28 

" 24— 29 

" 25— 30 

" 26— 31 

" 27-June 1 

" 28—" 2 

" 29—" 3 

" 30—" 4 

M 3I-" 5 

June . . . 1 — 6 

.... 2— 7 

.... 3- 8 

... 4— 9 

.... 5— 10 

.... 6— 11 

.... 7— 12 

....8- 13 

... 9— 14 



Period of Probable Conception- 

B. E. 



Apr 20^ — at next monthly 

" 30—" " 



May 



June. 



1 — 

2 — 
3— 
4— 

5—' 



.... 6—" 
.... 7-" 
.... 8—" 
.... 9—" 
....10—" 

11 — " 

....12—" 
....13-" 
.... 14— " 
....15-" 
....16—" 
....17-" 
....18—" 
....19-" 

20 — " 

....21—" 
....22— " 
....23-" 
....24—" 
....25-" 
....26—" 
....27—" 
....28—" 
....29—" 
....30-" 
....31—" 

.... 2—" 
.... 3—" 
.... 4—" 
.... 5-" 
.... 6—" 
.... 7—" 
.... 8—" 

• • • 9-" 

10 — " 

....11—" 

12 — " 

....13—" 
....14-" 
....I5-" 



1116 



SEXOLOGY. 



MONTHLIES. 

B. E. 



May 25 — 27 

" 26— 28 

" 27— 29 

" 28— 30 

* 29— 31 

" 30-June 1 

" 31—" 2 

June.... 1— 3 

" 2— 4 

" 3- 5 

" 4— 6 



July. 



. 5— 
. 6— 

• 7— 9 
. 8— 10 

■ 9— 1 

10 — 12 

11— 13 

12 — 14 

13— 15 

14 — 16 

15— 17 

16— 18 

17— 19 
.18 — 20 
.19 — 21 
.20 — 22 
.21— 23 
.22 — 24 
23— 25 
. 24 — 26 
.25— 27 
26— 28 
.27— 29 
.28— 30 
.29-July 1 
.30—" 2 

- 1— 3 

2— 4 

• 3— 5 
. 4- 6 

• 5— 
. 6— 

• 7— 9 
. 8— 10 
. 9— n 
. 10 — 12 
.11— 13 



Period of Probable 
Conception. 



May 



June 



July 



28- June 9 



29— 
30- ' 

31— 

. I — 

2 — 

3— 
4— 
5— 
6— 

7— 
8— 
9— 

10 — 

11 — 

12 — 

13— 
14— 

15— 
16— 

17— 
18— 
19-July 

20 — ' 
21 — ' 
22 — ' 
23—' 
24-' 
25—' 

26—' 

27—' 
28-' 

29—' 
30-' 

1 — 

2 — 
3— 
4— 
5— 
6— 
7— 
8— 
9— 

10— 

11 — 

12 — 

13— 
14— 



Probable Barren 
Period. 



June . . . 10 — 



July. 



12 — 
13— 
.14— 
15— 
,16— 

17— 
.18— 

.19— 
20 — 
.21 — 
22 — 
23— 
24— 
.25— 
.26- July 1 



■ •27— 
...28— 

..29—' 
..30— 
.. 1 — 
.. 2 — 

• • 3— 

• • 4— 

• • 5— 
.. 6— 

•• 7— 
.. 8- 

.. 9— 
..10 — 
..11 — 
. .12 — 
.13— 
..14— 
..15— 
..16— 

..17— 
..18— 
..19— 
. .20 — 
. .21 — 
..22 — 
..23— 
..24— 

• •25— 
..26— 



27- Aug. 1 



Period of Probable Conception. 
B. E. 



June 16 — at next monthly 



July 



Aug. 



-17— 

.18—" 
.19-" 
.20 — " 
.21—" 
.22—" 
.23—" 
.24-" 
.25-" 
.26—" 

•27-" 
.28—" 
.29-" 
•30-" 
1—" 
. 2—" 
. 3~" 

• 4-" 
■ 5-" 
. 6—" 

• 7-" 
. 8—" 

• 9-" 
.10 — " 
.11—" 
.12—" 

I3-" 
.14-" 
.15-" 
.16—" 

I7-" 
.18—" 

.19-" 
20 — " 

.21—" 
.22 — " 

•23—" 
24-" 
•25—" 
.26—" 
.27—" 
.28—" 
29—" 
•30-" 
•31- " 
. I—" 
, 2—" 



TABLE OF CONCEPTION. 



1117 



MONTHLIES. 



Period of Probable 
Conception. 



Probable Barren 
Period. 

B. E. 



Period of Probable Conception. 
B. e. 

Aug 3 — at next monthly 

<< . «< « u 
4 — 

" 5~" " 

" 6—" " 

« - « « « 

« o " « «< 

" 9~" " 

" t o " " " 

" - - a « « 

" 12—" " 

" 13—" " 

14 — 

" I5-" " 

" J« " " « 

" i8— " " 

" 19—" " 

" 20—" " 

" 21—" " 

" 22—" " 

" 23-" " 

" 24—" 

" 25-" " 

" 26—" " 

" 27—" " 

" 28—" " 

" 29—" " 

" 30-" " 

" 3I-" " 

Sept i—" " 

« 2 " " " 

" '.'.".'.'.'. 3-" " 

<< . « « « 

4 — 

« - tt u u 

" 6—" " 

" 7-" " 

" 8—" " 

" 9—" " 

" io— " " 

" ii—" " 

" 12— " 

" I3-" " 

" 14—" " 

" I5-" " 

" 16— " " 

«< _ K a <t 

" 18-" " 



July. 



14 July 15 — 27 July 2&-Aug. 2 



" 13— 15 

" 14 — 16 

" 15- 17 

" 16— 18 

" 17— 19 

" 18— 20 

" 19 — 21 

" 20 — 22 

" 21— 23 

" 22 — 24 

" 23— 25 

" 24— 26 

" 25- 27 

" 26— 28 

" .27 — 29 

" 28- 30 

" 29— 31 

" 30-Aug. 1 

" 3I-" 2 

Aug.. ..1— 3 

" 2- 4 

" 3- 5 

" 4- 6 

" 5— 

" 6— 

" 7- 9 

" 8— 10 

" 9— 11 

" 10— 12 

" 11— 13 

" 12— 14 

" 13 — 15 

" 14 — 16 

" 15— 17 

" 16— 18 

" 17- 19 

" 18— 20 

" 19— 21 

" 20 — 22 

" 21— 23 

" 22— 24 

" 23- 25 

" 24— 26 

" 25— 27 

" 26— 28 

" 27 — 29 

" 28- 30 



" 16— 28 

" 17— 29 

" 18— 30 

" 10- 3i 

" 20-Aug. 1 

" 21— 

" 22— 

" 23- 

" 24- 

" 25- 

" 26—- 7 

" 27—" 8 

" 28—" 9 

" 29 — " 10 

" 30—" n 

" 31—" 12 

Aug.... 1— 

" 2— 14 

" 3- 15 

" 4— 16 

" 5- 17 

" 6— 18 

" 7— 19 

" a- 20 

" 9 — 21 

" 10 — 22 

" 11- 23 

" 12— 24 

" 13— 25 

" 14— 26 

" 15- 27 

" 16— 28 

" 17- 29 

" 18- 30 

" 19- 31 

" . 20-sept. 1 



21 — 2 

22-" 3 

23—" 4 

24—" 5 

25 — " 6 

26—" 7 

27—" 8 

28—" 9 

29 — " 10 

30—" 11 

31—" 12 



" 29—" 

" 30-" 

." 3I-" 5 

Aug 1 — 6 

" 2- 7 

" 3- 8 

" ..... 4- 9 

" 5— 10 

" 6— 11 

" 7— 12 

" 8- 13 

" 9- 14 

" 10— 15 

" 11— 16 

" 12— 17 

" 13- 18 

" 14— 19 

" 15- 20 

" 16— 21 

" 17 — 22 

" 18- 23 

" 19— 24 

" 20— 25 

" 21 — 26 

" 22 — 27 

" 23- 28 

" 24— 29 

" 25— 30 

" 26— 31 

" 27-Sept. 1 

" 28—" 2 

" 20-" 3 

" 30—" 4 

" 3I-" 5 

Sept.... 1— 6 

" .... 2— 7 

" 3- 8 

" 4— 9 

" 5- 10 

" 6— 11 

" 7- 12 

" 8— 13 

" 9— 14 

" TO— I 

" II — l6 

" 1-2— 1/ 

" 13- I 



1118 



SEXOLOGY. 



MONTHLIES. 



E. 



Period of Probable 
Conception, 



Probable Barren 
Period. 



Period of Probable Conception. 
B. E. 

Sept 20 — at next monthly 

" 21—" " 

" 22.— " " 

" 23— " " 

" 24—" " 

" 25—" " 

" 26—" " 

" 27—" " 

" 28—" " 

" 29—" 

" 30—" " 

Oct i—" " 

" 3—" " 

tt . tt tt it 

4 — 

it - tt tt tt 

" 6—" " 

" 8—" " 

" o_ " 

" 10—" " 

" 11—" " 

" 12—" " 

" 13—" " 

" 14—" " 

(< (i <t it 

" 16—" " 

" 17-" " 

" 18—" " 

" ig— " " 

" 20—" " 

" 21—" " 

" 22 " " " 

<< 2^ " " " 

" 24—" " 

" 25-" " 

" 26—" " 

" 27—" " 

" 2&-" " 

" 20—" " 

" 30-" " 

« -. " « tt 

Nov 1— " " 

« 2 " '* " 

" 3-" " 

" 4-" " 

U - it tt tt 

it zr « tt «« 



Aug.... 20— 3ilSept. 
" 30-Sept. 1 



" 3i- 

Sept.... 1- 
" 2- 



.... 4— 
.... 5— 
.... 6— 
.... 7— 
.... 8— 
.... o— 

10 — 

11 — 

12 — 

.... 13— 
.... 14— 
....15— 
....16— 
.... 17— 
.... 18— 
....10— 

20 — 

21 — 

22 — 

....22,— 

....24— 

— 25— 
....26— 
— 27— 



Oct 



28— 
2^ -Oct 
30-" 

1 — 

2 — 
3— 
4— 

■ 5 — 
6— 



Oct . 



8— 

9— 

10 — 

11 — 

12 — 
13— 
14— 
15— 



8 

9 
10 
11 
12 
13 
1 A 
'5 
l6 

r 7 



... 4— 

... 5— 
... 6— 

... 7— 

... 8— 
... o— 
. . .10 — 
. . .11 — 
. . . 12 — 
. . • 13— 
. . . 14— 

...15— 
...16— 
...17— 
...18— 

. . . IQ-Oct 

. . .20 — 
. . .21 — 
. . . 22 — 
...23— 

...24— 
...25— 
...26— 
...27— 
...28— 
...20— 
...30— 



2 — 

3— 

4— 
5— 
6— 

7— 
8— 

9— 
10 — 
11 — 
12 — 
13— 
14— 
IS— 
16— 

17— 
18— 



13 
14 
15 

16 

17 

18 

1 

20 

21 

22 

23 

24 

25 

26 

27 

28 

29 
30 
1 
2 
3 
4 
5 
6 



Sept. 



...14— 

...15— 
...16— 

. . . 17— 

...18— 

...10— 

...20 — 

. . .21 — 

. . . 22 — 

...23— 

...24— 

...25— 

...26-Oct 

...27-" 

...28—" 

...29-" 



Oct 



....30— 

1 — 

2 — 

.... 3— 

.... 4— 

.... 5— 

.... 6— 

.... 7— 

.... 8— 

.... o— 

11 — 

. . . . 12 — 
.... 13— 
.... 14— 
....15— 
....16— 
....17— 
....18— 
....10— 

20 — 

. . . .21 — 

22 — 

....23— 
....24— 
....25— 
....26— 



9 

10 
11 
12 
13 
14 
15 
16 

17 

18 

19 

20 
21 
22 
23 
24 
25 
26 

27 
28 
29 
30 
3i 

27-Nov. 1 
.28—" 2 
29—" 3 
30— " 4 
•31—" 5 



TABLE OF CONCEPTION. 



1119 



MONTHLIES. 



E. 



Oct ....16— 18 

....17— 19 

18 — 20 

19 — 21 

20 — 22 

21 — 23 

22 — 24 

....23— 25 

24 — 26 

....25— 27 

....26— 28 

27 — 29 

....28— 30 

....29— 31 

30-Nov. 1 

31—" 2 

Nov 1 — 3 

.... 2— 4 

.... 3— 5 

....4- 6 

.... 5— 7 

.... 6— 8 

.... 7— 9 

.... 8— 10 

.... 9— 11 

10 — 12 

11— 13 

12 — 14 

....13— 15 
14 — 16 

....15— 17 

....16— 18 

.... 17— 19 

.... 18— 20 

19 — 21 

20 — 22 

....21— 23 

22 — 24 

....23— 25 

24 — 26 

....25— 27 

....26— 28 

....27 — 29 

....28— 30 

29-Dec. 1 

30—" 2 

Dec 1 — 3 

• 2- 4 



Period of Probable 
Conception. 

B. E. 



Oct 



" 21— 

" 22— 

" 23- 

" 24— 

" 25— 

" 20— 

" 27- 

" 28— 

" 29- 

" 30— 

" 31— 

Nov 1 — 

" 2 — 

" 3— 

" 4— 

" 5— 

" 6— 

" 7- 

" 8— 

" 9- 

" 10 — 

" 11— 

" 12— 

" 14— 

" 15— 

" 16— 

"' 17- 

" 18— 



Dec 



• 19— 31 
.20-Nov. I 

2 

3 

4 
5 
6 

7 

8 

9 

10 
11 
12 
13 
14 
15 
16 

1/ 
18 

19 

20 
21 

22 
23 
24 
25 
26 

27 
28 
29 
30 



19-Dec. 1 



.20 — 
21 — 

.22 — 

23— 
.24— 

25— 
,26— 

• 27— 

.28— 
.29— 
30— 

1 — 

2 — 

3— 

4— 
■ 5— 



Probable Barren 
Period. 

B. E. 

Nov 1 — 6 

" 2- 7 

" 3- 8 

" 4— 9 

" 5— 10 

" 6— 11 

" 7— 12 

" ..... 8- 13 

" 9— 14 

" 10— 15 

" 11— 16 

" 12— 17 

" 13— 18 

" 14— 19 

" 15— 20 

" 16 — 21 

" 17 — 22 

" 18— 23 

" 19— 24 

" 20— 25 

" 21 — 26 

" 22 — 27 

" 23- 28 

" 24— 29 

" 25— 30 

" 26-Dec. 1 

" 27 — " 2 

" 2$-" 3 

" 29—" 4 

" 30—" 5 

Dec 1 — 6 

" 2— 7 

" 3- 8 

" 4— 9 

" 5— 10 

" 6— 11 

" 7— 12 

" 8— 13 

" 9— 14 

" 10— 15 

" 11— 16 

" 12— 17 

" 13- 18 

" 14- 19 

" 15— 20 

" 16— 21 

" 17— 22 

" 18- 23 



Period of Probable Conception. 
B. E. 



Nov, 



Dec 



. 7 — at next monthly 

8_ " " 

9_" « 
10—" " 



....11—" 

12 — " 

....13—" 
....14—" 
....I5-" 
....16—" 
....17—" 
....18—" 
....19—" 

20—" 

....21—" 
....22—" 
....23-" 
....24-" 
....25-" 
....26—" 
....27—" 
....28—" 
....29-" 
....30-" 
1 — " 

.... 2—" 

.... 3—" 
.... 4—" 
.... 5—" 
.... 6—" 
.... 7-" 
.... 8—" 
.... 9—" 
....10—" 
....11—" 
....12—" 
....13—" 
....14-" 
....15-" 
....16—" 
....17-" 
....18—" 
....19-" 
....20—" 
....21—" 

22—" 

....23-" 
....24-" 



1120 



SEXOLOGY. 



MONTHLIES. 



Period of Probable 
Conception. 



Probable Barren 
Period. 



Period of Probable Conception. 
B. E. 



Dec 



• 3— 

■ 4— 

■ 5— 
. 6— 

• 7— 
. 8— 

• 9— 

.10 — 

ii — 

.12 — 

13— 
14— 

■ 15— 

.10— 

17— 
.18— 
.19— 

.20 — 

.21 

.22 — 

23— 
.24— 

25— 

,20— 

,27— 

.28— 
20— 



5 
6 

7 
8 

9 

10 

ii 

12 

13 
14 

15 

16 

17 

i 

19 

20 
21 
22 
23 

24 
25 

26 

27 

28 

29 
30 
3i 



30-Jan. 1 
31—" 2 



Dec 



6— 

7 — 

.... 8— 
.... 9— 

10 — 

11 — 

12 — 

.... 13— 
.... 14— 
.... 15— 
....16— 
....17— 
....18— 
....19— 



1 

19 
20 
21 
22 
23 
24 
25 
26 
27 
28 
29 
30 
31 

.20-Jan. 1 

.21 — 

22 — 

23— 



24— 

" 25— 

" 26— 

" 27— 

" 28— 

" 29— 

" 30— 

" .....31— 

Jan 1 — 

" *2 — 

" 3— 



Dec .... 19 — 

" 20— 

" 21— 

" 22— 

" 23- 

" 24- 

" 25— 

u 26— 

" .^_. . . 27-Jan. 

" 28—" 

" 29-" 

" 30-" 

" 3I-" 

Jan 1 — 

" 2 — 

" 3— 

~" 4- 

" 5- 

" 6— 

" 7- 

" 8— 

" 9- 

" 10 — 

" 11 — 

" 12 — 

" 13- 

" 14- 

" 15— 

u 16— 



Dec 25 — at next monthly 

" 26—" 

" 27-" 

" -.28—" 

" 29-" 

" 30-" 

" 31—" 



Jan. 



.. 1 — 

. . 2 — " 
•• 3-" 
•• 4~" 

• • 5-" 
..6—" 

•• 7—" 
.. 8—" 

.. 9-" 
..10—" 
..11—" 
..12—" 

• •13—" 
..14-" 

• •15—" 
..16—" 
..I7-" 
..18—" 

..I9-" 
. .20 — " 
. .21 — " 
. .22 — " 



PERIOD OF GESTATION. 
Length of Period — This interesting and anxious period in a young 
wife's life is usually reckoned at 280 days, or 40 weeks, or 9 calendar 
months. Dr. Reid, in his report upon 500 cases, found the following: 
23 cases in the 37th week. 
48 cases in the 38th week. 
81 cases in the 39th week. 
131 cases in the 40th week. 
112 cases in the 41st week. 
63 cases in the 42d week. 
28 cases in the 43d week. 
8 cases in the 44th week. 
6 cases in the 45th week. 



TABLE OF PREGNANCY. 



1121 



Reckoning the Count. — It would be well in reckoning the "count" to 
begin about three days after the last monthly period, the rule being that 
conception is more likely soon after menstruation than at any other time. 

A Pregnancy Table. — The following table, showing the probable 
beginning, duration and completion of pregnancy, and indicating the 
date on or about which the date of labor may be expected, may be found 
both convenient and useful. It allows three days after the usual 280 
days; that is, the "count" begins three days after the last monthly or 
menstrual period: 

THE PREGNANCY TABLE. 



Last Day of Labor On or 

Monthlies. About. 

Jan. i Oct. 1 1 

2 '* 12 

" 3 " 13 

" 4 " 14 

" 5 " 15 

" 6 " 16 

" 7 " 17 

" 8 " 18 

" 9 " 19 

" IO " 20 

" II " 21 

" 12 " 22 

" 13 " 23 

u 14 " 24 

" 15 " 25 

" 16 " 26 

" 17 " 27 

" 18 " 28 

" 19 " 29 

" 20 " 30 

" 21 " 31 

" 22 Nov. 1 

" 23 " 2 

" 24 :. " 3 

" 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 '• 8 

" 30 " 9 

" 31 " 10 

Feb. 1 " 11 

" 2 " 12 

" 3 " 13 

" 4 " 14 

71 



Last Day of Labor On or 

Monthlies. About. 

Feb. 5 Nov. 15 

" 6 " 16 

" 7 " 17 

" 8 " 18 

" 9 " 19 

" 10 " 20 

" 11 " 21 

" 12 " 22 

" 13 " 23 

" 14 " 24 

" 15 " 25 

" 16 " 26 

" 17 " 27 

" 18 " 28 

" 19 " 29 

" 20 " 30 

" 21 Dec. 1 

" 22 " 2 

" 23 " 3 

" 24 " 4 

" 25 " 5 

" 26 " 6 

" 27 " 7 

" 28 " 8 

Mar. 1 " 9 

2 " 10 

" 3 " 11 

" 4 " 12 

" 5 " 13 

" 6 " 14 

" 7 " 15 

" 8 " 16 

" 9 " 17 

" 10 " 18 

" 11 " 19 



Last Day of Labor On or 
Monthlies. About. 

Mar. 12 .Dec. 20 

" 13 " 21 

"' 14 " 22 

" 15 " 23 

" 16 " 24 

" 17............ " 25 

" 18 "- 26 

" 19 " 27 

" 20 " 28 

" 21 " 29 

" 22 " 30 

" 23 " 31 

" 24 Jan. 1 

" 25 " 2 

" 26 " 3 

" 27 " 4 

" 28 " 5 

" 29 " 6 

" 30 * 7 

u 3i " 8 

April 1 " 9 

" 2 " 10 

" 3 " 11 

" 4 " 12 

" 5 " 13 

" 6 " 14 

" 7 " 15 

" 8 " 16 

" 9 " 17 

" 10 " 18 

" 11 " 19 

" 12 " 20 

" 13 " 21 

" 14 " 22 

" I5..-.- " 23 



1122 



SEXOLOGY. 



Last Day of Labor On or 

Monthlies. About. 

Apr. 16 Jan. 24 

" 17 *" 25 

" 18 " 26 

" 19 " 27 

" 20 " 28 

" 21 " 29 

" 22 " 30 

' 23 " 3i 

" 24 Feb. 1 

" 25 " 2 

" 26 " 3 

" 27 " 4 

" 28 " 5 

" 29 " 6 

" 30 - 7 

May 1 " 8 

" 2 " 9 

3 " 10 

" 4 " 11 

*' 5 " 12 

" 6 - 13 

" 7 " 14 

" 8 " 15 

" 9 " 16 

" 10 " 17 

" 11 " 18 

" 12 " 19 

" 13 " 20 

" 14 " 21 

" 15 " 22 

" 16 " 23 

" 17 " 24 

" 18 " 25 

" 19 " 26 

" 20 " 27 

" 21 " 28 

" 22 Mar. 1 

" 23 " 2 

" 24 " 3 

" 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 " 8 

" 30 u 9 

" 31 " 10 

June 1 " 11 

" 2 * 12 



Last Day of Labor On or 

Monthlies. About. 

June 3 Mar. 13 

" 4 " 14 

" 5 " 15 

" 6 " 16 

" 7 " 17 

" 8 " 18 

" 9 " 19 

" 10 " 20 

" 11 " 21 

" 12 *' 22 

" 13 " 23 

" 14 " 24 

" IS " 25 

" 16 " 26 

" 17 " 27 

" 18 " 28 

" 19 " 29 

" 20 " 30 

" 21 " 31 

" 22.. v April 1 

" 23 " 2 

" 24 " 3 

" 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 " 8 

" 30 " 9 

July 1 " 10 

" 2 " 11 

" 3 " 12 

" 4 " 13 

" 5 " 14 

" 6 " 15 

" 7 " 16 

" 8 " 17 

" 9 " 18 

" 10 " 19 

" 11 " 20 

" 12 " 21 

" 13 " 22 

" 14 " 23 

" 15 " 24 

" 16 " 25 

" 17 " 26 

" 18 " 27 

" 19 " 28 

" 20 " 20 



Last Day of Labor On or 

Monthlies. About. 

July 21 Apr. 30 

" 22 May 1 

" 23 " 2 

" 24 " 3 

" 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 " 8 

" 30 " 9 

" 31 " 10 

Aug. 1 " 11 

" 2 " 12 

" 3 " 13 

" 4 " 14 

" 5 " 15 

" 6 " 16 

" 7 " 17 

" 8 " 18 

" 9 w 19 

" 10 " 20 

" 11 " 21 

" 12 " 22 

" 13 " 23 

" 14 " 24 

" 15 " 25 

" 16 " 26 

" 17 " 27 

" '18 " 28 

" 19 " 29 

" 20 " 30 

" 21 " 31 

" 22 June 1 

" 23 " 2 

" 24 " 3 

■ 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 M 8 

" 30 v 9 

" 31 " 10 

Sept. 1 " 11 

" 2 " 12 

" 3 " 13 

" 4 " M 

" 5 " 15 

« 6 " 16 



TABLE OF PREGNANCY. 



1123 



Last Day of Labor On or 

Monthlies. About. 

Sept. 7 June 17 

" 8 " 18 

" 9 " 19 

" 10 " 20 

" II u 21 

" 12 " 22 

" 13 " 23 

" 14 " 24 

" IS " 25 

" 16 " 2% 

" 17 " 27 

" 18 " 28 

" 19 " 29 

" 20.. " 30 

" 21 July 1 

" 22 "... " 2 

" 23 " 3 

" 24 " 4 

" 25 " 5 

" 26 " 6 

" 27 " 7 

" 28 " 8 

" 29 " 9 

" 30 " 10 

Oct. 1 " 11 

" 2 " 12 

" 3 " 13 

" 4 " 14 

5 ij 

" 6 " 16 

" 7 " 17 

" 8 " 18 

9 " 19 

" 10 " 20 

" 11 " 21 

" 12 " 22 

" 13 " 23 

" 14 " 24 



Last Day of Labor On or 

Monthlies. About. 

Oct. 15 July 25 

" 16 " 26 

" 17 " 27 

" 18 " 28 

" 19 " 29 

" 20 " 30 

" 21 " 31 

" 22 Aug. I 

" 23.... " 2 

" 24 " 3 

" 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 " 8 

" 30 " 9 

" 31 " 10 

Nov. 1 " II 

" 2 " , 12 

" 3 " 13 

" 4 " 14 

" 5 " IS 

" 6 " 16 

" 7 " 17 

" 8 " 18 

9 " 19 

" 10 " 20 

" 11 " 21 

12 " 22 

" 13 " 23 

" 14 " 24 

" 15 " 25 

" 16 " 26 

" 17 " 27 

" 18 " 28 

" 19 " 29 

" 20 " 30 

" 21 " 31 



Last Day of Labor On or 

Monthlies. About. 

Nov. 22 Sept. I 

" 23 " 2 

" 24 " 3 

" 25 " 4 

" 26 " s 

" 27 " 6 

" 28 " 7 

" 29 " 8 

" 30 " 9 

Dec. 1 " 10 

" 2 " 11 

3 " 12 

" 4 " 13 

" 5 " 14 

" 6 " 15 

" 7 " 16 

" 8 " 17 

" 9 " 18 

" 10 " 19 

" 11 *' 20 

" 12. " 21 

" 13 " 22 

" 14 " 23 

" 15 " 24 

" 16 " 25 

" 17 " 26 

" 18 " 27 

" 19 " 28 

" 20 " 29 

" 21 " 30 

" 22 Oct. 1 

" 23 " 2 

" 24 " 3 

" 25 " 4 

" 26 " 5 

" 27 " 6 

" 28 " 7 

" 29 " 8 

" 30 " 9 

" 31 " 10 



1124 SEXOLOGY. 



LESSENING OF THE PAIN OF CHILDBIRTH. 

Pain is Abnormal — In the beginning of his career the obstetrician 
is confronted with the question as to whether pain during labor is a 
natural phenomenon or not. Looking over the animal kingdom in a 
general way we are obliged to admit that there is more or less natural 
pain at this time. The question thus resolves itself into what is normal 
and what is an abnormal amount of pain. Depending upon the individual, 
a normal amount of pain in one case would be abnormal in another, or 
vice versa. We must admit that pain at this period is of a much more 
abnormal character in the higher classes of human beings than in the 
lower. For instance, the active housewife is less apt to have the amount 
of pain during labor that the lady of leisure is prone to have. In both 
cases, however, in comparison with the lower orders of animal life, the 
amount of pain suffered appears to be abnormal. 

Bules for Avoiding Pain — The first duty of the obstetrician is, there- 
fore, to lessen as much as possible the amount of pain suffered at this 
period. The measures to be taken must be primarily prophylactic in 
character, although much can be done at the period of confinement to 
relieve pain. During pregnancy the modern dress is to be condemned, 
if not at all times. The weight of both under and outer garments should 
fall upon the shoulders and not upon the hips and abdomen, and the waist 
should be left untrammeled. Corsets should not be worn at all, and, if 
needed, the bust should be supported by a band or girdle. Then, atten- 
tion should be directed to the diet, which should be principally vegetable 
in character, the farinaceous foods and fruits being most freely used. 
Stewed and cooked fruits are especially to be recommended to the patient. 
Meat in small quantities should be allowed only once a day, and then 
well cooked. 

An Easy Childbed. — There is always more or less congestion in the 
pelvic organs during pregnancy, which appears to increase as the time 
of confinement approaches. This is a natural accompaniment of the great 
changes which are taking place during this period, and is unquestionably 
the reason that in no animal life is birth unattended by pain. Here much 
can be done by the obstetrician to allay the possibility of pain, and, de- 
pending greatly upon his care and in the selection of his drugs, to allay 
this genera] inflammation, will be his principal success in insuring his 
patient a comparatively easy childbed. 



BIRTH IN THE ABSENCE OF A PHYSICIAN 1125 

Remedy Against Pain. — One of the best remedies is the saw palmetto. 
It has given excellent results in lessening pain. Its principal field 
of action is the pelvic organs, to which it is unquestionably an anti- 
phlogistic tonic and anodyne. It allays the inflammation of the mem- 
branes of these organs and appears to have a soothing action on the nerve 
supply of the womb, ovaries and bladder. Hence, the beneficial results 
to be obtained by its use — in teaspoonful doses four times a day for the 
last eight weeks of pregnancy — is to place the organs in such a condition 
that pain will be reduced to a minimum. 

Auxiliary Remedies — As a prophylactic measure we would suggest 
daily oil massage of the abdominal and perineal muscular walls from the 
fifth month on, and the administration of teaspoonful doses of sweet oil, 
with the saw palmetto, during the last two months. If the above instruc- 
tions are implicitly carried out during labor, there will be little use for 
anything to relax the muscles and relieve pain. However, where pain 
to an excessive degree exists we administer chloroform in the second and 
sometimes in the third stage of labor. It should not be pushed to the 
full extent of unconsciousness. It is best administered by the patient 
herself. As soon as she begins to reach this stage the cone falls from 
her hand and is not used again until the patient fully recovers. In this 
way comparatively little chloroform is used and the best results obtained. 

WHAT TO DO IF BIRTH OCCURS IN THE ABSENCE OF A PHYSICIAN. 

In such an emergency and until a doctor arrives the midwife or 
attendant should know something of the nature of the presentation of the 
child. If a head presentation, and the birth be difficult by reason of a 
failure of the shoulders to pass, the forefinger may be inserted under the 
child's armpit, and gentle pulling exerted. This assistance overcomes the 
difficulty in most instances. 

The Navel Cord. — Place the child to one side, beyond range of the 
mother's discharges, seeing, of course, that a possible wrapping of the 
navel cord about its neck does not interfere with its breathing, and that 
the mucus be removed from its mouth. As soon as the child has given 
signs of life by breathing and crying, and not before, tie a strong string 
tightly around the navel cord, some two inches from the belly, and knot 
it well. Do the same some four inches from the belly. Then cut the 
cord between the two tyings. 

The Afterbirth. — Do not pull on the navel cord to help the expulsion 



1126 SEXOLOGY. 

of the afterbirth (placenta). Give time for its natural expulsion. If it 
prove tardy the abdomen in the region of the womb should be subjected 
to gentle friction and pressure by the hand. This will stimulate the 
womb to expel the afterbirth. When the afterbirth has passed a stout, 
broad bandage should be drawn firmly around the abdomen and fastened. 
A doctor might not use such a bandage at all, but it is well for a nurse in 
his absence to do so as a precaution against hemorrhage. It should be 
worn for several weeks. 

Necessity for Rest — The mother should not be allowed to move from 
her position or to exert herself for several hours after delivery. Every 
hour spent in perfect quiet reduces the chances of flooding. After this 
rest, and perhaps a little sleep with it, if a cup of warm tea has been 
given, the bed may be dressed, the mother not, however, changing posture. 
Or she may be moved to a clean bed. 

The Infant — Meanwhile the infant should have been well greased 
all over with lard or oil, and dressed ; the next day thoroughly bathed in 
warm water. After being dressed, it should be placed with its mother, 
both to nourish itself and to encourage the flow of milk. By this time a 
doctor should surely have arrived, and his business would naturally be to 
look after the further welfare of the mother and child. 



PART II OF BOOK VIII 



Treats of the care of the mother before and during 
child-birth, and is a thorough treatise on the child's 
life during infancy. 



Baby Clothes Prepared Before Birth. 1 147 

Bathing New-born Infant 1146 

Breast Feeding 1153 

Breasts, Changes in 1129 

Care of New-born Infant 1145 

Catarrh of the Mouth 1181 

Catarrhal Stomatitis 1 181 

Cessation of Menstruation 1129 

Child, The 1129 

and Mother 1 129 

Development of 1 162 

Premature Birth of 1148 

Training of . . 1 192 

Children's Pitfalls 1193 

Cholera Infantum 1 185 

Cleft Palate 1182 

Clothing 1 130 

Clothing for Children, Abdominal 

Bandages 1 152 

Clothing for the Infant 1151 

Dress for an Airing 1152 

Rubber Diaper 1152 

Warmth Required 1151 

Wet Clothes, Danger of 1152 

When to Shorten Clothes 1152 

Quality and Quantity 1151 

Colic 1 182 

Composition of Milk for Various 

Ages 1155 

Confinement 1 142 

Bed 1145 

Bobbin for 1144 

Cotton Pledgets for 1144 

Delivery Pads for 1143 

Doctor and Nurse in 1142 

Gauze Sponges for 1 144 

Gauze Squares for 1144 

Nurse and Doctor in 1142 

1127 



. Place of 1 142 

Preparations for 1142 

Room 1 145 

Sanitary Pads for 1143 

Sponges, Gauze, for 1144 

Supplies Needed in 1143 

Cramp in Stomach 1 184 

Crying Children 1 192 

Diarrhoea, Infant 1 184 

Development of Child 1162 

Diet for Young Children 1174 

Evacuations of Child 1173 

Feeding Young Children 1173 

Gastralgia 1 184 

Hare Lip 1 181 

How First Teeth Come 1 165 

How to Prepare Day's Food 1157 

Hygiene During Pregnancy 1130 

Ills of Pregnancy 1 137 

Incubation 1 148 

Indigestion in Young Children n 76 

Infant, The 1150 

Bathing 1 150 

Care of New-born 1 145 

Clothing for 1151 

Diarrhoea in 1184 

During Summer 1159 

Exercise 1 172 

Feeding 1153 

Genital Organs, Care of 1150 

Mouth, Care of 1 150 

Malformation of Mouth 1181 

Menstruation, Cessation of 1129 

Milk from Nursing Mothers 1154 

Milk from Sound Cow 1154 

Mixed Feeding 1153 

Miscarriage 1 141 

Modified Cow's Milk 1 153 



1128 



INDEX TO PAET II OF BOOK VIII. 



Morning Sickness 1 129 

Mother and the Child 1129 

Mouth, Care of the 1 164 

New-born Infant 1 146 

Bandage, The 1147 

Breathing, to Start, in 1146 

Cord, Dropping the 1147 

Crib, The . ...1148 

Dressing, Applying the 1147 

Eyes, Caring for the 1 146 

Navel, Care of 1 146 

Normal Birth Infants 1150 

Nursing Bottles 1157 

Nursing the Baby 1 186 

Out-door Playing 1172 

Overeating, Correction of . . . 1193 

Over-indulgence in Children 1193 

Physician, Absence of, in Child- 
birth 114$ 

Pregnancy 1 129 

Baths in 1132 

Blood-poisoning in 1 140 

Bone and Teeth in 1 135 

Breasts, Condition of 1134 

Bowels, Condition of, in 1133 

Cramps in 1138 

Diet in 1 133 

Duration of 1130 

Exercise in 1131 

Fresh Air 1 132 

Heartburn in 1138 

Hemorrhoids in H39 

Hygiene During 1 130 

Ills of 1 137 

Injuries, Mutual ...1137 

Kidney Complications 1138 

Leucorrhea in 1 140 



Nausea and Vomiting in 1137 

Piles in 1139 

Rest in 1131 

Signs of 1 129 

Skin, Care of, in 1132 

Teeth and Bone in 1135 

Toxemia in 1 140 

Varicose Veins in 1 139 

Vomiting and Nausea in 1137 

Whites, The 1140 

Prematurely-born Children 1148 

Basket Heat 1148 

Bathing and Clothing 1149 

Feeding 1149 

General Directions 1149 

Temperature 1 149 

Puberty, Development of 1194 

Pulse Rate of Children 1171 

Quickening 1130 

Respiration in Children 1171 

Signs of Health 1173 

Sleep Required for Infant 1172 

Sterilizing, Mode of ". 1144 

Summer Complaint 1185 

Table for Feeding 1 158 

Teething 1 163 

Diet in 1166 

Illness of 1 167 

Malformations in 1166 

Prevention of Decay 1169 

Time of 1163 

Temperature of Children 1171 

Tongue-tie 1 182 

Urination, Disturbances in 1130 

Weaning Milk for 1156 

Weaning Time 1 158 

When to Enter School 1194 



ILLUSTRATION 

How and when first Teeth Come 



1 165 



SEXOLOGY 

PAET II. 

THE MOTHER AND THE CHILD 



The expectant mother should not be considered as an invalid. To be 
with child is a natural physiological process, the fulfilling of the Divine 
mandate, and the highest crowning act of womanhood, yet the state of 
pregnancy is one involving the most delicate and highly sensitive organ- 
ism, and requires careful consideration both from the standpoint of the 
woman herself and the new life which she is bringing into being. Pre- 
natal influences and education are of vast importance, yet they are greatly 
neglected and persistently misunderstood. Those who would have healthy 
children must be themselves healthy. They must obey the laws of nature 
and morality. They must not expect good fruit from poor soil. Physical 
strength, good organization, agreeable temper and nobleness of mind beget 
their like; drunkenness, debility, debasement of body and mind, yield 
similar characteristics in the progeny. Children who inherit the former 
start from the highest vantage ground ; children with the latter start in 
the race of life handicapped and at great disadvantage. 

PREGNANCY. 
Signs of Pregnancy — The natural question of the expectant mother 
is as to how pregnancy manifests itself. The following are usual and 
predominating signs: 

1. Cessation of Menstruation — Other causes may suspend the men- 
strual flow, and not only so, but in some cases the menstrual flow is 
not suspended during first month or so of pregnancy. But it is usually 
true that this is a reliable sign, especially if menstruation has previously 
been regular. The missing of two successive periods, however, may be 
taken as a sign. 

2. Changes in the Breasts. — If the menstrual flow has been suspended 
and at the same time there are unusual sensations in the breasts, such as 
tenderness to pressure, stinging, prickling, and so forth, these may be 
accepted as further indication that pregnancy exists. 

3. Morning Sickness. — This is especially noticeable in the first preg- 

1129 



1130 THE MOTHER AND THE CHILD. 

nancy. Usually on rising there is considerable nausea which may or may 
not be accompanied by vomiting. Occasionally this nausea occurs in the 
evening instead of the morning. 

4. Disturbances in Urination. — In the early period of pregnancy there 
is often desire to frequently empty the bladder, and there are sometimes 
other annoying symptoms. These usually are due to pressure of the 
growing womb against the bladder and generally disappear after a few 
weeks. 

5. "Quickening." — This is the movement of the child in the womb, 
and is usually felt about the sixteenth to the eighteenth week. This as 
a rule may be accepted as conclusive that pregnancy exists. 

Duration of Pregnancy — Countless cases of childbirth in many coun- 
tries and under all conditions have fixed the duration of pregnancy at ap- 
proximately 39 weeks or 273 days. Figuring thirty days to the month it 
will be seen that the commonly mentioned period of nine months is not 
far astray. To arrive at the date on which a given birth will occur there 
are many ways of reckoning. (Consult index for special table, which 
will be found interesting.) However, to roughly estimate, the simplest 
rule is to count forward 280 days from the beginning of the last men- 
strual flow, thus allowing seven days for the menstrual period, or what 
amounts to the same thing, count backward 85 days, or possibly still more 
easy, count back three months and add seven days. It will seldom occur 
that the exact date will be thus arrived at — some will occur a few days 
earlier and some a few days later, but it is nevertheless a good general 
rule. Example: If the last menstruation began on 30th September, 
count back three months to 30th June and add seven days, giving the date 
of expected birth as 7th of July. 

By consulting the general index and looking under the respective 
sub-headings, there will be found full information in the matters of Con- 
ception, Pregnancy, Labor and other relevant subjects; but it is essential 
in this chapter to call attention to the special care which the condition of 
pregnancy demands. From the earliest moment after conception more 
than usual care should be taken as to general health, clothing, baths, diets 
and so forth, and therefore we shall here treat briefly as to such things 
as are most vitally exigent during pregnancy. 

PERSONAL HYGIENE DURING PREGNANCY. 

Clothing — This should be loose and comfortable and adapted to the 
gradual development of the abdomen and the breasts. Tight lacing is 



HYGIENE OF PREGNANCY. 1131 

injurious to both mother and child and should be carefully avoided. It 
gives rise to disorders of the stomach and liver and may cause uterine 
hemorrhage and abortion. The clothing should be sufficiently warm to 
protect against cold and the feet should be especially guarded in such 
regard. In winter or in cold and damp seasons a flannel bandage or roller 
around the abdomen will prove a valuable protection. The ordinary corset 
should be discarded early in pregnancy. There are models which are 
intended for the woman during this period, and unless the expectant 
mother decides to do without wearing corsets at all, she will find it well 
for her own comfort and also for the welfare of the coming child, to pro- 
vide herself with corsets especially adapted to the needs of pregnancy. 
Too much care cannot be taken not to let the feet become damp, and not 
only should the feet be properly protected in such regard, but special 
care should be exercised that the shoes worn are comfortable. Pregnancy 
demands that there shall not be unnecessary strain on the nervous system, 
and few things are harder on the nerves than painful feet. Comfortable 
shoes are an essential. Toward the end of pregnancy the feet sometimes 
swell, and it is then necessary to wear larger shoes and of more comfort- 
able shape than may be necessary at other times. High heels should not 
be used for not only is there greater danger of falling, but the wearing of 
high heels unduly throws the weight of the body forward and brings un- 
desirable pressure upon the lower part of the abdomen, already under 
strain. 

Exercise — All kinds of harsh or agitating exercise should be avoided, 
such as riding rapidly in a carriage over rough roads, horseback riding, 
lifting or carrying heavy loads, in short, anything that may jar or strain. 
But short, gentle and frequent walks should be taken throughout the 
whole period of pregnancy, and much of the time should be spent in the 
open air with mild exercise and occupation, and in this way the general 
health be kept in proper tone, the growing foetus be nourished and streng- 
thened and foundation laid for an easy labor and a good getting up. It 
is the abundance of air and occupation that largely explains the rapid 
labors and speedy recoveries of poor women. They are obliged to work, 
but in their very toil they are favoring nature's operations and their 
compensation is an easy confinement, unattended by much inconvenience 
or anxiety. Indolence during pregnancy is enervating to mother and 
foetus. 

Rest. — A pregnant woman should retire early to rest — at least by 
ten o'clock — and be up in good time in the morning for her ablution, 



1132 THE MOTHER AND THE CHILD. 

morning stroll in seasonable weather, and an early breakfast. She should 
use every means in her power to make and keep herself healthy, not only 
for the sake of herself and her husband, but also for the sake of the 
forming child within her and the welfare of humanity. 

Fresh Air and Ventilation — Fresh air is needed by everyone. It is 
indispensable to health. It is especially essential to the pregnant woman. 
Where circumstances and weather permit there is nothing better for her 
than to sleep out of doors. Where this is not possible she should sleep 
with windows and doors so arranged as to give the maximum of ventila- 
tion, having due regard that there shall be no draughts. Not only is 
this necessary as regards the sleeping room, but it is also just as essential 
that the living rooms of the home should be thoroughly and properly 
ventilated. The windows in all occupied rooms of the house should be 
thrown wide open at different times of the day even in cold weather, that 
fresh air may enter. Unchanged air is unfit for the human lungs, and it 
is especially harmful to the pregnant woman. 

Baths and the Care of the Skin. — These are very important matters. 
While the skin should be kept in good condition at all times, it is especially 
necessary during pregnancy, as at this time the work of all the excretory 
organs is increased and the skin is one of the most important of these 
organs. It contains millions of pores which provide outlet for the waste 
material thrown off by the sweat glands. In a healthy person about a 
pint of water is each day eliminated through these pores, carrying with 
it various waste material. If the pores become clogged,the waste products 
are kept in the blood until they are disposed of by the lungs, bowels and 
kidneys, and this retarded elimination is injurious to the whole system. 
The pores must be kept open, the skin generally in healthy condition, 
and circulation stimulated, and this can be best attained by washing the 
entire body thoroughly every day, followed by good towel friction. Shower, 
tub or sponge bath may be used, and while the body is still wet should be 
briskly rubbed with a rough towel. A morning bath is recommended in 
most cases as it is usually more effective, and there is less danger of catch- 
ing cold if the water is cool. Cold baths are not to be recommended as 
a rule, though if a woman has been accustomed to a cold morning plunge, 
it is sometimes permissible to continue it during pregnancy, provided she 
gets into a healthy glow by brisk rubbing immediately afterward, and that 
the shock is not too great. However, as a general rule it is recommended 
that at tli is time the chill should be taken from the water. In addition to 
this daily cool bath the pregnant woman should take either two or three 



CONDITION OF THE BOWELS. 1133 

warm baths each week, using plenty of soap as these are necessary for the 
thorough cleansing of the skin. These warm baths should be taken at 
night just before retiring. Hot baths are sometimes beneficial and give 
rest, but the pregnant woman should avoid taking hot baths at the time of 
the normal menstrual flow and at no time during pregnancy should the 
hot bath be taken frequently. Both in respect of hot baths and very cold 
baths much discrimination is necesary during pregnancy, it being safer 
as a rule to confine the baths to the daily cool (not cold) bath and the 
bi-weekly warm bath. 

Diet — A due amount of care should be given to diet. Meat should 
be eaten but once a day; rich soups and highly-seasoned foods avoided, 
and all alcoholic stimulants strictly shunned. During the earlier stages 
of pregnancy rather less should be eaten than at ordinary times, for 
although it is true that two have to be nourished instead of one, yet there 
is less drain upon the system because the expectant mother is no longer 
unwell and the foetus up to the third month is not much larger than an 
egg. An overloaded stomach favors the distressing nausea and morning 
sickness of early pregnancy. During the latter months of pregnancy, 
however, the diet should be fuller, for if it be too light it is likely to make 
the mother a poor nurse for her child, both in the quantity and quality 
of her milk. 

Condition of the Bowels. — Almost all women suffer from greater or 
less constipation during this period. This is largely due to increased 
pressure exerted by the enlarging womb upon the intestines and this 
becomes greater during the latter months. It is of the greatest impor- 
tance throughout pregnancy that the bowels should move freely at least 
once a day. Whenever this can be accomplished by laxative foods resort 
should not be had to purgatives or enemas. A good laxative diet will 
include fresh fruits such as apples, peaches, pears, oranges, cherries, figs, 
pineapples, grapes, strawberries, raspberries, grapefruit, etc. Cooked 
fruits, such as prunes, apples, apricots, etc., are not so effective but are 
wholesome and may be eaten freely. The activity of the intestines is 
stimulated and increased by graham and whole-wheat bread, com-meal 
and the bran foods. Ordinary bran, eaten raw with good cream is often 
successful in relieving constipation at this period when other things fail. 
Bran bread is often beneficial, and the following recipe is recommended : 
1 cup of cooking molasses, 1 teaspoonful of soda, 1 small teaspoonful of 
salt, 1 pint of sour milk or buttermilk, 1 quart of bran, 1 pint of flour; 
stir well and bake for one hour in a very slow oven. It may be baked in 



1134: THE MOTHER AKD THE CHILD. 

loaf form or as bran biscuits or "gems" as may be preferred. This bran 
bread may be eaten freely every day and if persisted in is almost certain 
to give favorable results. Do not bake too much at one time, as it becomes 
quickly hard, whereas it should be eaten moist and tender. Fresh vege- 
tables are wholesome at this time, and if eaten with olive oil are laxative. 
Onions, asparagus, tomatoes, peas, spinach and practically all vegetables 
are recommended, but sometimes some of them, such as cabbages, radishes, 
etc., are not readily digested, and when this is found to be the case in 
respect of any vegetable or other article of food, the same should be 
eliminated from the diet. Different people are affected differently in this 
regard. 

If constipation is not relieved by diet, the old and well-known remedy 
of senna may be tried. One good receipt is that for "Senna Prunes:" 
An ounce of senna leaves is put in a jar and a quart of boiling water 
poured over them ; let them stand two hours, then strain, and to the liquid 
add a pound of well-washed prunes and let them soak over night; then 
cook in the same water until tender, sweetening with two tablespoonfuls 
of brown sugar. The syrup and the fruit are both laxative. Commence 
with half a dozen prunes with syrup at night and increase or decrease 
the quantity as may be found advisable. Another receipt is the following : 
Eemove the stones from a pound of dried prunes and mix with them a 
pound of good dried figs, first having thoroughly washed the prunes ; run 
the mixture through a meat chopper, adding two ounces of finely-pow- 
dered senna leaves. Stir this mixture with two tablespoonfuls of mo- 
lasses. This makes a thick paste. Commence at bedtime by eating about 
three good tablespoonfuls and increase or decrease on following nights as 
may be deemed expedient. The paste should be kept covered in a glass 
jar and in a cool place. If the senna is unpalatable commence with a 
smaller quantity and gradually increase. If constipation continues in 
spite of these measures, it will be well to consult the family physician 
before resorting to purgatives. Enemas are sometimes helpful, but their 
regular employment is not advised. 

Condition of the Breasts. — Every mother should have an inborn desire 
to nurse the coming baby. Breast-fed babies as a rule thrive better than 
bottle-fed babies. More bottle-fed babies die than breast-fed babies. It 
is estimated from carefully prepared statistics that the breast-fed baby 
has seven times as good a chance to live as a bottle-fed baby. Also it is 
bettor for the health" and happiness of the mother if she be able to nurse 
her child. The healthful measures already set fortk, if properly followed, 



TEETH AND BONE. 1135 

will greatly tend to make the mother competent to nurse her baby when 
it comes, but it is necessary to say a word in regard to the breasts during 
pregnancy that these may be found in proper condition when the time 
comes. The clothing of the expectant mother should be sufficiently loose to 
give ample room for development of the breasts. During the latter months 
of pregnancy special regard should be had to the nipples. They require 
toughening at this time, and every night at bed time should be washed 
with warm soap and water, then anointed with lanolin and covered with 
a piece of soft linen. They sometimes require special attention in 
addition to this, and it is therefore well to have the family physician 
observe the condition of the nipples about eight weeks before confinement 
that he may determine whether or not any special treatment is necessary. 
Teeth and Bone. — In order that the child may have good teeth and 
good bone it is necessary to begin with the expectant mother. She must 
not only have plenty of good fresh air and good food, but the food must 
be of a nature to create bone in the forming child. Science has proven 
that the formation of various tissues in our bodies are influenced by the 
nature of our diet and that in order to meet the requirements of our 
systems our food must contain the elements which go to make up these 
tissues. So if we wish the baby's teeth and bones to be as they should be 
we must incorporate in the mother's food such elements as will make the 
right bone formation. This may be done by supplying the system with 
the required elements in a medicinal form, but if we can sufficiently 
supply these elements in the food itself, we will find our purpose better 
and more economically accomplished than by the administration of medi- 
cine. An analysis of bone shows it to be chiefly composed of the phosphate 
and carbonate of lime, with the chloride of sodium and phosphate of 
magnesia present in small quantities. Unless, then, the food taken by the 
mother contains an adequate proportion of these bone-forming elements, 
the child will either be lacking in such regard or the mother will be de- 
prived of these elements for her own bones and so harmed. Teeth and 
bones owe their hardness to phosphate of lime, which is found in abun- 
dance in whole wheat bread and those cereals which consist of the whole 
kernel of wheat, oats or rye, but is absent in things made from white flour 
from which the gluten has been abstracted. The child that is deprived of 
lime phosphates in its food is likely to be subject of rickets, curvature 
of the spine and loss of teeth, and young or old people who live chiefly on 
white bread, pastry and the like are sure to have trouble with their teeth. 
Alkaline, phosphates, and other soluble salts are found in meat, eggs, 
milk and also in many articles of the vegetable kingdom. In the matter 



1136 THE MOTHER AND THE CHILD. 

of this creation of teeth and bone the use of lime water is strongly recom- 
mended. It may be purchased at any drug store or may be made at home 
by putting a piece of quick-lime the size of a hickory nut into an eight 
ounce bottle and fill with water, shaking to facilitate dissolution. After 
the lime settles the top is poured off. It is taken with milk in propor- 
tion of about one part of lime water to ten parts of milk. It is a well- 
known fact that no matter how good her teeth have previously been, when 
she begins to bear children every woman commences to suffer with her 
teeth. The cause lies partly in the fact that the woman lacks sufficient 
lime in her system to supply her own needs and those of the forming child, 
which in consequence absorbs the substance for its bones from the roots 
of the mother's teeth, and partly because the disturbance of nutrition dur- 
ing pregnancy is frequently the cause of an acid condition of the mouth 
with inflammation of the mucous membrane, accompanied by sore and 
bleeding gums. These sometimes become so sore as to makes it impossible 
to use a toothbrush and food lodging in and between the teeth ferments, 
makes a feeding ground for bacteria and causes further acidity. These 
conditions, acting through the fifth nerve, which supplies the teeth, not 
infrequently gives rise to a severe toothache that may continue some 
hours, notwithstanding that there may be no decayed teeth in the mouth. 
If the teeth are in good order, the saliva should be examined and kept 
in a neutral condition — that is, neither acid or alkaline in reaction. Tests 
can be regularly made with red and blue litmus paper which may be 
obtained at any drug store. Moisten the tongue with saliva and touch 
it to a piece of blue litmus paper, and if it be acid this blue paper will 
turn red — if it should be alkaline it will turn the red paper blue. By the 
use of alkaline mouth washes this condition of acidity may be relieved. 
Dentists commonly recommend what is called milk of magnesia (Phil- 
lips), but any good antiseptic mouth wash will be found serviceable, 
such as borolyptol, listerine, pasturine and glyco-thymoline. But where 
gums are very soft and spongy it may be found necessary to use a more 
astringent wash to harden and shrink the gums, and for such cases the 
following prescription is recommended: 

R— Tr. of myrrh 2 drachms 

Tr. cinchona co 6 drachms 

Honey 1 ounce 

Water 2 ounces 

Rub on the gums several times a day. 

Or tincture of myrrh in water as -a gargle may be used, teaspoonful 
to a glass of water. 



ILLS OF PREGNANCY. 1137 

In such cases as this prescription fails it will be advisable to see a 
dentist, who will be able to undertake a thorough cleansing of the teeth 
in the recesses of the gums which cannot be reached with the toothbrush in 
the ordinary way. It is true that there is a very popular opinion prev- 
alent that no woman should enter the dentist chair while in pregnancy, 
but the best authorities to-day are of opinion that if the dentist be properly 
qualified and the condition be made known to him, he will operate in such 
manner as to cause no harm, but on the contrary greatly benefit the 
patient. Brightness and cheerfulness during pregnancy is essential for 
the welfare of both mother and offspring, and it is not too much to say 
that there cannot be requisite cheerfulness where the expectant mother 
is a constant sufferer from toothache. It is then of vital importance that 
suffering from troubles of the teeth should be removed, and if ordinary 
means are not sufficient then that a competent dentist should be consulted, 
but he must be told of the condition of the patient. 

Necessity of Comfort and Cheerful Surroundings It is of the utmost 

importance that the expectant mother be surrounded with comfort, cheer 
and happiness ; that no unkindness be shown her by her husband or family ; 
that she have all advantages of mental ease and comfort to implant in 
the miniature human being qualities good and noble. How readily moth- 
ers believe in birth-marks, yet how ignorant or negligent many of them 
are of prenatal impressions affecting health and nfbrals. The pregnant 
woman, too, must be cheerful herself. It is a duty she owes the coming- 
child. 

Mutual Injuries. — It is to be remembered that during a prolonged 
period mother and child form together but one living existence, and what- 
ever injures the mother's constitution also involves that of her progeny. 
A fall that in any way hurts the mother may equally harm the unborn 
child and oftentimes to even greater and fatal effect. 

The Father. — It is not amiss here to say that the health of the father 
at the time of impregnation also influences very much the future child's 
welfare. He should be physically and morally sound. 

SOME ILLS OF PREGNANCY AND HOW TO AVOID THEM. 

Nausea and Vomiting. — The majority of pregnant women suffer from 
"morning sickness." It is a distressing but not an alarming ailment. 
A little dry food, such as toast or crackers, taken before rising and well 
chewed and then swallowed without liquid will sometimes relieve the 

72 



1138 THE MOTHEE A^D THE CHELD. 

trouble. Some women find comfort and good results from taking a cup 
of tea or coffee, while with others they may have the reverse effect. A 
good preventive is to eat six small meals a day instead of three large ones, 
eating very lightly at the last meal of the day. The tendency to nausea 
is easily established and it is therefore important to ward off the initial 
attack. Keep the mind from dwelling on the subject of sickness and from 
anticipating the attack of nausea. A healthy mental attitude is of great 
advantage in this regard. Worry or any other morbid condition of mind 
exaggerates the ailment. Plenty of out-of-door life and a cheerful, happy 
mind will do much to counteract this illness. However, if there is much 
vomiting and this increases or persists in spite of precautionary meas- 
ures, the family physician should be consulted, as medical skill is some- 
times necessary to cope with it. 

Heartburn. — This is a sensation of burning in the throat caused by 
an abnormal development of acid in the stomach. It has nothing what- 
ever to do with the heart. The trouble may be overcome by taking a glass 
of rich milk or a tablespoonful of olive oil fifteen or twenty minutes 
before each meal, the idea being that the fat in the milk or oil will retard 
the secretion of acids. However, if an attack has begun it will only be 
aggravated by taking milk, oil or any other fat, and everything in the 
way of milk, oil or fat or greasy food must be avoided until the attack is 
over. This trouble js sometimes most succesfully treated by means of 
alkaline drinks. A good prescription is the following: Bismuth subnit., 
24 grains ; magnesia powd., 1 drachm ; sugar milk, 1 drachm. In 12 pow- 
ders; one after feeding. 

Cramps. — These sometimes occur during the later months of preg- 
nancy owing to pressure on the nerves, the attacks frequently occurring 
during sleep or when the limbs are stretched upon waking. Relief may 
be obtained by rubbing and by application of hot cloths. To merely ele- 
vate the feet will sometimes be sufficient. 

Kidney Complications. — If there be any tendency to kidney trouble 
it is more apt to manifest itself during pregnancy than at other time, 
and also during this period there may be discomfort from the kidneys 
without any real kidney trouble. The quantity of urine passed in 24 
hours should be from time to time measured. If less than three pints be 
passed during that time it is evidence that not enough water is being 
taken. If also the urine is dark in color and shows sediment, it is evi- 
dent that the preen ant woman must drink more water. The two danger- 
ous elements in urine to be guarded against are sugar and albumen. Their 



VARICOSE VEINS. 1139 

presence can only be told by specific chemical tests, and as the presence of 
either of these elements in the nrine may be of serious import, every 
pregnant woman should have her urine frequently examined by the family 
physician, say not less than once a month during the earlier stages of 
pregnancy and twice a month during the latter half, or even more fre- 
quently if there be suspicion. Use a perfectly clean jar or vessel with 
a cover. This must be thoroughly scalded and kept in a cool place. Com- 
mencing at some convenient hour in the morning, the first urination 
should be into some other vessel and the urine thrown away, but on each 
subsequent occasion until the same hour next morning that there is in- 
clination to make urine, empty the bladder into the special jar or 
vessel, keeping it tightly covered at all times between. From this vessel 
fill a perfectly clean six-ounce bottle, which should be corked tightly and 
a label put on it giving name, date and the total quantity passed in the 
twenty-four hours. Send this at once to the doctor. A teaspoonful of 
boracic acid will keep the contents of the jar from decomposing without 
affecting the urine from an examination standpoint. 

Varicose Veins — Owing to the unusual pressure on the blood vessels 
during pregnancy there is sometimes a swelling of the surface veins of 
the legs, which is known as "varicose veins." When this trouble occurs 
the patient should sit or lie down frequently, and when sitting should 
rest the feet on a stool or chair in order to relieve the pressure. In severe 
cases it will assist relief to wear a thin flannel bandage about the calves of 
the legs, bias strips of flannel three inches wide being sewed together to a 
length of eight yards. Bind the legs before rising, commencing to wind 
at the toes, but leaving the heels uncovered. Wind the bandage round and 
round the leg and well over the knee or higher if the veins of the thigh 
are affected. Usually it is well to have the doctor or nurse attend to this 
bandaging, and where the trouble persists in spite of these precautions the 
Hoctor should in any case be called upon to direct treatment. 

Piles (Hemorrhoids) This ailment is of the same nature as varicose 

veins, only in different location, being in the rectum. The trouble is ag- 
gravated by constipation and is augmented by straining at stools. The 
call to the closet should always be immediately obeyed, but if the bowels 
do not move readily do not strain, but use some simple laxative such as 
licorice powder, though in so far as possible the bowels should be regu- 
lated by laxative diet rather than by direct medication. The patient should 
lie down frequently while the trouble is severe, and oftentimes a pillow 
under the hips will afford relief. 



1140 THE MOTHER AND THE CHILD. 

Leucorrhea (the "whites"). — This whitish discharge from the vagina 
is frequently due to the congestion of the vaginal walls resulting from 
pressure of the enlarging uterus on the blood vessels through which the 
blood is ordinarily returned to the general circulation. When this is the 
cause it is not usually serious though it may be very annoying. Douches 
sometimes relieve, but as a rule the doctor should be consulted before 
using this treatment. 

Toxemia (Pregnancy Blood-Poisoning) . — As pregnancy advances the 
mother is constantly receiving back into her blood an increasing quantity 
of waste matter from the growing child which must be eliminated as well 
as that which would naturally come from her own system. If the ex- 
pectant mother's own nutritional processes are imperfect and she is un- 
able to eliminate all these waste materials, a condition may result that 
may prove serious both for the mother and the child. This condition 
is called "Toxemia," and as its name implies, is a species of blood-poison- 
ing. The following are some of the symptoms: Serious and, persistent 
vomiting, repeated headaches, dizziness, puffiness about the face and 
hands, blurring of the vision or spots before the eyes, neuralgic pains, 
especially about the pit of the stomach, muscular twitching. It does not 
follow that any one of these symptoms nor all of them combined neces- 
sarily mean toxemia. They may be due to entirely different cause which 
may be removed without serious consequence of any kind. But when 
such symptoms appear they should be brought to the attention of the 
family physician, and it will be well to send him immediately a speci- 
men of the urine, for the results of toxemia are so serious that they must 
not be overlooked, and if placed in the hands of competent physician at 
the beginning he will probably be able to remedy the ill before it gains 
undue headway. Many women are inclined to think that all such dis- 
turbances are a natural accompaniment of pregnancy and repeat the old 
adage that "a sick pregnancy is a safe one." There is no truth in this 
saying. If the pregnant woman is in healthy condition and carefully fol- 
lows the rules for health laid down in this chapter, she will usually be 
free from most and sometimes all of the ills of pregnancy. Every preg- 
nant woman should endeavor not only to be conversant with the necessary 
simple rules of health during pregnancy, but should strive to carry them 
out in every way. Guard unremittingly against continued constipation; 
avoid excessive quantities of meat ; drink a liberal amount of water ; take 
plenty of outdoor exercise and keep the house well ventilated day and 
night; bathe every day; wear loose, light, but suitably warm and com- 



MISCARRIAGE. 1141 

fortable clothing; get plenty of rest and sleep at least eight hours out of 
the twenty-four, and do not become overtired at any time ; have the urine 
examined frequently and at stated intervals ; strive to be happy, seek self- 
control, and do not worry; consult the doctor when symptoms of illness 
persist in spite of all precautions. Pregnancy is natural and it should be 
healthy. 

Miscarriage. — The placenta and the uterus do not become firmly 
united until the eighteenth week of pregnancy, and hence it is that mis- 
carriage is most likely to occur during these early weeks. The possible 
causes of this mishap are many. Oftentimes it is impossible to discover 
the true cause. Once having had a miscarriage, no matter what the cause, 
there is greater danger of another, and women thus sometimes get into un- 
controllable habit of miscarriage. Among common causes the following 
may be mentioned: washing, sweeping, lifting, moving heavy articles, 
running a sewing machine and so forth, or it may result from amusements 
that cause too great bodily strain, as dancing, tennis, golf, horseback 
riding, hill climbing, jolting over rough roads in carriage or automobile, 
etc. It may be due to some imperfect development of the child in embryo, 
to some constitutional disease of the mother, to some abnormality in the 
uterus or to its misplacement. In these latter cases it cannot usually 
be avoided. In perhaps the majority of cases prevention lies in guarding 
against over-exertion during the first few months. When there has been 
previous miscarriage and so a possible tendency for it to again occur, a 
stay of several weeks in bed will sometimes avail when nothing else would. 
Such women should go to bed immediately there is any indication of 
bleeding or of abdominal pain. If it persists it is wise to send for the 
doctor, especially if pregnancy has advanced beyond the sixth week. 
Whether doctor is obtainable or not she must remain absolutely at rest 
until all trouble is over. If the miscarriage occurs before the sixth week 
it may appear to be nothing more than a severe menstrual flow, but it must 
be remembered that no matter at what period it may occur a miscarriage 
is an entirely different happening from a menstrual flow and certain dan- 
gers are always present. A foetus, or in other words a child in embryo, 
has formed in the uterus and has come away in an unnatural way. Before 
a miscarriage can occur there must be a loosening of the foetus (or un- 
formed child) from the uterus. If this loosening is so slight that the life 
of the foetus is not endangered, a miscarriage may oftentimes be averted 
by resting in bed. If in spite of this rest the bleeding continues it in- 
dicates that so much of the foetus has been detached from the walls of the 



1142 THE MOTHER AND THE CHILD. 

uterus that miscarriage is almost certain to result. In such cases the 
doctor should be at once summoned and anything that has come away 
before his arrival should be saved for his inspection, that he may judge 
as to just what has occurred. To neglect a miscarriage, even at the 
earliest stage, may mean complete loss of health and years of suffering, 
while in many cases if it have the proper care of a competent physician 
at the time it may be deprived of ill results. Never regard a miscarriage 
as something that should be concealed. If it has come about in a natural 
way or by accident it is a matter calling for sympathy, not condemna- 
tion, and it is unjust to oneself to permit it to pass without the proper 
medical treatment. 

PREPARATIONS FOR CONFINEMENT. 

Doctor and Nurse. — The family physician should be told of the ex- 
istence of pregnancy at as early date as possible. It is not only advisable 
that he should regularly examine the urine from the beginning; but if he 
has had the case under observation from the start he will be in much better 
position to deal with any untoward symptoms that may develop than he 
would had the case not been under his previous observation. It is well 
also to engage the nurse some time before the expected event, and it will 
usually be found advantageous to consult the doctor as to the nurse. The 
nurse should visit the home a few weeks before the expected date and make 
herself thoroughly familiar with the house and see that all necessities for 
the occasion are in readiness. As to the time a nurse will be required, 
cases vary, but she should remain at very least two weeks, and if possible 
four and in some cases longer. Many a case of life-long invalidism has 
resulted from the lack of suitable and sufficient care from doctor or nurse 
or both at confinement, and a few extra dollars spent on nurse and doctor 
at this time may save much greater expenditure later and perhaps save 
years of suffering. 

Place of Confinement. — It is becoming more and more common for 
women to go to hospital to be confined. It is to be recommended in many 
ways. If any emergency occurs there are not only all appliances which 
may be required ready for instant use, but doctors and nurses to assist 
in any way that may be desired. In the matter of cost the hospital 
confinement will usually bo cheaper than one at home, not only because of 
the saving in the matter of the many things it is necessary to get for a 
home confinement, but in the matter of the nurse, as at home there is not 



SUPPLIES NEEDED FOR CONFINEMENT. 1143 

only the nurse's salary, but her laundry and board. At the hospital the 
weekly amount paid includes the board of the patient, the routine care and 
all appliances of every kind that may be used. At the hospital ward 
nurses will usually be sufficient, but it is a great comfort to the mother 
and a help to the doctor if a special nurse is also engaged for the first 
two weeks, and where expenditure for such special nurse can be afforded 
it is to be advised. Many of course prefer confinement at home, and in 
such case everything must be gotten ready for the event a very consider- 
able time in advance, and the importance of engaging a competent nurse 
must not be overlooked, for the best nursing that can be had is desirable 
for the woman in childbirth. 

Supplies Needed. — For a confinement at home the following supplies 
should be on hand : Two to four pounds of absorbent cotton ; one large 
package of sterile gauze (25 yards) ; two yards of stout muslin for ab- 
dominal binders; twelve old towels or diapers; two old sheets; two yards 
of bobbin or very narrow tape, for tying the cord. With these supplies 
the mother or nurse may make the necessary pads and bandages, which 
must be sterilized in accordance with instructions hereinafter given. The 
following further supplies should also be in readiness: one hundred bi- 
chloride of mercury tablets ; four ounces of powdered boric acid ; one bottle 
of white vaseline ; one pound of pure Castile soap ; one quart of grain 
alcohol; one douche pan; one stiff hand brush; one slop jar or covered 
enamel bucket ; three pottery or agateware basins, one 16 inches and two 11 
inches in diameter ; at least three pitchers, each capable of holding a 
quart and upward ; one and one-half yards of rubber sheeting, at least 
thirty-six inches wide, or one and one-half yards of white table oilcloth, 
to protect the mattress ; one two-quart fountain syringe ; one medicine 
glass ; one medicine dropper ; one drinking tube. 

Sanitary Pads. — These are for the purpose of absorbing the discharges 
after delivery. They should be ten inches long and four inches wide, and 
one inch thick. They may be made of absorbent cotton, or for economy 
may be largely made of batting, but there must be a layer of the absorbent 
cotton on one side. Cut the sterile gauze into pieces the right size to 
fold around the cotton and extend two or three inches beyond it at each 
end. At least five dozen of these pads will be needed. They are pinned 
front and back to the abdominal binder, which is simply a strip of cotton 
cloth 12 inches wide and long enough to be fastened comfortably around 
the abdomen. 

Delivery Pads — Make two pads, each a yard square and four inches 



11-44 THE MOTHER AND THE CHILD. 

thick. Cotton batting may form the principal part of the thickness, but 
there must be at least one inch top layer of absorbent cotton. Cotton waste 
if boiled in washing soda and thoroughly dried in the sun makes a cheap 
and effective filling in place of the batting, but as the texture is loose a 
thicker layer must be used. If necessary newspapers may be used both to 
protect the mattress and for the delivery pads, but for the latter must be 
covered with old sheets which have been sterilized. 

Gauze Sponges — These are made by cutting sterile gauze into 15-inch 
lengths, the width of the gauze. One raw edge should be folded down 
about three inches, then double the strip by putting the selvage edges 
together, putting the raw edge of the fold on the outside. Fold this into 
thirds both ways and turn the sponge inside out so as to have all the raw 
edges inside. Two dozen of these pads will be required. 

Cotton Pledgets — These are wads of absorbent cotton about the size 
of an egg y having the ends of the cotton twisted into the roll. Make sev- 
eral dozen of these and keep them in a small pillowcase or cheesecloth 



Gauze Squares. — These are needed to wash the baby's eyes and for 
other purposes. They should be cut out of the gauze in four-inch squares. 

Bobbin. — Cut ordinary cotton bobbin into six 9-inch lengths for tying 
the cord. 

Mode of Sterilizing. — Dressings may be sterilized in the oven, but 
there is danger of scorching, and, moreover, dry heat is less effective than 
moist heat, and it is therefore better to use steam. The smaller things 
may be sterilized in a large kettle or saucepan, and the larger ones in the 
wash boiler. For the first place a bowl upside down in the bottom of the 
kettle, using a bowl several inches high; put a plate on top of this bowl; 
put the dressings on the plate. For convenience in handling they may 
be placed in a cheesecloth bag. The water should just cover the bowl, 
but not the plate. Cover the kettle tightly. The articles should remain 
for a full hour after the water begins to boil. To sterilize in the boiler 
make a muslin hammock, somewhat longer than the length of the boiler, 
so that it will hang down about a third the depth of the boiler, and put 
the articles in this hammock, using great care in fastening the ends of 
the hammock to the boiler handles and making sure that it is so placed 
that the articles cannot tumble out. It will facilitate handling to first 
place the articles in a cheesecloth bag. The boiler should be filled about 
one-quarter full of water and after the water has come to the boil the 
articles should steam for a full hour, when they may be taken out and 




Lying-in Room. 




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Applying the Abdominal Binder. 








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PROPORTIONS OF A HEALTHY CHILD'S BODY 



60 mm. 

(2% in.) 



6 mm. 
(2% in.) 




Fig. 437. At birth. 

Length of head 12 cm. <4V 2 in.) 

Lngth of face about half the 

length of head. 




At age of one year. ^ 

Lengtn of head 16 cm. (6 in.) • 

Length of face from one-thirteenth to g 

one-twelfth larger than top of head. 




Length of body 
about four head 
engths. 



New-born boy. 

About one-seventh natural size. 



20 cm. 
(7% in.) 



6 cm. 
(2% in.) 



16 cm. 
(6 in.) 



10 cm. 
(3% in.) 



10 cm. 
(3% in.) 



_ , ..i cm, 
(10% in.) 



27.5 cm. 
(10% in.) 



I cm. 
. i m In.) 




Hoy five and a half years old. 

one lifi i '-in ii natural size. 



Length of body 
about five head 
engths. 



Two-year-old boy. 
About one-fifteenth natural size. 



THE BED IN LABOR. 1145 

dried. Sun-drying by hanging on clothes line is perhaps best way where 
possible, but they may be dried in the oven, great care being taken not to 
let them burn. They should then be put away in a perfectly clean drawer 
or other closed and suitable place, ready for use when required. 

Confinement Room — This should be the brightest and cheeriest room 
in the house. If possible it should be near a bath-room, and if there is 
a communicating room which can be used by the nurse and baby, it will 
greatly assist the mother in matter of rest. The room should be scrup- 
ulously clean and should be free from heavy draperies and upholstered 
furniture. 

The Bed. — A single metal bed is to be preferred to the ordinary double 
bed, which is both too wide and too low. If low bed must be used, it will 
be well to raise it six or eight inches by putting strong, square blocks 
under the legs, first of course removing the castors so that there will be 
no danger of the bed slipping off the blocks. It is necessary that there 
shall be a good and comfortable mattress. If the mattress sags in the 
middle it should be remedied by placing three obstetrical boards — 5 ft. by 
12 in. — between the springs and mattress. The bed should be in such 
position that both the doctor and the nurse can get at it at the same time, 
and also it should be where the best possible light falls on it, especially at 
night, as light is of great importance in case stitching is necessary. A 
portable electric lamp is an excellent thing if it can be arranged. 

CARE OF THE NEW-BORN INFANT. 

While no one is herein advised to usurp the place of a physician 
or a skilled nurse in the lying-in room, yet, under peculiar circumstances, 
it may fall to the lot of some member of the family to act in an emergency 
as a nurse or even as a physician. 

What to Do in Absence of Physician. — In such a case after the child 
has been born care should be exercised that no blood or fluid be drawn into 
the lungs during efforts to establish breathing. As soon as the child 
breathes well and cries lustily several times, the cord may be tied and cut 
in this fashion : Take a piece of strong heavy wrapping cord or a braided 
silk, a fishing line serves admirably, and tie the cord two fingers' breadth 
from the belly. Tie again further away and cut the cord between the 
two strings. Should the child not breathe well when born hold it up by the 
feet. This gives an opportunity for mucus and fluid to run out of its 



1146 THE MOTHER AND THE CHILD. 

■> 

mouth. Spank it gently. If the cord beats feebly cut it and remove the 
baby from the mother. 

To Start Breathing — If it has not yet begun to breathe souse its body 
quickly in cold or hot water. Immerse in hot and cold water alternately, 
frequently hang it head downward. Once the child breathes well or cries 
well roll it in a warm blanket or woolen shawl, lay it on its right side in a 
suitable place until the mother has been cared for as described in a pre- 
vious chapter. 

Bathing — All strong, well-developed infants may be given a thorough 
cleansing bath soon after birth. If the child is covered by a white, cheesy 
substance it may be thoroughly greased with advantage. For this purpose 
pure olive oil is superior, although unsalted hog's lard or vaseline makes 
a good substitute. After rubbing this cheesy substance loose with the 
grease, give a soap and water bath. To give the bath the child should be 
laid across the lap on a blanket or large soft towel. The bather should 
wear a rubber apron and should have on a chair by her side a large basin 
of warm water and a bar of castile soap. A soft wash cloth or bath sponge 
may be used for the washing process. This completed, wrap the child in 
the towel and dry the skin by rubbing on the outside of the towel. Dry 
within all folds of skin very carefully. The entire body may now be 
dusted with baby powder: lycopodium, talcum or powdered starch. 

Caring for the Eyes. — If the eyes are now properly cleansed that con- 
dition which mothers so dread, "sore eyes," may be avoided. They are 
best cleansed by dropping sterile boiled water in them by means of a new 
clean medicine dropper. A boric acid eye wash may be employed if the 
eyes seem to be inflamed at birth. 

Boric acid I teaspoonful 

Distilled water 5 ounces 

Note — Should the child be very weak or breathe feebly, it is well 
to postpone bathing or simply grease the child and wait until it is stronger 
before using soap and water. 

Care of the Navel (Umbilicus). — Our grandmothers were wiser than 
they knew when they used singed linen to dress the umbilical cord and 
umbilicus (navel string and navel). We know that only sterilized dress-, 
ings should be used about the navel. Among the best is sterile or borated 
cotton or sterilized gauze. If these cannot be had any piece of soft cloth 
or linen may be sterilized by baking in an oven for one-half hour and 



THE NEW-BORN INFANT. 1147 

handled only with clean hands. In dressing the cord it should first be 
washed clean with sterile or boiled water, then dusted with some antiseptic 
dusting powder. Boric acid is frequently used, although the following 
formula will be found more frequently used by physicians and obstetric 
nurses : 

Salicyclic acid I part 

Powdered starch 16 parts 

Mix well and use as a dusting powder. 

Applying the Dressing. — Your cloth or gauze may now be applied. 
Take a piece about four inches square, cut a hole in its center, pass the 
cord through and lay it upward and toward the left, add more dusting 
powder and fold in the edges of the dressing. The bandage may now 
be applied. 

Dropping of the Cord. — The stump of the cord usually separates 
within a week, although it may remain longer. The rule is to allow it 
to drop off of its own accord. At any time when adjusting the bandage 
if the dressing is blood-stained or if pus is seen about the navel call the 
physician's attention to it at once. 

The Bandage. — The bandage is applied to the infant's body for two 
reasons : First, to keep in place and to keep clean the dressings on the 
cord; second, to furnish support to the abdomen, and protect the intes- 
tines. During infancy the child uses all of its abdominal muscles at each 
breath, hence it is important that the bandage be pinned just snugly. If 
too tight it will interfere with breathing. It may, too, cause greater 
than normal pressure in the groins and hernia may result. The bandage 
should either be knit or should consist of a strip of flannel six inches 
wide and eighteen inches long. The bandage should be worn from three 
to six months. 

Baby Clothes Prepared Before Birth. — One dozen white gowns for day. 

One-half dozen woolen gowns for night. 

Six abdominal bandages. 

Six woolen undershirts. 

One-half dozen knit socks. 

One dozen large safety pins. 

One dozen small safety pins. 

One-half dozen large, soft towels. 

Three or four baby wash-cloths. 

Powder, powder-box and puff. 



1148 THE MOTHER AND THE CHILD. 

Two light, soft shawls. 

Two dozen diapers. 

Two flannel bathing aprons. 

One rubber apron. 

The Crib — A crib is better than a cradle. It should be provided 
with a cheap mattress and a mackintosh, two soft blankets, two pillows, a 
washable comforter and a counter-pane. A good-sized clothes-basket with 
a large hair pillow makes an excellent crib for early infant life. It is 
especially useful when the child is weak, and artificial heat must be 
supplied. 

THE CAKE OF PREMATURELY-BORN CHUjmEN. 

Premature Birth. — Fright, accident or disease may cause the pregnant 
woman to deliver herself of her infant before term. Physical deformity 
of the mother may make it necessary for the physician to bring on labor 
some weeks before term. The care of infants born under such circum- 
stances causes parents and nurse great anxiety. The lives of many such 
infants are sacrificed yearly because the average nurse (untrained) knows 
nothing of their care. 

Incubation. — Every effort must be made to conserve the heat of the 
prematurely-born infants. To do this successfully, an .artificial media 
must be supplied to take the place of the mother's womb. To speak figura- 
tively, the "hatching" must be completed. Incubators are made for this 
purpose, and are for sale or for rent in every large city in this country. 
These incubators are planned similarly to the incubator in which chicken 
eggs are hatched. The great advantage of this apparatus, if successfully 
conducted, is a uniform high temperature can be obtained, and the mois- 
ture of the atmosphere accurately regulated. Feeding can also be done 
without disturbing the infant or allowing much heat to escape. However, 
in hospitals and elsewhere difficulty has been found in properly conduct- 
ing child incubators and preference is now given to the "Basket Heat" 
method described in the following paragraph. 

Basket Heat. — Take a large clothes-basket, line it with a double 
blanket, place on its bottom and stand around its sides a row of hot water 
bottles Cheer bottles filled with hot water serve admirably) ,reline with 
another blanket, and place a thin pillow over the bottom row of bottles, and 
you have an improvised incubator that has saved the lives of many infants 
and gives greater opportunity for safeguarding the infant at all points. 



THE PREMATURELY-BORN INFANT. 1149 

Bathing and Clothing — Prematurely-born infants must not be given 
a general bath. The face, if soiled, may be cleansed. The entire body 
should be greased with olive oil, lard or vaseline. The cheesy substance 
wiped off with cotton. The entire body, except around the anus and face 
should then be sheathed in carded lamb's wool or raw cotton, and around 
the whole, a bandage. A bunch of cotton may be placed over the anus, 
to receive urine and feces. 

Temperature — The infant must now be provided with a high, even 
temperature, varying from 95 degrees to 85 degrees Fahrenheit, depend- 
ing upon how weak it is when born. No other clothing is required, except 
a blanket cover. This temperature can be accurately maintained with the 
incubator, or approximately maintained with the basket properly and 
skillfully manipulated. 

Feeding. — It is frequently impossible for the premature child to 
suckle at the mother's breast, but diligent effort should be made in this 
regard. If the act cannot be performed then the mother's breast should 
be pumped, and the milk thus gotten kept warm by placing in a cup stand- 
ing in warm water. It should be given to the infant as soon as possible 
after being drawn. It is best given by means of a medicine dropper. 
"Where the mother has no milk, milk may be prepared as per formula for 
modified milk, and then dilute it one-half with sterile water. Only a few 
teaspoonfuls can be given at a feeding, but the feeding should be more 
frequent than with the child born at regular time — say once an hour. 
The infant must be kept by its artificial heat, or in the incubator while 
this is being done. It may even be fed without waking. 

General Directions. — Such infants sleep almost continuously, and cry 
usually when too cold. When too hot they will be seen to be restless, and 
to breathe rapidly. These observations must guide in regulating tempera- 
ture. Should stimulants be required, the physician will direct the kind of 
stimulation and dose. The child must not be removed from its wool or 
cotton suit for a soap and water bath until such time as it would have 
been at term if unborn, and not then unless it appears to have gained 
strength. 

To remove soiled cotton about anus, do so by turning child on its side ; 
remove cotton, wipe off buttocks with moist cloth; replace fresh cotton, 
and turn child back as before. Do not drag a prematurely-born child out 
of the incubator or basket to nurse it or to show it to inquiring friends. 



1150 THE MOTHER AND THE CHILD. 



INFANTS OF NORMAL BIRTH. 



Infant Bathing. — An infant should be regularly bathed from head to 
foot once a day. The outfit for the baby's bath should consist of an infant 
bath table, bath thermometer, washcloths, soap, oil, powder and towels. 
The tub and table should be of white enamelware. 

A bath thermometer should be used to determine the temperature 
of the water. Squares of cheesecloth or soft turkish toweling should be 
prepared — a dozen each time — to be used as washcloths. 

By no means use highly scented soaps, they contain chemicals that 
irritate the skin. Imported castile is the best. Wet the baby's head before 
putting into the bath. This is to guard against congestion. Burnt flour 
should be used in case of chafing. Be careful to guard against draughts 
and bathe the child near an open fire, if possible — if not, the bath should 
be given in a perfectly warm room. Have the clothing hanging at the fire, 
well warmed and ready to put on at once. The petticoats should be put 
one in the other, and the dress over them, so that all three may be slipped 
on at once. Every little waist should be furnished with buttons or button- 
holes and with drawing-strings at top and bottom for drawing to the 
proper size. 

A large turkish towel should be laid upon the table and the baby 
wrapped in it as soon as removed from the tub. Two small linen towels 
are necessary — one for the face, the other for drying the creases between 
the thighs. 

Care of the Mouth. — The mouth of the nursing child should be gently 
cleansed several times a day with a piece of soft linen dipped in boiled 
water or boric acid solution. The mother's or nurse's hands must be clean 
when washing the baby's mouth. It is particularly important to keep the 
breast-fed baby's mouth clean, lest the baby infect the mother's nipple, 
and sore nipples or even breast abscesses result. It is equally important 
during teething. .It is to be remembered, however, that too frequent wash- 
ing of the baby's mouth may rub off some of the natural mucous mem- 
brane and give opportunity for entrance of germs, and it is also to be kept 
in mind that it is equally important that the mother's nipples be kept 
constantly clean and that they be antiseptically washed just before each' 
nursing, as otherwise the child's mouth may become diseased from the 
mother's nipples. 

Care of the Genital Organs. — It is of the greatest importance to begin 
in early infancy an intelligent inspection and cleansing of the genital 







in* 






^' '*>- 'l 


%&Mm 


% < ^ ^ *J 




L ifl 




Bag . : .-- v \ . V ; - ■ 











^pfc. 






ft 


- 

1 






■■; 1 


mr 


J^Bs 






| 



The Old Way. 



The Infant Bath Table. 





A turkish towel should be laid upon Applying the Diaper and Abdominal 

the table. Bandage. 



E. T- S. 



Look through each nipple y 

it. You should barely be able : -je 

easy to make a hole J 
needle point, but you c 



1FOOT 



;, 



Witen Mile of miljc 
is Aeld upside down, 
one fbot&fomtaMe, 
one dntp will sir/ fie 
Uie ladle Just as i&e 
next one leaves l/te 
nipple. 

Too slow 



Ikderss/m conditions, MilJc flows from 
there trill &e 2 or 3 nipple in s/n&ll 
drops between mp/?£e 2>al ocml/rraoas 
and ia&le~ $£rezim„ 

Just ri<*ht. 
ftsAoutd takeffvm 100 Fast 

/O to 2o mmules 
for emptying Ike 
Aollfe. 



E. J. S. 



CLOTHING FOR THE INFANT. 1151 

organs. With boys the penis should be examined; the foreskin drawn 
back over the shaft of the penis ; any secretion beneath the skin should be 
removed with a soft cloth and warm water. The skin should then be 
drawn forward again as soon the the cleansing has been completed. If 
this precaution is not observed the penis may become swollen to such an 
extent that it may become impossible ; if the foreskin cannot be withdrawn 
over the penis the boy should be circumcised. Proper cleansing beneath 
the foreskin will prevent, or often cure, bed-wetting ; will prevent pre- 
mature erections; playing with the penis, and masturbation. 

Caring for the vulva and clitoris in girls is equally important, but 
much simpler to do. It prevents the formation of habits not alone loath- 
some and disgusting, but augurs for the future health of the child. 

Care of the Eyes. — It is well to cleanse the eyes of the new-born 
infant as directed in giving its first bath. Its eyes may be advantageously 
cleansed with sterile water, or boric acid solution used from a dropper 
several times a day for some days after birth. It is not necessary to use 
medicine or eye washes in the baby's eyes to strengthen them ; but during 
the first three months, when but few tears are secreted, the eyes may 
be cleansed as above, when dust or dirt of any sort gets into them. 

The abominable custom of mothers and nurses taking babies out in 
carriages without sunshades, allowing the child to lie on its back with the 
sun beaming on the baby's face, cannot be too strongly condemned. 

CLOTHING FOR THE INFANT. 

Quality and Quantity. — The quality and quantity of the child's 
clothing must be regulated by the means of its parents. Every mother 
will probably have the best she can afford, but, whether rich or plain, it 
should be carefully made; all seams felled, and no rough edges left to 
chafe the tender skin. Six of every garment — three night flannels and 
three for day — constitute the minimum layette. Twelve diapers may 
answer, by careful management, but unless they can be washed every day 
at least eighteen will be required. A flannel cape or a woolen shawl is 
necessary to throw around the child in passing from one room to another 
during the first weeks of its existence. Summer and winter, until it is two 
years old, it should wear a flannel shirt long enough to cover the abdomen. 

Warmth Required. — During the early months of the child's life, 
warmth is peculiarly needful for the infantile system, and where there 
is any tendency to weakness and imperfect development of animal tern- 



1152 THE MOTHER AlSfD THE CHILD. 

perature, flannel clothing is particularly necessary to favor the accumula- 
tion of warmth in the infant's body. Benefit may also result from its 
gentle stimulating action upon the cutaneous surface. In hot weather 
muslin may be used instead of flannel, but even then a careful mother or 
nurse will change at once the clothing to suit the varying states of the 
weather. In summer infants are not infrequently kept too warm by too 
thick and warm coverlids while sleeping. 

The Rubber Diaper — The rubber diaper has many friends and many 
foes, and there is much to be said on both sides. If the nurse is careful 
it will be found a comfort, since it keeps the clothing dry and can do no 
harm except where it is made an excuse for not changing the child as 
frequently as is necessary. When it is used there should be two or three, 
and they should be frequently aired. Wash them always in cold water 
and wipe on a towel ; then hang them in a cool place to dry. When the 
baby's skin is very delicate their use may cause chafing, unless great care 
is taken; this is the only valid objection urged against them. 

Dress for an Airing. — When the child is sent out for an airing, which 
may be done in two weeks after birth in summer and in a month's time in 
winter if the weather is good, and in midday, be sure that it is well 
wrapped. A knitted worsted spencer, buttoned behind, for wear under 
the cloak, and a shawl over all if the weather is cool, will protect the little 
one from harm. 

When to Shorten the Clothes. — The proper time for "shortening" the 
clothes is about the end of three months in summer, or six months in 
winter. This shortening should be only of the extra length, being still 
long enough to extend below the feet for nearly a year, to protect the 
lower parts of the body against changes in temperature. By the end of a 
year the feet should be entirely free, so as to allow free motion of the legs. 

Danger of Wet Clothes.— The child should be kept dry as possible. 
Wet diapers or stockings, when permitted to remain on the child for some 
time, give rise to bowel and febrile complaints. They tend to cause 
excoriations and painful irritation of the skin about the groin and but- 
tocks. Examine frequently the underclothing of a child, and if any part 
be found wet, immediately replace it with clothing that is dry and clean. 

Abdominal Bandages. — Many advise the continuance of these through- 
out the first year and even longer. This, however, is not absolutely essen- 
tial. In cold weather they should be retained for at least three months, 
but in hot weather may be abandoned at end of the first or second month. 



INFANT FEEDING. 1153 



INFANT FEEDING. 

Obstacles to the Mother's Nursing. — Circumstances ofttimes arise when 
the mother cannot, or should not, nurse her infant. Disease of mother or 
child, a poor development of breasts or nipples and absence or lack of 
milk development, or even the premature birth of child may prevent 
breast feeding. It is always best for mother and child to continue breast 
feeding at least a few weeks unless forbidden by the physician. 

Breast Feeding. — The infant should be applied to the breast six or 
eight hours after birth, and four or six times a day thereafter, until milk 
formation is fully established. This accomplished the mother must estab- 
lish regular hours for feeding. From 6 A. M. to 10 P. M. she should 
nurse it every two hours, and through the night period every three hours 
(see special table in regard to feeding). The nipples as well as the 
child's mouth should be cleansed carefully with a boric acid solution 
before nursing, and cleansed with pure water afterward. A scarcity of 
mother's milk must be met with tonics and nourishing food. 

Wet-Nursing. — When a mother cannot nurse her child, a competent 
wet-nurse is most desirable. She should be known to be free from bad 
habits; to be moral; to be even tempered; to be clean and free from 
disease. There ought not to be a period of more than two or three 
months between the age of her babe and the one to be nursed. The same 
hours for feeding night and day should be exacted of her that the mother 
should give. 

Mixed Feeding. — Where a mother's milk is not sufficient in quantity 
it is wise to continue nursing at night and several times during the day. 
At the other nursing periods give modified cow's milk, or some infant 
food prepared for a child of the same age, bottle-fed. 

Artificial Feeding. — Artificial feeding of infants has undergone such 
complete changes in recent years that the advice of elderly mothers and 
grandmothers cannot be depended upon. Now that we know many kinds 
of germs infect milk as brought from the dairy, sterilization must be 
insisted upon. Now that many men in every large city devote their time 
exclusively to infant disease and infant feedinc; we have gotten out of 
the rut in which physicians, mothers and nurses formerly trod. Manufac- 
turers of infant food found it necessary to so modify methods of prepara- 
tion that their finished products would harmonize with proven ideas. 

Modified Cow's Milk. — In the hands of an intelligent mother or nurse 
73 



1154 THE MOTHER AND THE CHILD. 

the home modification of fresh cow's milk is, next to mother's milk, the 
best infant food. 

The following comparative table will help the better to understand 
why the various dilutions of milk are made: 

MILK FROM NURSING MOTHERS. 

Fat 4 per cent. ^ 

Sugar 7 " I 

Proteid I5 « f Total solids 12.65 per cent. 

Ash 15 " J 

Water 87.35 

Reaction Persistently alkaline 

MILK FROM A SOUND COW. 

Fat 4.04 per cent. ^ 

Sugar 4.55 " ( 

Proteid 4.15 " [ Total solids 13.45 per cent. 

Ash 71 " J 

Water 86.55 

Reaction Feebly acid 

What the Above Tables Tell. — From the above tables it will readily 
be seen why cow's milk alone is not a, suitable food for infants. It will 
be seen that normal cow's milk has about the same proportion of fat as 
human milk; that it has much less sugar; that it has nearly three times 
as much proteid substance, and that the percentage of ash, or mineral 
matter, is far too high. Add to these facts the well-known truth that the 
proteid of cow's milk is more difficult to digest than that of human milk, 
and you have sound reasoning for modifying cow's milk, as shall be 
directed hereafter. 

A perusal of the table analysis of colostrum, the first secretion in the 
human breast, should now be made. 



ANALYSIS OF COLOSTRUM OR FIRST MILK. 

(The breast secretion before milk is formed.) 



■} 



Fat 1.71 per cent 

Sugar 4.90 

Proteid 1.72 " ' Total solids ' 9.12 per cent. 

Ash 79 

Water 00.88 



INFANT FEEDING. 



1155 



Meaning of Above Table. — From this table the careful reader will see 
how little fat the infant gets during its first days after birth. The infant 
fed artificially should be given such a modified milk that its chemical 
analysis will approximate first colostrum, later human breast milk, and 
still later, human breast milk plus its enrichment by the mother eating 
large quantities of rich, highly nutritious food. 

Medical Method. — In large cities, and where families can afford the 
expense, this is easily done by the physician. He just writes a prescrip- 
tion similar to the above table, adding the amount of food wanted at each 
feeding and the number of feedings per day. This prescription is then 
sent to the milk laboratory where it is accurately and scientifically pre- 
pared just as medicine is compounded in a pharmacy. This method is 
expensive and can only be used by those who need not consider cost. 

Home Method. — This method may be closely approximated, however, 
at home by using a list of tables very carefully worked out experimentally. 
In these tables the cream used has been skimmed cream of a twelve hours 
rising. No ash or mineral matter allowed for except that in water. 



First and Second Week. 
Chemical Formula. Home Formula. 



Fat 2 

Sugar 5 

Proteid 75 

Water 92.25 



per cent. 



Cream 4 ounces 

Milk ounces 

Milk sugar 6 teaspoonfuls 

Lime-water 1 ounce 

Water 15 ounces 



Third Week. 



Fat 2.5 

Sugar 6 

Proteid 1 

Water 90.5 



per cent. 



Cream 5 ounces 

Milk o ounces 

Milk sugar 7$ teaspoonful.' 

Lime-water 1 ounce 

Water 14 ounces 



3-5 
6 



Fat 

Sugar , 

Proteid 1 

Water 89.5 



Fourth to Sixth Week. 
per cent. 



Cream 6 ounces 

Milk 1 ounce 

Milk sugar y\ teaspoonfuls 

Lime-water 1 ounce 

Water 12 ounces 



1156 



THE MOTHER AND THE CHILD. 



Fat 3-5 

Sugar 6.5 

Proteid 1.5 

Water 88.5 



Sixth to Eighth Week. 
per cent. 



Cream 7 ounces 

Milk 1 ounce 

Milk sugar 8£ teaspoonfuls 

Lime-water 1 ounce 

Water 11 ounces 



Fat 4 

Sugar 7 

Proteid 1.5 

Water 87.5 



Second to Fourth Month. 

per cent. 



Cream 8 ounces 

Milk 1 ounce 

Milk sugar 9 teaspoonfuls 

Lime-water 1 ounce 

Water 11 ounces 



Fourth to Tenth Month. 



Fat 4 

Sugar , 7 

Proteid 2 

Water 87 



per cent. 



Cream 8 ounces 

Milk 2i ounces 

Milk sugar 8i teaspoonfuls 

Lime-water 1 ounce 

Water 8i ounces 



Tenth to Twelfth Month. 



Fat 4 

Sugar 7 

Proteid 2.5 

Water 86.5 



per cent. 



Cream 8 ounces 

Milk 5 ounces 

Milk sugar 7! teaspoonfuls 

Lime-water 1 ounce 

Water 6 ounces 



FOE WEANING. 



Fat 4 per cent. 

Sugar 5 " 

Proteid 3 

Water 88 " 



Cream 8 ounces 

Milk 7$ ounces 

Milk sugar 6 teaspoonfuls 

Lime-water 1 ounce 

Water 3^ ounces 



Why Lime is Added In these mixtures the lime-water is added to 

preserve the alkalinity of the milk as well as to add lime salts for the food. 
Where the water used comes from lime rock heds it will not be necessary 
to add so much lime-water. In such cases, and, indeed, in many cases 
weak barley-water or arrow-root-water agrees better with the infant than 
plain water. 



NURSIXG BOTTLES. 1157 



HOW TO PREPARE A DAY'S FOOD. 

Consult the table for intervals of feeding and quantity to feed; for 
example : a four weeks old baby. It will be seen that nine feedings by day 
and one feeding by night is advised. Each feeding consists of one and a 
half to two ounces of food. A glance shows that from fifteen to twenty 
ounces are required for twenty-four hours. Make up the food as follows 
from table fourth to sixth week: 

Cream 6 ounces 

Milk = i ounce 

Milk sugar 7^ teaspoonfuls 

Lime-water I ounce 

Water 12 ounces 

Dissolve the milk sugar in the water, add lime-water, milk and cream ; 
mix thoroughly in vessel and divide in ten nursing bottles. Plug each 
bottle with clean cotton and stand in a kettle of warm water. Place the 
kettle over the fire, keeping the water boiling twelve to fifteen minutes. 
Do not allow the food to boil. Remove the nursing bottles and place in 
a cool place until ready for use. When ready to feed the baby take a 
bottle, stand in lukewarm water until heated, remove cotton, and place 
over the bottle a freshly scalded nipple and you have a sweet, clean, 
sterile infant food. 

Nursing Bottles. — Bottles of medium size and round, with flat bottom 
and small, short necks are best. Rubber nipples which slip over the neck 
of the bottle are the only safe nipples to use. All nursing bottles having 
rubber tubes and nipples are dangerous, dirty and should not be used. 
All bottles must be cleaned as soon as empty and again before refilling 
they must be cleansed with boiling water. The nipples must be turned, 
cleansed with soap and water and boiling water and may then be kept in 
boric acid solution until ready for use. 

This cleansing of the nipples and bottles is very important and 
should be conscientiously attended to. Sometimes nurse maids, through 
carelessness, neglect to do this, and the so-called milk infection, which 
generally results from unwashed bottles and dirty nipples is likely to 
follow. 



1158 



THE MOTHER AND THE CHILD. 



TABLE SHOWING FEEDING HOURS AND QUANTITIES. 









Number 


Number 


Number 








Interval 


Interval 


of day 


of night 


of 


Amount 


Total 


Age. 


hours by 


hours by 


feedings, 


feedings, 


feedings 


at each 


amount in 




day. 


night. 


6 A. M. 


10 P. M. 


in 


feeding. 


24 hours. 








10 P. M. 


6 A. M. 


24 hours 






1 Week 


2 


3 


9 


2 


11 


1 oz 


10-11 oz. 


2 " 


2 


3 


9 


2 


11 


1 to 1£ " 


11-14 " 


4 " 


2 


4 


9 


1 


10 


11 to 2 " 


15-20 " 


6 " 


2 


4 


9 


1 


10 


2£ » 


25 " 


8 " 


2* 


4| 


7 


1 


8 


Si " 


28 " 


3 Months 


2£ 




7 




7 


4 


28 " 


4 " 


2* 




7 




7 


4£ " 


3i " 


5 " 


3 




6 




6 


5* " 


33 " 


6 " 


3 




6 




6 


6 " 


36 " 


7 " 


3 




6 




6 


H " 


39 " 


8 " 


3 




6 




6 


7 " 


42 " 


9 " 


3 




6 




6 


7* » 


45 " 


10 " 


3 




6 or 5 




6 or 5 


8 or 9£ " 


48 ■« 


11 " 


3 




5 




5 


9£ " 


48 " 


12 " 


3 




5 




5 


10 " 


50 " 



This table shows equally well the hours and intervals to feed a breast- 
fed baby. 

Condensed Milk. — Condensed milk fattens babies to an abnormal ex- 
tent, and while they are fat and plump, experience shows that they are too 
weak to withstand any trifling disease. It is a poor permanent food. It 
does have a useful place in infant feeding. While .traveling or during 
the night in hot weather, it is an excellent substitute for the regular food. 
It should be made up for a single feeding at a time. For a child three 
months old : 

Condensed milk 2^ half-teaspoonfuls 

Water 2 ounces 

Lime-water 2 teaspoonfuls 

Salt a small pinch 



This quantity may be increased or decreased according to the age of 
the child. 

Weaning Time. — The age at which a child may be weaned has been 

suggested to be some time between the eighth and fourteen month. 

Much depends upon mother, child, surroundings and season. A strong 

child may be weaned early. It is best to avoid weaning in summer. If 

the mother or nurse cannot attend personally to preparing the food, and 



CARE OF THE INFANT IN SUMMER. 1159 

keeping bottles and food scrupulously clean, it is wise to continue nursing 
even the full fourteen months. 

Gradual Weaning.- — If the child is weaned early, do it gradually by 
substituting some artificial food. If late, the mother may stop the breast 
at once, and the child will experience little difficulty in transferring to 
some other food. Should the mother again become pregnant, she must 
wean her infant. 

RULES FOR MANAGING THE INFANT DURING THE SUMMER MONTHS. 

The great increase of sickness and death among young children dur- 
ing the summer months is due largely to ignorance on the part of mothers 
and nurses. Attention to the following rules would save many a life : 

1. Bathe the child once a day in tepid water. If it is feeble, sponge 
it all over twice a day with tepid water, or with tepid water and vinegar. 

2. Avoid all tight bandaging. Make the clothing light and cool, and 
so loose that the child may have free play for its limbs. At night undress 
it, sponge it, and put on a slip. In the morning remove the slip, bathe 
the child, and put it in clean clothes. If this cannot be afforded, thor- 
oughly air the day clothing by hanging it up during the night. Use clean 
diapers, and change them often. 

3. The child should sleep by itself in a cot or cradle. It should be 
put to bed at regular hours, and be early taught to go to sleep without 
being nursed in the arms. Without the advice of a physician never give it 
any spirits, cordials, carminatives, soothing syrups or sleeping drops. 
Never quiet it by candy or cake ; they are the common causes of diarrhoea 
and of other troubles. 

4. Give the child plenty of fresh air. In the cool of the morning and 
evening send it out to shady places. Whenever it seems to suffer from the 
heat, let it drink freely of ice water. 

5. Keep your house sweet and clean, cool and well aired. In very 
hot weather let the windows be open day and night. Correct all foul 
smells by pouring into the sinks and privies carbolic acid or quick-lime, or 
the chloride of lime, or a strong solution of copperas. These articles can 
be got from the nearest druggist, who will give the needful directions 
for their use. 

6. Breast milk is the only proper food for infants. If the supply is 
ample and the child thrives on it, no other kind of food should be given 
while the hot weather lasts. If the mother has not enough, she must not 



1160 THE MOTHER AND THE CHILD. 

wean the child, but give it, beside the breast, modified cow's milk. Nurse 
the child once in two or three hours during the day, and as seldom as 
possible during the night. Always remove the child from the breast as 
soon as it has fallen asleep. Avoid giving the breast when you are over- 
fatigued or over-heated. 

7. If, unfortunately, the child must be brought up by hand, it should 
be fed on a milk diet alone — that is, warm milk out of a properly ster- 
ilized nursing-bottle. Modified cow's milk is the best. If the child 
thrives on this diet, no other kind of food whatever should be given while 
the hot weather lasts. At all seasons of the year, but especially in sum- 
mer, there is no safe substitute for milk, if the child has not cut its front 
teeth. Sago, arrow root, potatoes, corn flour, crackers, bread, every pa- 
tented food, and every article of diet containing starch, cannot, and must 
not, be depended on as food for very young infants. 

8. Buy only whole milk known to be of good quality. Prepare either 
modified cow's milk or artificial foods exactly as directed under infant 
feeding. Keep bottles of food in a cool place, on ice, or if in the country 
and without ice lower a basket containing the filled nursing bottles in a 
well near the surface of the water. It is best to have the milk delivered 
during the early morning and have it prepared and sterilized before the 
day becomes hot. 

9. If the milk should disagree, one-half to one tablespoonful of lime 
water may be added to each bottleful. Whenever pure milk cannot be 
gotten, try the condensed milk, which sometimes answers well. It may be 
prepared by adding to ten tablespoonfuls of boiling water, without sugar, 
one tablespoonful or more of the milk, according to the age of the child. 
Should this disagree, a teaspoonful of arrow root, sago or cornstarch may 
be cautiously added to a pint of the milk. If milk in any shape cannot be 
digested, try, for a few days, pure cream, diluted with three-fifths or four- 
fifths of water — returning to the milk as soon as possible. 

10. The nursing-bottle must be kept perfectly clean; otherwise the 
milk will turn sour and the child will be made ill. After each meal it 
should be emptied, rinsed out, taken apart and the nipple and bottle 
cleansed in boiling water and placed in clean water, or in water to which 
a little soda has been added. It is a good plan to have eight or ten nursing- 
bottles, and to use them by turns. Then when food is prepared for the 
day each feeding can be placed in a bottle and kept ready for use in some 
cool place or in the refrigerator. The best kind is the plain bottle with a 
rubber nipple and no tube. 




Wrong Way to Hold the Baby. 




Right Way to Hold the Baby 
© E. J. S. 




Feeding the Baby. 




Quieting- the P>aby. 
©E. J. S. 



CAKE OF THE INFANT. 1161 

11. Do not wean the child just before or during the hot weather, or, 
as a rule, until after its second summer. If suckling disagrees with the 
mother she must not wean the child, hut feed it, in part, out of a nursing- 
bottle, on such food as has been directed. However small the supply of 
breast milk, provided it agrees with the child, the mother should carefully 
keep it up against sickness; it alone will often save the life of a child 
when everything else fails. When the child is over six months old, the 
mother may save her strength by giving it one or two meals a day of 
modified cow's milk or some prepared infant food put into a nursing-bottle. 
When from eight months to a year old, it may have also one meal a day 
of the yolk of a fresh and rare-boiled egg, or one of beef or mutton broth, 
into which stale bread has been crumbled. When older than this, it can 
have a little meat finely minced ; but even then milk should be its principal 
food, and not such food as grown people eat. 

12. The moment a diaper is soiled it should be removed and washed 
in water containing a small quantity of soda. Do not let diapers stand 
in soiled state. Before using again they must be thoroughly dried and 
care taken that all soda is removed. 

13. When the baby is breast fed the mother must be very careful in 
regard to her nipples. Keep them clean by washing them with a mild 
solution of boracic acid and water both before and after each nursing 
(the water should be cool). The mother's bowels should move at least 
once daily as constipation with her deleter iously affects the child. Eat 
plain, well-cooked food. Drink plenty of pure water between meals, but 
avoid beer and other alcoholic drinks, as their reflex action on the child is 
bad. Use tea and coffee sparingly. Get all sleep possible. A restful 
mother makes a restful child. Take reasonable exercise, be in the open 
air as much as possible and be sure that living and sleeping rooms are 
properly ventilated. 

14. The following is recommended as to the feeding of breast-fed 
babies : 

(a.) From birth to three months. — Nurse the baby for fifteen min- 
utes every two and one-half hours. ~No child should be nursed more than 
nine times in twenty-four hours. 

(b.) From third to sixth month. — Nurse baby twenty minutes every 
three hours and not more than eight times in the twenty-four hours. 

(c.) From sixth to ninth month. — Let the child nurse every three 
hours. 



1162 THE MOTHER AND THE CHILD. 

(d.) From ninth to twelfth month. — Let the child nurse every three 
and one-half hours. 

Putting these instructions in tabulated form we have the following: 

No. of Intervals Night Duration 

Aci Nursings of Nursing Nursing of Nursing 

IO P.M. to 7 A.M. 

Birth to 3 months g 2\ hours 2 Not over 

3d to 6th month 7 to 8 3 hours 2 15 or 30 

6th to 9th month 6 3 to 3I hours 1 Minutes 

9th to 12th month 5 3^ hours 1 



DEVELOPMENT OF THE CHILD. 

Mothers, nurses and friends are often badly misinformed as to what 
constitutes a healthy, normal, full-term child, and often know less about 
what should be its natural development. 

Weight. — The average weight of infants at birth is six and one-half 
pounds for a girl and seven and one-half pounds for a boy. Of course, 
great variations from this may occur. Children have weighed at birth 
but two and three-fourths pounds and have lived to develop into strong 
manhood, while, on the other hand, children have been born weighing as 
much as twenty-two pounds. During the first week after birth the infant 
loses steadily in weight. Sometimes a full pound is lost, usually not more 
than a half pound. After the first week there should be a steady gain 
of two to four ounces each week. The baby should frequently be weighed, 
and if it does not increase in weight some change of food should be made. 

Length. — The average baby at birth measures twenty inches in length. 
At six months it should be twenty-four inches. At birth the trunk is 
longer in proportion than the body. The first growth is largely in the 
length of the legs. Growth usually occurs in cycles. While gaining 
rapidly in weight little is gained in length. While teething, or imme- 
diately after, the growth in length is marked. 

General Development. — The fat, flabby child, such as we see when 
bottle-fed with condensed milk, or occasionally when breast-fed, is not a 
bealtny child. An acute illness will be badly borne. Rickets, bow-legs 
and delayed teething are noted. The healthy child has pink skin, rounded 
limbs, with firm muscles. Tt is not necessarily fat. It is always active 
when awake. 

Periods of Development. — "For convenience the child's life may be 
considered as consisting of three periods: The first period extending 



TEETHING. 1163 

from birth to the beginning of teething; the second, that of teething (milk 
teething); the third extends from the first teething to the end of the 
second teething. 

Durings the first period breast milk is the ideal food. At this time 
babies cannot digest starchy foods, hence all table food, bread and the 
like must be withheld. During the second period saliva is formed in the 
mouth and occasionally good broths may be given. During the third 
period the digestive apparatus is prepared for more complex food. See 
Special Diet Lists. 

Exercise and Air. — Almost as important as food and bathing is that 
of exercise and air for the growing infant. Exercise for its muscular sys- 
tem can be secured by massage after the bath, and by dressing in such a 
way as to give the child the freedom of its limbs. It is of great im- 
portance that the child be taken in the fresh air and sunshine as much as 
possible. Only in inclement weather should this be neglected. A baby 
carriage is desirable for this purpose. A sun-bath given with the nude 
baby on a pillow inside a sunny window in winter and in the fresh air in 
summer is healthful. Nurseries should be large, airy and well ventilated, 
and should be located on the sunny side of the house. The heating plant 
should be so managed as to give an equal temperature of 72 degrees, with 
fresh outside air entering at all times. 

TEETHING OR DENTITION. 

Time of Teething.— The most usual age for an infant to begin teething 
is from the sixth to the eighth month. This is only a general rule. Bottle- 
fed babies, delicate infants and children with rickets, teethe later than the 
eighth month. Precocious infants may teethe much earlier. Children are 
occasionally born with one, two or more teeth ; others have no teeth until 
the eighteenth month. 

How the Teeth Come. — The lower central incisors usually appear first, 
and in a few weeks the four upper incisors follow. From the twelfth to 
the fourteenth month the remaining lower incisors and the premolars come 
through. There is a long delay preceding cutting of the incisors. They 
appear from the eighteenth to the twentieth month. The remaining 
molars appear about two and a half years of age. The full set of milk 
teeth numbers twenty, ten in each jaw. The accompanying diagram 
shows their appearance most graphically. It sho shows the full set of 
teeth and the age at which they appear. 



1164 THE MOTHER AND THE CHILD. 

Convulsions. — Dentition is a physiologic process and should cause no 
serious disturbance to the health of the child. It is true that there may 
be considerable irritability of temper, and resulting from it some digestive 
disturbance. The dreaded convulsions of teething are very much over- 
rated. 

What to Observe in a Child — The most important points to be at- 
tended to in making up an opinion of a child's condition are the counte- 
nance, noting its expression, coloration, wrinkles, etc. ; the sleep ; the cry ; 
the state of emaciation or fatness; the condition of the skin, as to erup- 
tions, color, temperature, degrees of dryness, swelling, etc. ; the pulse ; the 
respiration; the signs furnished by the mouth and throat; the power of 
sucking; and, finally, the state of the abdomen. 

Keeping the Baby's Mouth Clean. — The development of a child's teeth 
is very considerably affected by the care which the mother takes in keep- 
ing the baby's mouth clean and in thoroughly sanitary condition. During 
early life the baby's mouth should be constantly watched and taken care 
of many times each day, in order that the gums and mucous membranes 
may be kept in healthy condition. This is done by washing out the 
baby's mouth before each nursing so that no infected mucus or other 
foreign materials may be carried into the stomach and cause indigestion, 
and also as preventive of poison being carried to the mother's nipples. 

A glass-stoppered bottle should be procured and filled with a satur- 
ated solution of boracic acid, the bottle with stopper out being first thor- 
oughly boiled to insure sterilization. The solution is made by adding 
a heaping teaspoonful of boracic acid to a pint of water which has been 
previously boiled for at least ten minutes, care being taken that such water 
after boiling is properly covered until put in the stoppered bottle, as if 
exposed to the air the water would again become contaminated with bac- 
teria and the effect of the boiling entirely lost. The solution is ready for 
use as soon as dissolved. Shake before using. 

As required for use pour a small quantity into a cup or shallow dish 
— just enough for one using, as that which has been poured out of the 
bottle must not be used a second time nor poured back into the bottle. 
A piece of clean absorbent cotton is wound around the index or little 
finger and dipped into the solution in the cup or dish and the baby's 
mouth is gently but thoroughly swabbed, taking care to wash the insides of 
the fheeks, about the gums and the upper and under sides of the tongue. 
Should there be considerable mucus present it may be wise to use several 
pieces of cotton to make the mouth clean, but under no circumstances 



TEETHING. 



1165 



HOW AND WHEN FIRST TEETH COME. 





N^o-nxr 




18 to 20 months. , 









17 to 25 years 



rT 




1166 THE MOTHER AND THE CHILD. 

use the same piece of cotton twice, and take a fresh piece each time you 
dip into the solution. If sterilized cotton is not obtainable any light, 
white fabric may be sterilized for the purpose by boiling it for an hour 
or baking it in an oven with temperature over 212° F. for forty minutes. 
It is well to cut the cloth into small pieces of requisite size before steriliz- 
ing and after sterilizing. Keep them in sterilized jar that must be kept 
covered. Then before nursing, the mother's nipples should also be washed 
with the same solution, of course using a fresh piece of cotton. Where 
the baby is fed from bottle great care must be taken to keep the rubber 
nipple clean. It should be scalded immediately after using and put into 
a covered receptacle containing boracic solution until it is again needed. 

Effect of Diet on Teeth — The baby's teeth are greatly affected by the 
food it eats. Of course nothing must be given that does not thoroughly 
agree with the child's digestion and oftentimes it takes much experi- 
menting to find the food most suitable for the child, what agrees with one 
frequently not agreeing with another, but in so far as possible the food 
should contain sufficient material of a bone-building nature to thoroughly 
supply that requirement in the child. The free and continuous use of lime 
water in milk not only aids digestion, but is of great value in building 
up bone. Emulsion of cod liver oil is frequently given to infants who 
are cutting teeth, and being a nourishing food it aids dentition by toning 
up the system while, being rich in phosphates, it hardens and develops 
the bones. 

Malformations. — Heredity usually plays an important part in the 
shape, size and color of teeth, but their hardness, symmetry and utility 
may be very considerably benefited by attention to the child's diet during 
dentition and to early care that no force is brought to bear in an ab- 
normal direction in the forming and growth of the mouth and teeth, 
such, for instance, as is frequently caused by thumb-sucking. The child 
so naturally puts its thumb or finger in its mouth and seems to derive so 
much contentment therefrom that the mother is very apt to permit the 
habit to grow, and the facial expression of the child may thereby become 
so moulded in a wrong or abnormal direction as to be a serious affliction 
throughout life, for during the first year of the childs' life the jaws are 
very plastic and may be readily forced in unnatural directions, not only 
causing deformity in the jaw, but also in many cases displacement of the 
teeth and the ill probably remains unnoticed until the hardening process 
of the bones makes remedy painful and difficult — in some cases impos- 
sible. Thus what is commonly called a parrot mouth — that is, abnormally 



TEETHING. 1167 

high palate or vault, narrow upper arch, protruding upper teeth and re- 
truding lower ones, may be directly attributable to thumb sucking. As 
the infant lies in recumbent position that portion of the thumb which is 
continuous with the palm of the hand rests firmly with constant force 
upon the partially developed gums and roof of the mouth, pressing the 
latter upward and narrowing the width, while the back of the thumb 
resting on the lower lip and chin acts as a fulcrum, bringing the full 
weight of the arm upon the lower jaw, pressing it downward and back- 
ward. This produces not only a deformity in facial expression, but 
causes false location of the teeth, rendering them incapable of properly 
performing the work which nature intended of them, thereby preventing 
that mastication of food which is essential to good digestion. Deformities 
of course are often due to heredity, as for instance large teeth may be in- 
herited from one parent and small jaws from the other, causing a crowd- 
ing of the teeth within too small a space. Lip sucking is another bad habit 
which may result in depressing the teeth. By drawing the lower lip into 
the mouth a pressure is exerted upon the teeth which may force them in- 
ward to such an extent as to result in deformity, the space for the back 
teeth being greatly contracted, causing crowding of the teeth. Mouth 
breathing also produces irregularity of the teeth. The habit is commonly 
indulged in during sleep. It may be due to some nasal obstruction of the 
air passages, in which case operation may be necessary. Where there is 
no nasal obstruction the mouth should be so bandaged as to make breath- 
ing through it difficult and thus induce breathing through the nose. Spe- 
cial rubber appliances for this purpose can be secured. Also there may be 
local causes for irregularity of teeth such as too long retention of the first 
teeth or their too early extraction, or delayed eruption of permanent teeth 
or their injudicious abstraction. In all cases where such deformities are 
found to exist, whatever their cause, it is well to consult with a dentist of 
undoubted standing and qualifications at as early an age of the child as may 
be possible, as frequently under careful professional care in early child- 
hood such difficulties may be largely overcome. 

Illness of Teething. — During the eruption of the deciduous or tem- 
porary teeth the child is apt to suffer from indigestion. The lower cus- 
pids or canines, which may come from the fourteenth to the twentieth 
month, are very commonly called stomach teeth, and the corresponding 
upper ones called eye teeth. This is due to an idea, which is traditional, 
that the cutting of these two lower teeth cause an especial disturbance of 
the stomach and that the cutting of the upper ones affect the eyes. This 



1168 THE MOTHER AND THE CHILD. 

idea is erroneous. The fact is that during this time the whole system is 
undergoing very important changes, the organs of digestion are adapt- 
ing themselves to the assimilation of other food than milk, and these con- 
stitutional changes during dentition produce susceptibility to nervous and 
digestive troubles and the mother should be more than ordinarily watch- 
ful throughout this whole period, but in the specific cutting of a "stomach 
tooth" there is no more reason to expect disturbance in the stomach than 
in the cutting of any other tooth. Delayed or difficult dentition may 
result in general disturbance of the digestive system or affect the whole 
constitution and exaggerate any other ailment of the child existing at this 
time, and special care should be taken that the child should not catch 
cold at this period, as this may retard dentition and be the cause of serious 
disturbance. The severity of illness commonly depends upon the number 
of teeth advancing at the same time, but individuals constitutionally 
vary, and a single tooth in one case may be the cause of much greater 
disturbance than the oncoming of a number of teeth in the case of an- 
other child. 

Hot gums, redness, swelling and pain are ordinary and normal symp- 
toms during teething and should not cause anxiety unless they be accom- 
panied by high fever, vomiting, diarrhoea or other noticeable disturbance 
of the system. The flow of saliva (drooling) which accompanies teething 
generally allays abnormal inflammation and keeps the gums sufficiently 
moist and cool. Relief may often be given by rubbing the affected gum 
with a gold or silver thimble. The thimble must be boiled for fifteen 
minutes before using, in order to destroy all germs. But when the gum 
where the tooth is coming is hard and white, the mouth dry and the baby 
feverish, fretful and sleepless, the gum should usually be lanced, as other- 
wise there may be convulsions, followed by serious and sometimes fatal 
constitutional disturbance. 

Lancing is also sometimes necessary when the gums themselves dis- 
play no untoward symptoms, the only indications being general disturb- 
ance of the system due to dentition and which may be alleviated by lanc- 
ing, and this sometimes even when the teeth have put in a partial appear- 
ance as a tooth may be held back by the bands of tissue which draw over 
the surface of the tooth between the cusps, and these bands must be cut 
to permit of free egress of the tooth. Where lancing is necessary relief 
usually immediately follows the operation, which is of most simple nature, 
but which should be done by physician or dentist. The lancet must pierce 
the gum until it touches upon the tooth and to relieve the pressure must 



TEETHING. ■ 1169 

completely divide all overlying tissue. The tightly-stretched tissues have 
little nerve sensation and the pain caused by lancing is therefore very 
slight and is but momentary. However, lancing is by no means always 
essential, the teeth as a rule cutting their own way through without as- 
sistance. 

The eruption or cutting of teeth should occur as soon as the teeth 
are hard enough for use, and as the hardness is dependent upon the 
amount of lime salts the teeth contain, as distinct from purely animal 
matter, dentition will be delayed if the child's diet has been lacking in 
this necessary element, as there is further apt to be general disturbance 
of the system in various ways. 

Temporary and Permanent Teeth. — Temporary teeth contain more 
organic matter. Consequently they are softer and more quickly subject 
to decay than the permanent teeth, and unless great care be exercised they 
are apt to be destroyed and lost before they have performed those im- 
portant functions which are necessary of them before the coming of ifee 
permanent teeth. Temporary teeth are not only essential to proper mas- 
tication of food during a period of rapid growth, but they have an im- 
portant relation in the development of the jaw and their early extraction 
may not only seriously affect digestion and so the constitution but may 
retard jaw development, resulting not only in a prejudice to facial ex- 
pression, but the crowding of the permanent teeth with resultant ill effects 
of various kinds.- The importance then of retaining the first teeth until 
the second teeth are ready to take their place cannot be overestimated, and 
therefore there should be constant watchfulness of them and they should 
not be permitted to prematurely decay. Under normal conditions and 
where proper attention has been given to prevent decay, the roots will 
become absorbed and the crowns drop out without even the assistance 
of a string. But if decay be permitted in the temporary teeth the 
nerve fibres will be affected and cause such irritation of the pulp tissue as 
will result in its premature decay and prevent its natural absorption, 
which would otherwise occur. The child is not only the subject of severe 
toothache until gumboil forms, but the space to be occupied by the per- 
manent tooth instead of being free for its advance is filled up with roots 
of the temporary one, so that there is danger of the permanent tooth 
being forced to one side or other on its course through the gum, result- 
ing in misplaced teeth and inefficient mastication. 

Prevention of Decay. — The most potent factor is cleanliness. Chil- 
dren should be trained in the assiduous use of the toothbrush from the 
74 



1170 THE MOTHER AND THE CHILD. 

earliest possible age, and should use it after each meal, and until the 
child is capable of doing this the mother or attendant should carefully 
wash the mouth and teeth twice daily, using a clean rag and an antiseptic 
wash and further should at least once a day use a brush, in order to 
remove particles that cannot be reached with a cloth. The brush should 
be small with uneven rows calculated to suit the spaces between the teeth. 
It should be of medium stiffness. A brush that is too soft does not suffi- 
ciently stimulate the gums, while one that is too stiff will cause bleeding 
and soreness. Do not be content with merely brushing teeth on their outer 
surface. They must be brushed across and up and down, both inside and 
out and no material permitted to remain in any space or crevice. Con- 
stant watchfulness and regular care will greatly conduce to hard and 
pearly teeth and will not only save the child from much suffering from 
decaying teeth, but healthy gums and mucous membranes with sound 
teeth will ensure that with proper mastication the food taken into the 
stomach will be in right condition for easy and natural digestion, which 
is an essential of general good health. With the first indication of decay 
the child should be taken to the dentist and his teeth given such atten- 
tion as may be necessary. After the child is two to three years of age 
he should be taken to the dentist several times a year to make sure there 
are no cavities, which will sometimes be found in spite of care. 

Filling Temporary Teeth. — Many people take the view that it is un- 
necessary to fill temporary teeth, as they are shortly to'be superseded by 
permanent ones, but there are a number of reasons why all cavities should 
be filled as they occur: (a) Unnecessary suffering from toothache is pre- 
vented; (b) Inability to properly masticate food is avoided; (c) The 
retention of all the temporary teeth until the permanent ones are ready 
to take their place is assured and thereby the fullness of arch for the 
permanent teeth is conserved and developed. 

Dental Care of Permanent Teeth. — The retention of all permanent 
teeth is of extreme importance, but perhaps none so important as that of 
the first permanent molars which at the age of about six years appear 
back of all the milk or baby teeth. These are often mistaken for tem- 
porary teeth and permitted to decay until beyond ordinary methods of 
restoration. The early extraction of these permanent molars is almost 
certain to result in the malposition of other teeth, permitting them to 
occlude improperly, throwing additional and unintended strain on other 
teeth, causing improper mastication and frequently resulting in pre- 
judicial change in facial expression. The upper and lower molar teeth 



TEMPERATURE OF CHILDREN. H71 

should so meet each other as to interlock like the cogs of a wheel and it 
is the loss of the first permanent molar which more often disarranges the 
whole occlusion than any other tooth. In case this tooth has been neg- 
lected until it is beyond proper repair, there is an advantage in having 
it extracted before the commencement of the eleventh year, in order that 
the second permanent molar which cuts through at from the twelfth to 
the fourteenth year may have room to grow a little forward from its 
regular place and together with the third molar occupy the allotted space 
for the three teeth and so give regularity as to the final complement of 
teeth. 

Where a child is suffering from toothache and for some reason can- 
not be taken to a dentist, a little carbolized resin placed in the cavity 
on a little piece of cotton will so harden over the exposed nerve as to 
sometimes afford relief for several weeks, but a dentist should be con- 
sulted at the earliest date possible. 

Pulse Rate of Children 

Young infants ioo to 102. 

First year 115. 

Second year 118. 

Second to sixth year Sleeping, 76 ; waking, 92. 

Sixth to ninth year Sleeping, 73 ; waking, 90. 

Ninth to twelfth year Sleeping, 72 ; waking, 80. 

Twelfth to fifteenth year Sleeping, 70 ; waking, 72. 

In girls the rate is about five beats higher. 

Temperature of Children. — 1. The daily range of temperature is 
greater in the healthy child than that recorded in healthy adults, amount- 
ing to 1, 2 or 3 degrees. 

2. There is invariably a fall of temperature in the evening, amount- 
ing from 1 degree to 3 degrees Fahrenheit. 

3. This fall may take place before sleep begins. 

4. The greatest fall is usually between 7 and 9 P. M. 

5. The minimum temperature is usually observed at or before 2 A. M. 

6. Between 2 and 4 A. M. the temperature usually begins to rise, such 
rise being independent of food being taken. 

7. The fluctuations between breakfast and tea time are usually 
trifling in amount. 

8. There seems to be no very definite relationship between the fre- 
quency of the pulse and respirations and the amount of the temperature, 
the former being subject to many disturbing influences. 

Respiration in Children. — The average frequency of the breathing in 



1172 THE MOTHER AND THE CHILD. 

new-born children and during the first week of life is thirty-nine times per 
minute. It may rise, however, upon very slight disturbances, to fifty, 
sixty or eighty. In perfectly healthy infants, during sleep the respiration 
may fall to twenty-five per minute. 

Between 2 months and 2 years the average number of respirations per minute is 35. 
Between 2 years and 6 years the average number of respirations per minute is 23. 
Between 6 years and 12 years the average number of respirations per minute is 22. 
Between 12 years and 15 years the average number of respirations per minute is 20. 

Evacuations of a Child. — The healthy motion varies in color from a 
light orange yellow to a greenish yellow, and in number from two to four 
times daily. 

Smell should never be offensive. Slimy, mucus-like, jelly motions 
indicate worms. Offensive, acid, pale-green motions indicate a disordered 
stomach. Dark-green evacuations indicate acid secretions and more seri- 
ous stomach or bowel disorder. 

Fetid, dark-brown stools are present in chronic diarrhoea. Putty-like, 
pasty passages are due to acidity curdling the milk or to torpid liver. 

Amount of Sleep Required Each Day 

At 4 months 20 hours of sleep is required. 

At 6 months 18 hours of sleep is required. 

At 1 year 15 hours of sleep is required. 

At 2 years 13 hours of sleep is required. 

At 4 years 12 hours of sleep is required. 

At 7 years 11 hours of sleep is required. 

At 9 years ioi hours of sleep is required. 

At 14 years 10 hours of sleep is required. 

Infant Exercise. — Exposure of infants to pure air should begin in a 
very few weeks after birth ; an hour or two a day at first, but daily when- 
ever the weather permits. They soon evince a strong desire for the open 
air. When yet carried by the nurse they point to the door ; when crawl- 
ing they try to approach it ; when walking they attempt to escape from the 
house to the air without. This, however, must not be construed into 
advice to carry out the child in unfavorable weather or for a long time, 
with an idea of hardening it. Catarrhal inflammations are easily pro- 
duced in children. 

Out-Door Playing. — When old enough to play and romp, the dress 
should not be so fine as to require an order of good care. Nothing affords 
more real enjoyment to children, and at the same time tends more de- 
cidedly to give them a sound and active tone of mind and body than a 
liberal indulgence in exercise and in their innocent sports out of doors. 



DIET FOR CHILDREN. 1173 

General Signs of Health — "Rotundity is the beauty of youth." Dr. 
Meigs says of a healthful child : "Its tissues are firm and solid ; its surface 
of a cool and pleasant temperature; its coloration of clear and exquisite 
white, firmly tempered with a faint rosy tint in a warm atmosphere, or 
slightly marbled with light bluish spots in a colder air. Few marks more 
certainly indicate a healthful temper of the constitution than the clear and 
exquisitely tinted pink color of the palmar and plantar surface of the 
hands and feet of a young child. Nothing indeed can be more beautiful 
or perfect in shape and contour than the figure of a fine, hearty young 
child ; nothing more pleasing to the eye than its delicate but vivid color- 
ing ; and nothing more expressive of the fullness of health than its whole 
appearance." The movements and gestures of a child give a clue to its 
condition. Healthy children, when awake, are in almost constant motion, 
or at constant play. 

Diet. — "Food is the primary necessity in raising children; the char- 
acter, quantity and time of administration should each have the scrupulous 
attention of all those who are responsible for the welfare of children." 
Dr. A. Jacobi says : "Children not only eat to live, but eat to grow also." 
Children need to be fed oftener than adults. The growing boy and girl 
each require a relatively greater quantity of food than the adult. The 
best results are to be gotten by a mixed animal and vegetable diet. 

The following is a useful summary: 

GENERAL RULES FOR FEEDING YOUNG CHILDREN. 

1. Allow time for meals. 

2. See that the food is thoroughly masticated. 

3. Do not allow nibbling between meals. 

4. Do not tempt the child with the sight of rich and indigestible food. 

5. Do not force the child to eat against its will, but examine the 
mouth, which may be sore from erupting teeth; and examine the food, 
which may not be properly cooked or flavored. If good food is refused 
from peevishness merely, remove it and do not offer it again before the 
next meal time. 

6. In acute illness reduce and dilute the food at once. 

7. In very hot weather give about one-fourth or one-third less food 
and offer more water. 



1174 THE MOTHER AND THE CHILD. 

DIET FOR YOUNG CHILDREN. 

TWELFTH TO EIGHTEENTH MONTH. 

7 A. M. — Stale bread soaked in a breakfastcup of new milk. 

10 A. M. — Milk, six ounces, and soda biscuit, or a thin slice of but- 
tered bread. 

2 P. M. — Beef tea, six ounces, bread and a tablespoonful of rice and 
milk pudding. 

6 P. M. — Same as first meal. 

10 P. M. — Same as first meal. 

In alternation a lightly boiled egg, with bread crumbs and six ounces 
of milk may be given at 7 A. M., and at 2 P. M. a mashed baked potato 
moistened with four tablespoonfuls of beef tea; two tablespoonfuls of 
junket. 

EIGHTEENTH TO THIRTIETH MONTH. 

7 A. M. — New milk, eight ounces ; the yolk of an egg lightly boiled ; 
two thin slices of bread and butter, or else milk, and two tablespoonfuls of 
well-cooked oatmeal or wheaten grits, with sugar and cream. 

11 A. M. — Milk, six ounces, with a soda biscuit or bread and butter. 
2 P. M. — One Tablespoonful of rare mutton pounded to a paste, bread 

and butter, or mashed potatoes moistened with good dish gravy, a saucer 
of junket ; or else a breakfast cupful of beef tea or mutton or chicken 
broth, a thin slice of stale bread, a saucer of rice and milk pudding. 

6.30 P. M. — A breakfastcupful of milk, with bread and butter, or 
soft milk toast. 

TWO AND A HALF TO THREE AND A HALF YEARS— i. e., for Children 
Who Have Cut Their Milk Teeth. 

7 A. M. — One or two tumblers of milk, a saucer of thoroughly cooked 
oatmeal or wheaten grits, a slice of bread and butter. 

11 A. M. — If hungry, a tumbler of milk or a teacupful of beef tea, 
with a biscuit. 

2 P. M. — A slice of underdone roast beef or mutton, or a bit of roast 
chicken or turkey, minced as fine as possible; a mashed baked potato 
moistened with dish gravy, a slice of bread and butter, a saucer of junket 
or rice and milk pudding. 

7 P. M. — A tumblerful of milk and a slice or two of soft milk toast. 



DIET FOR YOUNG CHILDREN. 1175 

FROM THREE AND A HALF YEARS UP. 

BTeakfast. — Every day: Milk, porridge and cream, bread and butter. 
One dish only each day : Fresh fish, eggs lightly boiled, eggs poached, eggs 
scrambled, eggs (plain omelet), chicken hash, stewed kidney, stewed liver. 

Sound fruits may be allowed before and after the meal, according 
to taste, as oranges without pulp, grapes (seeds not to be swallowed), 
peaches, thoroughly ripe pears and cantaloupes. 

Dinner. — Every day : Clear soup, meat roasted or boiled and cut into 
small pieces, bread and butter. Two dishes each day: Potatoes baked, 
potatoes mashed, spinach, stewed celery, cauliflower, hominy, macaroni 
(plain), peas, string beans (young), green corn (grated). 

Junket, rice and milk or other light puddings and occasionally ice 
cream may be allowed for dessert. 

Supper. — Every day: Milk, milk toast or bread and butter, stewed 
fruit. 

From the third to the fifth year the child has twenty teeth, and often 
three meals a day suffice, although from the third to the fourth year four 
may be given. 

When the second set of teeth begin to replace the deciduous or milk 
teeth, which gradually decay, digestion is sometimes interfered with tem- 
porarily from lack of ability to masticate thoroughly, and the food should 
be thoroughly subdivided before it is offered to the child. 

Cereal Food — Bread, rice, oatmeal and other cereal foods should 
always enter largely into the dietary of healthy children after they are 
able to digest them. Their fats should be derived chiefly from butter and 
cream. The best fruits for them are oranges, cooked apples and stewed 
prunes. 

Diet Between Three and Four Years. — Children between three and four 
years of age should be fed when in health four times a day — at 7 A. M., 
10.30 A. M., 1.30 P. M. and 6 P. M. 

First Meal. — Half an orange, one and a half teaspoonfuls of oatmeal 
or hominy, well salted, with two tablespoonfuls of cream, but no sugar, 
and one glass of milk. 

Second Meal. — A glass of milk or cup of broth and one slice of stale 
bread. 

Third Meal. — Meat — either steak, chop or chicken — one green vege- 
table (e. g., spinach), one starchy vegetable (e. g., potato), water to drink, 
stewed prunes for dessert. 

Fourth Meal Bread and milk or milk toast. 



1176 THE MOTHER AND THE CHILD. 



FOODS FORBIDDEN TO ALL YOUNG CHILDREN. 

Indigestible Foods — The following articles are particularly indigesti- 
ble for children, and should not be allowed them under four years of age, 
and most of them should not be given under seven or eight years: Tried 
food of all kinds, game, salt food, the flesh of swine in all forms, pickles, 
salads, condiments, except salt, "stews," the "dressing" of fowl, sauces, 
visceral foods (such as liver, kidneys, tripe, etc.), all raw vegetables, pota- 
toes (except baked), tomatoes in any form; the coarser vegetables, such 
as beets, turnips, cabbage, and so forth; fancy bread, cake and pastry; 
griddle cakes, canned food of all kinds; fancy confectionery, sweets and 
preserves; cheese, rich soups, jellies, dried or unripe and overripe fruits 
(bananas, so often given to young children, are very bad for them), nuts, 
fruits with large seeds, such as grapes, the skin of all poultry, fruits or 
vegetables. 

Good Cooking. — All food should be plainly and thoroughly cooked. 
Xo greasy or highly seasoned dishes are permissible, and, as a rule, twice 
cooked meats are indigestible. 

Forbidden Drinks. — Tea, coffee and alcohol in every form must be 
withheld. The two former beverages interfere with digestion and make 
the child nervous, and the latter lays the foundation for a permanent 
alcoholic habit. Soda water with syrups should not be given. Too much 
water should not be allowed with meals, and what is given should not be 
ice-cold. 

Regular Meals. — Children, as they grow up, should continue to ob- 
serve regularity in the hours for taking meals, and the habits of per- 
petually nibbling at cake, crackers and confectionery between meals 
should not be tolerated. It is best for young children not to be put to 
sleep immediately after their most substantial meal of the day. As they 
require a nap in the early afternoon, many advise giving this meal at 
4 P. M. 

INDIGESTION IN INFANTS AND YOUNG CHILDREN. 

The stomachs of infants and very young children being in process 
of development are capable of digesting and properly assimilating but 
comparatively few articles of food, and these only when taken in small 
quantities at a time. Either overfeeding or the feeding of improper 
articles will cause derangement that may have serious consequences. 



INDIGESTION IN INFANTS AND CHILDREN. 1177 

Indigestion with infants and children, as with older people, may be 
acute, lasting only a few days, or perhaps but a few hours, or it may be 
chronic, lasting perhaps for months or even years. Bottle-fed children 
are more apt to suffer from indigestion than are those who are nursed at 
the mother's breast, if the mother be healthy and her milk of good quality 
and sufficient in quantity. When indigestion occurs with nursing infants 
it will usually be found to be due to the milk of the mother or wet-nurse 
which may be but temporarily affected by some local condition, such as 
strong mental emotions of grief, fright or anger, or by some passing phy- 
sical disturbance such as indigestion, or by indulgence in some article of 
diet not suitable for one who is supplying an infant with food from her 
breast. Sometimes a diet which one mother may find advantageous in 
providing wholesome milk for the child may be unsatisfactory with an- 
other. Where a wet-nurse is employed it may be that her own child was 
born too long before the birth of the child she is engaged to nurse, and so 
her milk not suitable for the younger child, as the composition of breast- 
milk changes gradually as time goes on. Reappearance of the menses 
while nursing generally has an unfavorable effect upon the milk which 
may assume such character that the child cannot assimilate it and wean- 
ing may become necessary. Indigestion, too, sometimes attends weaning, 
due to the new food being given too suddenly or in a strength beyond the 
child's power to digest. 

Delicate or feeble children ; sufferers from scrofula, rickets, etc. ; 
those recovering from acute diseases and complaints, and children who 
are teething all have delicate stomachs which are readily upset by very 
slight changes in quality or even the smallest increase in quantity, and 
they suffer from indigestion. Another fruitful cause of indigestion is the 
sudden change from a liquid to a solid diet. In older children overload- 
ing the stomach or eating food that is hard to digest are common causes 
of indigestion. 

Symptoms of Acute Indigestion in Infants and Children. — Both with 
nursing infants and with children who have passed first dentition there 
are marked signs of distress. They are cross, fretful and peevish and 
sometimes suffer great pain, sometimes simply moaning and in other 
cases breaking into fits of screaming. Usually the face is very pale and 
they have the appearance of severe illness. The food remains for a long 
time in the stomach in an undigested form, which causes nausea, retching 
and finally vomiting. The length of time between the meal and vomiting 
and the degree of digestion the food has reached in the stomach during 



1178 THE MOTHER AND THE CHILD. 

that time are indicative of the state of the stomach and severity of the 
attack. If vomiting comes at an early stage there is great and almost 
immediate relief. If vomiting is delayed there is fever, high pulse and 
prostration, the tongue is usually coated, the belly becomes swollen and 
hard, there are muscular twitchings and startings and these symptoms are 
sometimes followed by convulsions, especially in infants and very young 
children who are highly nervous. 

Attacks of acute indigestion usually come on suddenly and fre- 
quently can be traced to some specific violation of diet, and if vomiting 
follows quickly and is full and free there is almost immediate recovery 
and an hour or two after the child may be as well as ever or at worst is 
but slightly indisposed for a day or two. But, if vomiting or other relief 
be long delayed there is danger of serious trouble, especially in the case 
of infants and very young and delicate children. 

Treatment. — The undigested food, which is the cause of the irrita- 
tion, must at once be removed. With babies whether nursing at the breast 
or feeding from the bottle a quantity of lukewarm water may' be given 
by spoon or from bottle, and this should act as an emetic. At the same 
time an enema of soap and water may be administered to relieve any 
undigested food which may have passed into the bowels. After the 
stomach has been emptied no food should be given for four hours, and 
after that the greatest care exercised for the next twenty-four hours. If 
the child is at the breast and the trouble known to be due to some 
error of diet of the mother or wet-nurse, it may be well to keep the child 
from the breast until the disturbing cause has been removed with the 
mother or nurse, simply feeding it on barley water administered in small 
doses in the meantime — care of course being taken to relieve the breast 
of milk during this time by artificial means so as to prevent caking or other 
trouble. In some cases weaning or change of nurse may be necessary. 

As an emetic for children who are a little older, there is nothing 
better than ipecac administered in doses to suit the age, and this may 
sometimes be found advisable even with nursing children. For a child 
two or three years old a teaspoonful of the syrup of ipecac may be given 
or ten grains of the powder, and the dose repeated in twenty minutes if 
the first dose is not effective. This dose must of course be reduced for 
younger children to suit their particular age. If vomiting has not af- 
forded relief and the child draws up its legs and cries with pain, and the 
bowels appear hard and distended, a dose of castor oil should be given, 
and if the symptoms are very severe the action of the oil may be assisted 



INDIGESTION IN INFANTS AND CHILDREN. 1179 

by giving an enema of warm soapsuds. If there are indications of con- 
vulsions, especially if the child has suffered from them before, it should at 
once be placed in a warm bath. (See particulars as to treatment of con- 
vulsions under Accidents and Emergencies.) Application of hot flan- 
nels or poultices over the abdomen are often of much value in affording 
relief. 

In severe cases of indigestion too great care cannot be exercised as to 
feeding for several days. There is real danger in commencing the use of 
hearty food too soon or of giving it in too large a quantity. Even a 
nursing child must be brought back to the breast with care. It may be 
advisable to keep the child from the breast for a whole day, and then only 
permit it to remain at the breast two or three minutes every three 
hours, gradually increasing the time at each nursing in accordance with 
the improvement seen. During this time nourishment of the child may 
be sustained by small doses of barley water or by small quantities of prop- 
erly modified cow's milk and lime water, care being taken not to over- 
feed and the cow's milk being discontinued if it does not thoroughly 
agree with the child. 

Chronic Indigestion. — While not causing the immediate distress of 
acute indigestion, chronic indigestion in children is more difficult of 
treatment, as the cause of the trouble cannot be so readily told, and the 
cause must be known and removed before real betterment of condition can 
be hoped for. With infants who are nursing at the breast, strict regard 
must be had to the quality of the mother's milk, and if there is reason to 
judge that this is the cause, as is most frequently the case, the child must 
be changed to bottle feeding, in respect of which the utmost care must be 
taken that the ingredients of the nourishment thus administered are not 
only suitable to the child's age, but to its existing condition of stomach. 
Read carefully instructions as to Infant Feeding in an earlier part of this 
chapter. In bottle-fed children these same instructions on Infant Feed- 
ing should be carefully studied. In the case of older children particular 
care should be taken that their food is truly wholesome and especial en- 
deavor should be made that they have their meals at regular hours. Eat- 
ing between meals is often a source of serious digestive trouble. Yet the 
child should not be forced to go hungry because of some hard-and-fast 
rule. In children of from one to two years a bread and milk diet should 
be largely relied upon, though an occasional exception may be made. As 
a rule at this age vegetables are not wholesome, and potatoes, to which 
children usually show much partiality, are frequently a potent source of 



1180 THE MOTHER AXD THE CHILD. • 

stomach trouble. If potatoes are desired, they are much better baked 
than boiled, but even then should be given sparingly where the stomach 
shows indication of weakness. Where the child is given meat (which 
should not be until it has at least its molar teeth) rare (underdone) beef 
is probably best, whether as roast or steak, but chicken is also wholesome 
and sometimes lamb and even veal, if especially well done, will be found 
to meet all requirements of easy digestion. Fat meats of all kinds should 
be avoided and pork in any form is to be shunned. Ripe fruits may 
be used in season, but in moderation, and they should not be "over-ripe." 

Fresh air is of almost equal importance with proper diet. It is not 
unusual for a child quite free from indigestion during summer months, 
when it is almost constantly out of doors, to suffer continually from in- 
digestion during winter months, when it is kept almost completely within 
door. Fresh air and outdoor exercise are as needful to the child in winter 
as in summer. 

Existing constitutional troubles, such as rickets, scrofula, etc., or per- 
haps debility arising from some previous disease, such as measles, scarlet 
fever or other ailment, may cause chronic indigestion. Read the articles 
on these different constitutional diseases. In such cases an emulsion of 
cod liver oil (if the stomach will stand it) will often prove useful, and 
some of the numerous preparations of iron, or some of the bitter tonics 
may prove helpful. But do not constantly dose your child with medicine. 
There is always a danger of over-drugging children who have chronic 
indigestion, and this of itself oftentimes keeps up a trouble of the stomach 
which fresh air, moderate outdoor exercise and careful dieting would 
cure without medicine or very little of it. 

Among medicines that may be used in moderation and in doses to 
suit the age and constitution of the child, the following may be mentioned : 
Emulsion of cod liver oil, using an emulsion made with the lacto-phos- 
phates rather than the pure oil ; powdered carbonate of iron, administered 
in grain doses ; mix vomica as a bitters, one or two drops in half a wine- 
glass of water being given to a child of three years. Iron and mix 
vomica may be administered in the same preparation. The following 
prescription is frequently efficacious: 

R. — Tr. Nucis Vomica % drachm 

Elix. Calisaya 6 drachms 

Tr. Card. Co 2 drachms 

Ess: Pepsin 2 ounces 

Dose: Fifteen to thirty drops in water three times a day. 



MALFORMATION OF MOUTH. 1181 



CATARRH OF THE MOUTH OR CATARRHAL STOMATITIS. 

This is an affection of the mouth due to stomach trouble. The mu- 
cous membranes of the mouth and tongue are not only red and swollen, 
but are covered with a thick slimy mucus, and there is considerable local 
pain. The disease is common in infants and children, with whom it may 
be due to teething or to certain fevers, such as measles, scarlet fever, etc. 
The mucous membrane of the mouth becomes red and hot, causing a 
smarting or stinging pain, and there is an excessive secretion of saliva. 
The breath is foul and there is an unpleasant bitter taste in the mouth, 
accompanied by disturbance of the stomach and feverishness. The trouble 
usually subsides with treatment in a week, though sometimes endures 
longer. It is chiefly confined to infants and children, but occasionally is 
found in adults, chronic cases sometimes appearing in adults as the 
result of excessive use of tobacco or alcohol. 

Treatment. — Mix well together two tablespoonfuls of honey and 
half a drachm of powdered borax and give a teaspoonful twice a day, 
administering it slowly and in such manner as to anoint all sore spots that 
may be visible. An excellent mouth wash is the mixing together of 40 
grains of chlorate of potash, 15 drops of myrrh and 2 ounces of elixir of 
calisaya. A teaspoonful of this should be put in a wineglass of water 
and the mouth washed every four hours. If it is found too strong it may 
be further diluted. Another preparation which may be found beneficial 
is the following: Bismuth subnitrate, ^ drachm; magnesia powdered, 2 
drachms; bicarbonate soda, 12 grains; sugar milk, 24 grains. Make 
twelve powders ; one two hours after feeding. 

MALFORMATION OF MOUTH. 

Hare-lip Children are sometimes born with a curious malforma- 
tion of the upper lip, which has failed to unite at the centre previous to 
birth, and the child is left with a deep cleft sometimes reaching from the 
lip to the nostril. This cleft is usually at one side or other rather than 
in the center and sometimes is double — that is, there is a cleft on each 
side — or it may be complicated — that is, combined with a fissure of the 
palate (roof or upper part of mouth). It can only be remedied by sur- 
gical operation. The deformity may be so great as to prevent the child 
from nursing through inability to grasp the nipple or so inefficiently as 
to prevent securing sufficient food for nutrition. In such cases an im- 



1182 THE MOTHER AND THE CHILD. 

mediate operation is necessary. If the deformity does not interfere with 
nursing it is generally better to postpone operation until at least the fifth 
month, and may in some cases be advantageously delayed even as late as 
the eighteenth month. The operation is very simple, but should be per- 
formed by a skilful surgeon as in order to leave the least unsightly scar 
an exceptional nicety of adjustment of the parts is necessary. 

Cleft Palate. — This is similar in nature to hare-lip, of which it is 
often an accompaniment. It is apt to seriously interfere with speech 
and should be operated upon by surgeon, the operation, as in the case of 
hare-lip, being delayed for some months unless the cleft is of such nature 
as to interfere with proper nursing. 

Tongue-tie. — This malformation is caused by the undue shortness of 
the small membrane, called the f renum, which is attached to the tongue on 
the underside and which is thus sometimes to its very tip tied to the 
lower jaw. It can be detected when the child opens its mouth in crying 
and by its inability to thrust out the tongue. If it interferes with nursing 
it should be operated on the next day by nicking the band at the front edge 
and then tearing it back to about the usual position. No cutting should 
be resorted to, excepting in this superficial way, on account of a very 
active little artery which lies at the root of the tongue, and which, if 
wounded, might bleed so as to endanger an infant's life before the hemor- 
rhage is stopped. On this account, if nursing is not seriously interfered 
with, it is better to wait some months before this untying. Simple as 
the operation is it is always advisable to have it performed by a surgeon 
if one can possibly be obtained. If the tongue can be thrust beyond the 
red edge of the underlip no operation is likely to be necessary. 

COLIC. 

Colic is one of the most common troubles with young children, espe- 
cially during the first five or six months of infancy, and is invariably due 
to disturbed digestion. Both nursed and bottle-fed babies are subject to 
it, and it may occur in the healthiest baby from error in the last meal, 
and may be due in the case of a nursing baby to some indiscretion in diet 
on the part of the mother, or with a bottle-fed baby it may be due to a 
carelessly prepared bottle. See remarks on indigestion of children. 

Slight attacks are frequent with almost all infants, the baby suddenly 
becomes fretful, draws up its legs toward the abdomen, cries for a few 
minutes and then becomes quiet. In. a short time another attack occurs 



colic. 1183 

and in turn subsides, and thus it goes on until relief is secured. It fre- 
quently happens, however, that the attack is much more severe and the 
symptoms become violent: there is continued unappeasable screaming, 
spasmodic kicking, reddening of the face, writhing of the body, etc., and 
the abdomen usually is not only disturbed, but hard and tense. 

Treatment. — In the first place the feet and hands should be warmed 
by placing them against a hot water bottle or holding them before an 
open fire ; the baby should be turned on the stomach, lying on a hot water 
bottle or hot flannel; pat the back gently to help up the wind, and as a 
relief to pain and also as an aid to belching give a teaspoonful of hot 
water with or without the addition of a few drops of essence of pepper- 
mint, anise, gin, brandy or asafoetida. Hot catnip tea is a safe and often 
efficient remedy and a soda-mint tablet dissolved in a wineglass of hot 
water is often helpful in relieving pain. Frequently relief is obtained by 
a rectal injection of one or two teaspoonfuls of glycerine in from two to 
four ounces of cold water — or ten drops of turpentine in a half teacupful 
of warm water injected slowly into the rectum, the abdomen being at the 
same time gently rubbed, will be found an excellent remedy. When with 
a nursing child colic is frequent and severe, there is usually reason to 
believe that the mother's milk is unwholesome, and it will probably be 
necessary to put the child on a diet of modified cow's milk. 

The following prescription often proves of much avail in cases of 
violent colic: Bismuth subnitrate, 1 drachm; tincture cardamon comp., 
1 drachm ; glycerine, 2 drachms ; essence of pepsin, 4 drachms ; pepper- 
mint water to make 2 ounces. Fifteen to thirty drops, to be repeated. 

Mothers and nurses cannot be too strongly cautioned against reliev- 
ing colic by the common and pernicious habit of administering frequent 
doses of anodynes and carminatives. Almost all mixtures of this kind 
contain more or less opium and countless infants have been permanently 
injured by their employment, and beyond question death in many in- 
stances has been directly attributable to their habitual use. Among char- 
acteristic symptoms of continuous use of such drugs with infants are: 
loss of appetite and impaired digestive powers and constipated bowels, the 
skin then loses its healthy tinge, general apathy and debility follow, and 
if long continued there is apt to be termination in convulsions, -dropsy of 
the head, glandular swellings, incurable jaundice or fatal exhaustion oi the 
vital energies. These drugs are often administered to an infant by some 
nurse girl or woman in attendance without a mother's knowledge, and 
mothers should always be on guard against such happenings. 



1184 THE MOTHER AND THE CHILD. 



CRAMP IN THE STOMACH OR GASTRALGIA. 

Children are frequently troubled with cramps in the stomach or a 
form of neuralgia, which causes violent pains in the stomach. They may 
be the effect of cold, through exposure, wet feet, drinking ice water and 
like causes, or they may be forerunners of acute stomach indigestion, due 
to indiscretions in eating. 

The symptoms may be confined to mild intermittent pains in the 
stomach, or there may be such severe pain as to cause prostration, cold 
perspiration, f aintness and a general pallor of the face. 

Treatment. — The child should be put to bed and hot water bottles 
applied to the stomach and feet. Make a paste of mustard and olive oil 
(the olive oil prevents blistering) and spread this fairly thickly between 
two pieces of very thin flannel, which lay on the child's stomach. Ad- 
minister hot drinks such as strong ginger tea. Hot water with a little 
brandy or gin may be given and where there is much pain Hve drops of 
spirits of chloroform may be added. Usually ginger tea if made suffi- 
ciently strong is better than any liquor. No food should be given while 
there is any pain, and when this is entirely relieved only the simplest and 
most easily digested food should be given. 

INFANT DIARRHCEA. 

At no other period of life is diarrhoea so common as in infancy, 
and not only so but the attack at this stage of life is more likely to become 
unmanageable and assume dangerous character than in later childhood 
or adult life. 

The trouble may be due to any of various causes. Malnutritions 
food is the most potent cause. Nursing babies are less subject than 
bottle-fed infants. Infants fed with solid foods are especially liable to 
attacks, and where regularly allowed to partake of potatoes, meat, vege- 
tables, etc., are liable to become afflicted with chronic diarrhoea. Intense 
summer heat is conducive to this trouble and complaints are much more 
frequent with children during summer weather than at any other season 
of the year. 

Treatment. — A purgative dose of castor oil, laxol or syrup of rhu- 
barb may be given, or a powder containing one-tenth of a grain of calomel 
and one grain of bicarbonate of soda, giving one such powder each half 



CHOLERA INFANTUM. 1185 

hour until eight or ten have been taken, when follow with a teaspoonful 
of rice water or albumen water may be given, or whey. After this oe very 
careful in feeding and if necessary change food. 

If there has been continued diarrhoea for some time, the cleansing of 
the bowels by castor oil or other purgative will probably be unnecessary, 
and in such cases one-half to one grain of Dover's powder mixed with 
three grains of subnitrate of bismuth may be given, one such powder being 
administered every three or four hours. Another prescription recom- 
mended is the following: 

Bismuth subnit 24 grains 

Comp. chalk powder 16 grains 

Make into twelve powders. One every two, three or four hours. 

Where there is much prostration five or ten drops of brandy in a 
teaspoonful of water may be administered from time to time as judgment 
dictates. 

A teaspoonful, or one drachm, of castor oil is a purgative dose for a 
child up to six months, and is best administered in hot milk. For chil- 
dren up to six months, however, an enema of hot water (one pint) is 
frequently better than a purging dose. 

Where there is fever the child should be sponged from time to time 
with a mixture of hot water and alcohol — about equal proportions. 

CHOLERA INFANTUM (Summer Complaint). 

Symptoms — The first symptoms are heat and pain in the region of 
the stomach and bowels, hands and feet, followed by vomiting and purg- 
ing, or both, with griping and severe pains at the pit of the stomach. 
Evacuations become greenish-yellow and slimy, frequent and painful. 
Vomit is also greenish and more or less offensive and sour. There is great 
prostration, with loss of bodily heat and intense thirst ; later, a cold per- 
spiration appears, and unless relief is afforded the patient speedily suc- 
cumbs, or the disease passes into a chronic state. 

Causes. — Causes are : unwholesome food, hot weather, bad ventilation, 
or painful teething. 

Treatment. — 1. The first step is to remove the cause — a nursing 
babe may suffer from an improper diet on the part of the mother. Give 
the patient pure air and sunlight — a trip to the country or on the water 
75 



1186 THE MOTHER AND THE CHILD. 

may be all sufficient. If the trouble comes from teething, have the gums 
lanced and cared for. 

2. The treatment should generally be very simple. When the symp- 
toms first appear apply a spice plaster, or light mustard plaster, or flan- 
nels wrung out of hot water and spirits, over the whole abdomen; give a 
few teaspoonfuls of mint tea, and keep the child as quiet as possible. 

3. The following mixture has been used with great success, in early 
stages especially: 

Prepared chalk 10 grains 

Subnitrate of bismuth io grains 

Paregoric , 1% teaspoonfuls 

Syrup of ginger , 5 teaspoonfuls 

Gum arabic mucilage 5 teaspoonfuls 

Mix. Dose for child one year old, one-half teaspoonful two to six times a day, 
usually not oftener than once in five or six hours. Vomiting may be relieved by giving 
small pieces of ice, if the child is old enough to swallow them. This treatment will often 
bring relief, but if it does not, give a teaspoonful of flaxseed tea or slippery elm tea, with 
(for a child four to six weeks old) one drop of laudanum, once in two or three hours- 

4. If child is two or three months old, give two drops of laudanum ; 
if six months old, give three drops; if a year or more give from four to 
eight drops, according to age. If the stomach will not retain this remedy 
apply it as an injection, using a tablespoonful of thin boiled starch, blood 
heat, to double the amount of laudanum prescribed above — that is, two 
drops for a child of thirty days, four drops for a child of two or three 
months, and so forth. 

5. As a general rule, we may say, give as little medicine as possible, 
and if the simple remedies first named do not give prompt relief, as they 
very often will, with proper care, call a physician in preference to trying 
to handle the case in its severe forms. 



NURSING THE BABY. 

Throughout this chapter we have recommended that in all cases 
where possible the mother should nurse her child, and there is no more 
fitting point with which to close. 

It is stated on high authority that seven bottle-fed babies die to one 
that is breast-fed. It follows that it is the mother's duty to nurse her child 
if she can ; that is, if she has sufficient wholesome milk. The baby should 
be breast-fed until it is at least six months old, and should never be 



BREAST FEEDING. 118? 

weaned in hot weather. Mother's milk is made up of 87 parts of water 
and 13 parts of solids, these latter being fats, sugar, proteids, and salts. 
They are all essential to the nourishment of the child, the fats to build 
up fatty tissues of the body and produce body heat and energy ; the sugar 
gives similar results; the proteids build up the cells which compose the 
blood; the water holds the food in such solution that it may be digested 
and assimilated and aids the work of all the excretory organs ; the salts 
are needed chiefly for the blood. It is of course possible to modify cow's 
milk so that it closely resembles the mother's milk in the proportions of 
its composition, but there are qualities in the mother's milk which can- 
not be reproduced by imitation. Moreover, no one knows the exact state 
in which the mother's milk goes from her breast to the stomach of her 
babe, but we do know that it is perfectly adapted to the requirements of 
the child. 

Mother's milk not only gives the baby necessary help in the compli- 
cated task of growing, but to a large degree it renders the child immune 
to illnesses of many sorts and greatly increases the chance of life. Again 
it is easier to nurse a baby at the breast than to feed it by bottle. To 
secure pure milk, to properly modify it, to keep bottles and nipples and 
all utensils absolutely clean and sterilize them, is all matter requiring 
most scrupulous care and much work, and when the baby does not thrive 
and some change in its food is necessary, the difficulties of artificial feed- 
ing are multiplied. Too often it happens that the baby's first year is 
spent in a series of unfortunate feeding experiments, with the result that 
the growth and general development are seriously retarded. Then, too, a 
bottle-fed baby is often left to the care of nurse-maids who are careless 
and negligent as to the cleanliness of bottles and nipples and of the man- 
ner of feeding, and illness of the child follows. 

There are of course cases where the mother cannot nurse her child, 
no matter how much she would wish to do so. But as a matter of fact 
the cases are very rare when maternal nursing is really impossible. It is 
the duty of every doctor and every nurse to insist that the mother shall 
exercise this function — to do everything possible to establish lactation, 
to promote it and even to bring it back if for any reason the breasts have 
ceased to secrete. 

The milk does not come to the mother's breast until from 48 to 60 
hours after the birth of the child, but during the interim period the baby 
needs no food. It may be given a few drops of slightly warmed water now 
and then, and beginning some six hours after birth it should be put to the 



1188 THE MOTHER AND THE CHILD. 

breast every six hours until the milk arrives. The first secretion of the 
breasts is called Colostrum, and serves some useful purpose to the baby, 
but perhaps the greatest value of this early nursing is the training of 
mother and babe in the habit of nursing. For the first few days and until 
the relation between supply and demand is established, there may be an 
excessive flow of milk to the breasts. If there is overdistension of the 
breasts the excess milk may be removed by the use of the breast pump, but 
this should not be resorted to unless absolutely necessary, or relief may be 
obtained by gentle massage of the breast, using warm oil on the hands. 
However, all manipulation tends to stimulate the glands to greater ac- 
tivity, and it is therefore usually better to relieve the discomfort in other 
ways. A bandage properly made and properly applied is oftentimes most 
availing, but this requires professional skill for its successful use. Hot 
or cold applications (according to the weather and the patient's prefer- 
ence) are sometimes of avail. Great care must be exercised to adopt 
nothing but the gentlest methods. Usually nature will soon take care 
of the excess of milk. 

The nipples must be kept in good condition. They should be washed 
with boric acid or clean water after each nursing, thoroughly dried and 
at all times kept perfectly clean. They are apt to crack as a result of the 
baby's efforts to nurse and should this happen a nipple shield should be 
used (rubber or glass) until the abrasions are healed, for if the baby's 
mouth comes in contact with the sore nipple, infection may follow, which 
may lead to breast abscess, a most painful affliction and one which calls 
for surgical treatment. Cracked nipples may also result from permitting 
the baby to nurse too long at a time or at irregular intervals. Regularity 
in the times of nursing is of vital importance, both as respects the mother 
and the child. 

The question of whether the baby is getting enough food may be 
determined by weighing at the end of each week or oftener. There is 
apt to be a slight loss in weight the first week, but after that there should 
be a steady gain in weight. If the baby cries much or does not gain in 
weight, it may be that the mother's milk is deficient in some necessary 
qualities, and it will be well to consult the family physician. The mother 
should not decide to give up nursing the baby excepting under most ex- 
ceptional circumstances, and then only after consultation and advice. 
Even a very small quantity of mother's milk is valuable to the child, and 
especially during the first three months every effort should be made to 
give the child at least some quantity of maternal milk, even though the 



£iet fob the nursing mother. 1189 

bottle has to be resorted to as well. The attempt to nurse the baby will 
stimulate the flow of milk and with proper diet and general health will 
often establish this function, even when apparently hopeless. In the 
meantime the baby's food must be supplemented by cow's milk properly 
modified. 

Diet for the Nursing Mother — Usually this should be practically the 
same as during pregnancy, and the mother may largely follow her own 
inclinations as to what she eats. It is doubtful if the old idea that acids 
and vegetables taken by the mother cause colic with the child, neverthe- 
less if they, or any food or drink, disturb the mother's digestion it is apt 
to have an unfavorable effect upon the milk, and should be discontinued, 
and it is therefore necessary to watch the diet very carefully and eliminate 
all articles that do not thoroughly agree. Eat slowly, chew all food thor- 
oughly and above all refrain from worry, and the chances all are that the 
milk will agree with the baby. Constipation should be guarded against 
just as carefully as during pregnancy. 

If there be but scanty quantity of milk it is an indication that there 
should be a more generous diet. Plenty of fresh milk, eggs, fresh vege- 
tables, ripe fruit, and other plain simple food are required. In event of 
capricious appetite it will be better to take ^ve or six small meals daily 
instead of three large ones. It cannot be too strongly commended that 
the mother while nursing should be in a quiet state of mind. There is 
nothing that interferes with a good secretion of milk than an overwrought 
or nervous condition, and notwithstanding the troubles and sorrows may 
be such as to make it almost imposible to keep from worrying, the re- 
membrance of the little life that is so dependent on the mother's milk 
being wholesome may help to bring about a quieter state of mind. The 
mother should have pleasant outdoor recreation, and be surrounded with 
cheerful society, and as far as possible a variety of things that will in- 
terest her, and there should be every endeavor made to have at least eight 
hours sleep at night besides ample resting throughout the day. Air and 
sunshine are essential. 

When the nurse has gone and the mother is left to herself she is apt 
to grow weary with the care of the child which now devolves entirely upon 
herself while she is yet more or less weak from her confinement, and at 
this time there is apt to be a dimiuishment in the quantity of milk 
secreted, causing the mother to become discouraged and inclined to believe 
that she will have to give up nursing her child. This is almost invariably 
a mistake. The strain of this period is gradually relieved from day to 



1190 THE MOTHER AND THE CHILD. 

day as the mother and babe become gradually adjusted to each other's 
ways, health revives and slowly but certainly things grow more comfort- 
able, and with this improving state the milk will come back in its needful 
quantity. In a word, if the mother will specially strive to carry herself 
and the baby past this period she will in all probability be able to after- 
ward successfully nurse her child. Every possible effort should be made 
to this end before resorting to weaning. The return of the menstrual 
periods is not necessarily sufficient reason for weaning, though it some- 
times so affects the milk as to make it advisable, but pregnancy demands 
weaning because the mother's strength is not sufficient for the double tax. 

A MOTHER'S RESPONSIBILITY IN CHILD TRAINING 

"Mothers," remarked the cynic, "are of two classes: those who have 
preconceived ideas as to how to bring up their children and won't learn, 
and those who have no ideas and can't learn." 

Ignorance of Mothers. — We will probably not all agree to this rather 
sweeping statement, for most of us are fortunate enough to number among 
our acquaintances several brave, conscientious women who are true 
mothers in every sense of the word. But looking the facts squarely in 
the face, we must admit that there are lamentably few such examples, 
and that the majority of women are most woefully ignorant on the im- 
portant subject of child-training. 

Occupation of Motherhood. — In these days of skilled labor, a person 
who desires to teach a certain branch of knowledge will spend several 
years beforehand in preparation. Women as well as men have learned to 
their cost that in order to obtain a business position they must be able 
to perform its duties well. The sole exception to this rule seems to be in 
the case of motherhood, which, of all the occupations in which a woman 
can engage, is beyond doubt the highest and the most difficult. Possibly 
because there is no money consideration attached to her duties, a mother's 
labor in the bringing up of her children is not generally considered in the 
light of a profession, and hence a woman rarely hesitates to undertake 
this difficult task without a previous study of the subject. The disastrous 
result of this act is felt not only by the child but also by the thoughtless 
mother, who alone is responsible for the consequences. 

Who Are to Blame. — Ungrateful and wayward children have always 
been looked upon with horror, and unbounded sympathy expressed for the 
parents in their terrible affliction. All that is very right and proper, pro- 
vided it is the children and not the parents who are to blame. Unfortu- 



CARE OF THE CHILD. 1191 

nately the latter is too often the case, and the sympathy that is given the 
father and mother frequently belongs to the unhappy offspring, who are 
made the innocent victims of someone else's ignorance or wrongdoing. 

Children's Rights. — Too few mothers recognize the fact that their 
children have certain rights which should be respected ; that among these 
rights are a healthy body, a good disposition and an intellectual and moral 
training. To the extent of her powers a mother should provide these for 
her child. I emphasize these duties as appertaining to the mother, since 
it is she and she alone in whom is vested the important office of the edu- 
cation of her offspring. The father provides the funds and may aid and 
advise his wife, but he can never take her place in the lives of his 
children. 

Children's Imitative Powers — The most characteristic thing a"bout 
children is their power of imitation, and this power can be made to serve 
both, a desirable and an undesirable end. Few people realize the extent 
to which this practice is carried by the average child and the reason for its 
existence. The child is a stranger in an unfamiliar world and among 
people of whose customs he knows nothing. There is an undefined 
prompting which urges him to imitate the acts committed by those around 
him, and even the words they speak. Finally, by constant repetition, he 
begins to understand what to him at first was an enigma. In the case of 
the tiny baby this imitation is unconscious, but finally it is performed 
consciously. 

Children's Surroundings. — The tremendous importance of a child's 
surroundings will at once be seen. Since he must imitate, it is right that 
he should see and hear only things worthy of imitation, and herein lies 
a great difficulty ; for people cannot be made to comprehend that what they 
do and say in the presence of children can have any effect upon their 
characters. "The child is too young to take it in," they assert. Some day 
they are startled and embarrassed when the youngster repeats their action 
and the very words uttered by them, in the presence of strangers. The 
truth is that children comprehend more than we know, and the ideas 
which they receive may lie dormant for some time before they are able 
to give them out. This explains many seemingly incredible acts of 
memory on the part of very young children. 

Dispositions and Temperaments. — Not only do children imitate the 
words and actions of those around them, but they also reflect in a wonder- 
ful degree their dispositions and temperaments. If one or both of the 
parents are nervous and irritable, the chances are that their offspring 



1192 THE MOTHER AND THE CHILD. 

will be the same, and, on the contrary, if the family life is peaceful and 
happy it will be reflected in the sunny dispositions of the children. All 
these things will be considered by the wise mother who does not wish the 
little one to enter the great struggle of life with a terrible handicap at 
the very outset. 

Froebel's System. — Friedrich Froebel, the originator of the kinder- 
garten, and the greatest student of child nature that the world has ever 
known, was the first to see that the education of the child must begin 
when he is born. It is necessary, therefore, for the mother to understand 
the nature of the little being whose destiny lies in her hands, and to this 
end Froebel formed classes especially for mothers where they could be 
taught the physical, mental and moral requirements of their children. 
His book of songs and games is intended not only for the kindergarten 
but for the mother to use with her baby. The mottoes and commentaries 
on them are for the kindergartner's or mother's perusal. It is a work that 
all those who have the care of young children cannot well do without. 

Start of Child Training — The question is often asked, "How can a 
mother start the training of her child when it is yet too young to under- 
stand what she says ?" If the questioner will but consider for a moment 
she will realize that the education of a human being begins at the moment 
of birth, continues throughout life, and only ceases when he dies. Every 
physician will testify to the necessity of forming desirable habits in the 
period of infancy, when the character is still in a plastic condition. The 
foundation for habits of punctuality and self-control are easily laid in the 
infant by accustoming him to a regular life. His meals should be given 
at stated periods, also his walks and his bath. He should be put to sleep 
at the same time every day, and gradually he will learn to know what is 
required of him and cheerfully conform to it. 

Crying Children. — Children should be taught that no amount of 
crying and misbehavior will bring a coveted object which has once been 
denied them. A child who has thus been indulged once by a thoughtless 
parent will practice the same tactics another time. Children learn almost 
intuitively to connect cause and effect. "I cried for it and it was given 
to me, so it must be my crying that brings me what I want." And they 
lay that connection of ideas by for future use. In correcting this, as in so 
many other things, it is the first step that both counts and costs. There 
may be a scene or two at the outset when the half-formed will of the child 
is pitted against that of the mother, but what is that in comparison with 
the value of the final results in the formation of the child's character? 



TRAINING OF THE CHILD. 1193 

Few mothers realize the harm they can do a child by an unwise lowering 
of their parental authority. 

Over-indulgence. — Over-indulgences in smoking, drinking and other 
vices are loudly condemned by all right-thinking people. It is an inter- 
esting fact that any number of such cases have been traced directly back 
to the foolish leniency of the mother in allowing in her child excesses in 
little things. For example, baby is permitted to suck his finger and soon 
is not happy unless doing so. Finally, the mother notices the act and 
straightway provides a rubber-ring or something similar to take the fin- 
ger's place. The child quickly becomes accustomed to the new device, 
and when the ring is not forthcoming he sucks his cap-string, or anything 
within reach. Pencils, chewing-gum and candy take the place of the ring 
when the baby grows into the boy, and finally these give way to cigarettes 
when manhood is reached. Is it any wonder that a man finds the tobacco 
habit hard to break. He has been accustomed to having something con- 
stantly in his mouth, and with each year the habit grows stronger and 
his will weaker. 

Correction of Overeating. — Eating after the cravings of nature have 
been satisfied is a common fault in little children, and thoughtless adults 
will frequently urge them to partake of more food than the stomach can 
possibly have any use for. This is a fertile cause of ill-health, but far 
worse than that, it is more injurious to the moral nature. This also ap- 
plies to the excessive eating of candy and sweet things of which the child 
is very fond. The continual gratification of the appetite, or in fact of any 
of the senses, to a point beyond that which common sense dictates, can 
have but one result, and that is the loss of all self-control. 

Children's Pitfalls — It is far from my wish to discourage any mother 
in the training of her children by thus pointing out the numerous pit- 
falls that beset her way. These same pitfalls are many and deep, it is 
true, but continual watchfulness and a knowledge of wherein the danger 
lies will do much to keep one in the right path. It is to this in a large 
measure that the good kindergartner owes her wonderful influence over 
her small charges. She makes a study of each individual child, his 
virtues and faults, what he likes and dislikes and, in fact, all the pecu- 
liarities of his individual character. Thus she is enabled to correctly at- 
tribute his acts to the motives which prompted them and reward or punish 
the small doer accordingly. For it is a well-known fact that two children 
may do exactly the same thing — the one from a bad and the other from 



1194 THE MOTHER AND THE CHILD. 

a good motive ; and a person not understanding the different natures would 
be likely to treat both in the same manner. 

Rewards and Punishments. — The question of rewards and punish- 
ments is one of the gravest with which the mother and kindergartner is 
called upon to deal, for an unjust decision in such a matter is often the 
cause of much harm to the child. The arbitrator is practically in the 
position of God to the child who regards her decision as absolutely just 
and final. One of the saddest things that could happen to a mother is 
the loss of this faith, and it may safely be said that this loss only comes 
through her child's knowing that her decisions are unjust. She should be 
the standard of right and wrong in the eyes of her children, their con- 
science, so to speak, before their own has completely formed. 

When to Enter School — The age at which any given child may enter 
school must be decided for that child alone. The individual must be con- 
sidered. As a rule children are sent to school too early. Strong, robust 
children may be sent to school at six or seven years of age. They may 
even have spent two years in the kindergarten before reaching that age. 
On the other hand a delicate child had better be kept in the open air and 
sunshine until nine or ten years of age, or even later. It is more im- 
portant to a child to have a sound body than to have an educated brain. 

Development of Puberty. — Puberty is that time of life in a boy or girl 
when they emerge from boyhood or girlhood into manhood or womanhood. 
It is a time in the life of most individuals fraught with danger. To the 
boy approaching puberty, little care need be given except to surround him 
with good influence and moral companions. Teachers should be patient 
in cultivating the voice. Singing should not be indulged in until the 
"new voice" is well established. The boy should be watched so that no 
bad habits are formed. This period is reached in the average boy in from 
the fourteenth to the sixteenth year, and at such time as the first manifes- 
tations of puberty occur, the father should carefully explain to the boy the 
nature of the change in his physical state and endeavor to imbue him with 
ideas of chastity, not only from its moral but also from its physical aspect. 
There should be no false modesty in such discussion with the son. The 
boy is certain to become informed of the facts from other boys, and there 
is always danger that the information may be imparted to him in such 
manner as will pollute his mind instead of giving him ideas of the nobility 
of manhood. 

Puberty in Girls. — In girls, puberty is reached about the fifteenth 
year. At this time the mother must seek the girl's closest and strictest 



PUBERTY. 1195 

confidence, and before the first menstrual flow occurs it is the mother's 
duty to explain physical conditions to the child and prepare her for that 
which is soon to happen. Failure to do this may, and often does, result 
in mortification, suffering and sometimes permanent injury to the matur- 
ing child. She must do no severe mental work at this time, neither should 
she indulge in violent exercise. When weary and languid, encourage 
rest in a reclining posture, with short walks in sunshine and v fresh air 
daily. Many girls are better removed from school. The health and future 
usefulness of many girls are endangered, some even ruined, by injudicious 
care at this period. Moral companions must be secured at this period 
of life. 



PART I OF BOOK IX 

Describes the properties and uses of many simple 
remedies which should be in every home, giving also 
a number of instruments and articles which will be 
found very useful in the home treatment of disease. 

Liquid Medicines 1201 

Measuring Medicine 1200 

Medicine Chest 1 199 

Convenience 1 199 

Purpose of 1 199 

Miscellaneous Medicines 1205 

Mustard, Ground . 1205 

Mustard Plasters 1206 

Nitre, Spirits of 1202 

Paregoric 1202 

Pepsin 1204 

Peroxide of Hydrogen 1203 

Plasters 1206 

Mustard 1206 

Toothache 1206 

Pouring Medicine 1200 

Remedies, Household 1201 

Rhynitis 1204 

Seidlitz Powders 1205 

Soda 1205 

Spirits of Camphor 1203 

Spirits of Turpentine 1203 

Subnitrate of Bismuth 1204 

Sulphate of Quinine 1204 

Sweet Oil and Spirits of Turpentine. 1203 

Sweet Spirits of Nitre 1202 

Syrup of Ipecac 1201 

Tablets 1204 

Toothache Plasters 1206 

Turpentine, Spirits of 1203 

Valerianate of Ammonia 1201 

Vaseline 1206 

Whiskey 1201 

Witch-hazel 1203 

Zinc Ointment 1206 



Absorbent Cotton 1206 

Alcohol 1203 

Antiseptic Gauze Bandage 1206 

Aromatic Spirits of Ammonia 1201 

Bandages 1206 

Bicarbonate of Soda 1205 

Bismuth, Subnitrate of 1204 

Boric Acid 1206 

Bromide of Soda 1204 

Brown Mixture 1204 

Cabinet for Medicines 1207 

Calomel 1205 

Camphor, Spirits of 1203 

Camphorated Soap Liniment 1203 

Chalk Mixture 1204 

Chlorate of Potash 1206 

Chloroform Liniment 1203 

Chlorinated Lime 1205 

Cold Cream .... .^ 1206 

Coryza 1204 

Dropping Medicine 1200 

Essence of Ginger 1202 

Ginger, Essence of 1202 

Ground Mustard 1205 

Home Medicine Chest 1199 

Household Remedies 1201 

How to Dispense Medicines 1200 

How to Keep Medicines 1199 

Ideal Home Medicine Chest 1199 

Implements 1206 

Ipecac, Syrup of 1201 

Laudanum 1202 

and Lead Water 1203 

Lead Water and Laudanum 1203 

Lime-water 1204 

Lint Bandages 1206 

1197 



Book IX 



Home Administration of Medicine 



PAET I. 
THE IDEAL HOME MEDICINE CHEST 



Purpose. — The purpose of the home medicine chest should not be to 
displace the family physician, nor to take out of his hands the work that 
legitimately belongs to him, but rather to afford a convenient and ready 
means for giving relief in cases of minor indisposition where the physician 
would in all likelihood not be summoned, and in severe ailments for giving 
temporary treatment while awaiting his arrival. The intelligent mother 
who is watchful for any departure from the normal in her children, can 
often, if suitable remedies of a simple nature be at hand, prevent the 
development of more serious maladies. 

Convenience. — Moreover, even among adults, it is often a convenience 
and a safeguard to have available such medicines as they will be most 
likely to have occasion to use in emergencies or in the absence of medical 
aid. The small expenditure of money required to procure such an outfit 
will be amply repaid by the peace of mind and ease of body which it will 
give. Before entering upon a detailed consideration of the remedies which 
it is desirable to keep in stock, a few suggestions as to the handling of 
medicines in general will not be inappropriate. 

1. How to Keep Medicines. — All medicines should be plainly labeled, 
with their names, doses and general directions for use written in ink. 
Unless for temporary use only, liquids should be kept in glass-stoppered 
bottles. Never should a bottle be used which has contained something 
else, unless it has been thoroughly cleansed and the old label either scraped 
off or sufficiently defaced to prevent recognition. It is unsafe to simply 
paste a new label on top of the old one unless this precaution is observed, 

1199 



1200 THE IDEAL HOME MEDICINE CHEST. 

for the new one may not adhere, but may fall off, and occasion liability 
to error. 

All poisonous liquids should be in blue or other dark-colored bottles 
and should have some distinctive characteristic to the touch, as a rough 
surface. They should be plainly marked "Poison/' with directions to 
follow in case of poisoning by an overdose or otherwise. They should 
also be placed in a less accessible part of the medicine chest or closet, so 
as to make it more difficult to obtain them. 

2. How to Dispense Medicines — Medicines should never be poured out 
and administered without first reading the label. No matter what degree 
of certainty may exist that the right medicine is being employed, errors 
are liable to occur, and the most careful people may under some circum- 
stances make mistakes. Accordingly the risk of these errors should be 
reduced to a minimum by a scrupulous regard for this rule, a failure to 
adhere to which may cause, as it often has, suffering and death. Again 
medicines should never be poured out into a cup or glass and allowed to 
stand, unless proper precautions are taken to prevent the contents of the 
vessel being mistaken for something else. 

Pouring. — In pouring medicine from a bottle into a measuring glass 
the latter should be held perfectly straight, on a level with the eye, and the 
medicine slowly poured out from the side opposite the label, in order to 
prevent soiling the latter by drops running down the outside of the bottle. 

Dropping. — In dropping medicines, if a dropper is not available, the 
lip of the bottle should be moistened by touching it in one spot with the 
stopper on which is a drop of the medicine. By so tilting the bottle 
that the moistened part of the lip rests against the side of the stopper at 
an angle of about forty-five degrees, the liquid may be accurately and 
readily dropped out, if the hand is at all steady. 

Measuring. — In measuring liquids in spoons, two teaspoonfuls equal 
one dessertspoonful, two dessertspoonfuls equal one tablespoonful, and 
four tablespoonfuls one wineglassful. The size of spoons, however, varies 
considerably, so that they are unreliable for accurate dosage. 

Unless directions to the contrary are given it is always safer to dilute 
medicines freely. A little water added to a dose of medicine rarely dimin- 
ishes its efficacy, whereas in its pure form it may often be too strong and 
may do harm. 



LIQUID MEDICINES. 1201 



USEFUL REMEDIES FOR THE HOUSEHOLD. 

Number of Remedies. — To be of practical value in the home the num- 
ber of such remedies to be recommended for use among the untrained 
must necessarily not be large, nor their nature complex, but such as with 
ordinary care may be used without risk, and such as with ordinary intel- 
ligence may be employed in the most common of the simpler ailments. 
Accordingly, the following are suggested as fulfilling these conditions. 
Departure from this schedule may of course be made according as in- 
dividual preference, experience, and the advice of the family physician 
may dictate. 

LIQUID MEDICINES. 

1. Aromatic Spirits of Ammonia, two ounces of. — This is a diffusible 
stimulant, acting quickly as a restorative in cases of fainting or heart 
failure. Its effect as a stimulant does not last a great while. It should be 
cautiously held to the nostrils for the patient to inhale, and as soon as he 
can swallow a half teaspoonful should be given, diluted with a wineglass- 
ful of water, care being taken not to cause choking by administering too 
rapidly. Children may take ten drops at a dose. 

It is useful also for the relief of sick stomach and of headache de- 
pendent on disordered stomach. It may also be of benefit in coughs, after 
these have become loose, to aid in expectoration. For this purpose it 
should be taken every hour or two. 

Label. — For faintness, dizziness, nausea and headache. 

Dose. — Adults, a half teaspoonful ; children, ten drops, well diluted. 

2. Whiskey, four ounces of. — As a stimulant this acts less quickly 
than the former, but its effect is of longer duration. 

Label. — Stimulant. 

Dose. — Adults, a tablespoonful ; children, a half teaspoonful, in 
water. 

3. Elixir of Valerianate of Ammonia, four ounces of. — This is useful 
for nervousness, hysterical attacks and nervous headache. A teaspoonful 
or two may be given every hour until relief is obtained, in a wineglassful 
of water. 

Label. — For nervousness, and nervous headache. 

Dose. — Adults, a teaspoonful; children, ten drops, in water. 

4. Syrup of Ipecac, two ounces of. — This is a safe and efficient emetic 
when it is desired to empty the stomach of undigested food or to relieve 

76 



1202 THE IDEAL HOME MEDICINE CHEST. 

an attack of spasmodic croup. For a child a teaspoonful should be given, 
to be repeated if necessary in a half hour. Vomiting usually occurs in 
about twenty minutes without previous nausea and without warning. In 
dry, harsh coughs, from five to fifteen drops every two hours, aids in 
loosening the cough and aiding expectoration. 

Label. — As an emetic. 

Dose. — A tablespoonf ul for an adult ; a teaspoonful for a child. As 
an expectorant, thirty drops for an adult; ten drops for a child. 

5. Sweet Spirits of Nitre, one ounce of. — For the relief of slight fever, 
and to promote the action of the skin and kidneys, this remedy has long 
been popular in domestic use. It should, however, not be kept a great 
while as age causes it to deteriorate. An adult may take a half to one tea- 
spoonful in a wineglassful of water and a child from five to ten drops. 

Label. — For fever. 

Dose. — Adults, a half teaspoonful; children, ^.ve to ten drops. 

6. Essence of Ginger, four ounces of. — This is serviceable . for flatu- 
lence and colic. A teaspoonful for an adult or from fifteen to thirty 
drops for a child ; should be taken freely diluted with hot water, and may 
be repeated in a half hour if necessary. 

Label. — For colic and flatulence. 

Dose. — Adults, a teaspoonful; children, fifteen to thirty drops, 
well diluted. 

7. Paregoric, two ounces of. — Its most frequent use is for the relief 
of pain. As it contains opium its use for infants and children should be 
guarded, and usually only under the supervision of a medical attendant. 
Nevertheless a few small doses may be given with safety in such ailments 
as colic and in diarrhoea, after any undigested substances have been gotten 
rid of by a number of movements. It is of special benefit in diarrhoea 
accompanied by pain. An adult may take a teaspoonful in a little water 
every two hours, a child ten drops or an infant two drops. A dose at the 
very beginning of a cold will often check it. An irritating cough is also 
often relieved by moderate doses of fifteen or twenty drops every two 
hours. 

Label. — For pain and diarrhoea. 

Dose. — Adults, a teaspoonful ; children, ten drops. 

8. Laudanum, four ounces of. — As this contains a much larger pro- 
portion of opium than paregoric, still greater care should be observed in 
its employment, and whenever it is possible to use the milder preparation, 
as is usually the case for internal administration, this should be done. 



LIQUID MEDICINES. 1203 

Laudanum is, however, invaluable, locally applied, in painful injuries, as 
bruises, sprains, etc. Equal parts of laudanum and water are useful for 
this purpose. The dose internally for adults is from ten to twenty drops, 
and for children two or three drops. It should not be used for infants 
without the direction of a physician. 

Label. — Poison. 

Dose. — Adults, fifteen drops for pain ; antidote, produce vomiting by 
a teaspoonful of mustard in a cup of warm water. Give hot coffee in- 
ternally and by injection. 

9. Alcohol, eight ounces of. — This is useful as an evaporating lotion 
in headache and sprains, either pure or diluted with an equal amount of 
water. Sponging the surface of the body frequently with alcohol and 
water, in fevers, helps to reduce the temperature and adds to the comfort 
of the patient. In all cases where the patient is confined to bed for any 
length of time alcohol added to the bath is useful to aid in cleansing the 
surface and in preventing the patient from taking cold. 

10. Peroxide of Hydrogen, four ounces of. — This is used as a disin- 
fectant for open wounds. Being non-poisonous, it is especially well 
adapted for use by non-professional hands. When it comes in contact with 
blood or pus active effervescence takes place. In sore throat, diphtheria, 
etc., it is valuable, diluted with an equal amount of water, as a gargle. 
It should be kept tightly corked. 

11. Camphorated Soap Liniment, or Chloroform Liniment, four ounces 
of. — Useful in sprains, muscular soreness, rheumatic affections of the 
muscles, and as a counter-irritant to the chest in cases of bronchitis. 

12. Spirits of Camphor, two ounces of. This may be used locally 
for headaches, bites of insects, etc., and inhaled through the nostrils 
for colds. 

13. Spirits of Turpentine, four ounces of. This is for external use 
and will be found of value in making turpentine stupes and also as an 
ingredient in making liniments. 

14. Lime Water and Linseed Oil (equal parts), four ounces of. This 
is sometimes called carron oil and should be kept handy for burns of 
any description. 

15. Witch-hazel, one pint of. This is for local use in bruises, sprains, 
application to hemorrhoids, etc. 

16. Lead Water and Laudanum, eight ounces of. This is for external 
use only. It is useful for sprains of all kinds and for reducing swellings. 



1204 THE IDEAL HOME MEDICINE CHEST. 



TABLETS. 



The use of compressed tablets has become so universal that a list of 
convenient remedies in this form is given. They economize space, are 
inexpensive and often more agreeable to take than liquid medicines. They 
are conveniently kept in wide-mouthed bottles, each containing an ounce, 
and provided with screw caps. 

1. Subnitrate of Bismuth, fifty tablets of, each containing five grains. 
— This is a non-poisonous and efficient remedy for nausea, vomiting and 
diarrhoea. As it is tasteless it is easily administered to children, mixed 
with a few drops of water after crushing it. The dose may be repeated 
every hour even to young children. 

2. Chalk Mixture, fifty tablets of. — These are so made that each tablet 
when crushed and mixed with water represents a teaspoonful of chalk 
mixture. In diarrhoea, especially of children and infants, this makes an 
efficient remedy, aiding in the correction of an acid condition of the intes- 
tinal discharges. The dose may be repeated every two hours. 

3. Lime-water, one hundred or more tablets of. — These are made so 
that each, when dissolved in a teaspoonful of water, shall represent a tea- 
spoonful of lime-water, and are used in sick stomach. Added to milk, in 
the proportion of one or two tablespoonfuls of the prepared lime-water to 
a half tumblerful of milk, the "biliousness" of which many people com- 
plain when taking milk is usually obviated. 

4. Pepsin, fifty tablets of, each containing five grains. — These are 
used for indigestion, one being given at each meal time. In the diarrhoea 
of infants, which is caused by a failure to properly digest their food, this 
is often markedly beneficial. 

5. Bromide of Soda, fifty tablets of, each containing five grains. — In 
headache and sleeplessness from nervous conditions and overfatigue, one 
of these may be taken every two hours, a child taking half that amount. 

6. Brown Mixture, fifty tablets of. — These are made to represent a 
teaspoonful of the liquid medicine. For coughs of a bronchial character 
a tablet may be taken every two hours. 

7. Sulphate of Quinine, fifty tablets of, each containing two grains. — 
In malarial conditions one may be taken every three or four hours. As 
a general tonic one three times a day will be useful. At the beginning 
of a cold ten grains will often check its progress. 

8. Coryza or Rhinitis, one hundred of. These are effective in the 



MISCELLANEOUS MEDICINES, 1205 

early stages of coryza or cold in the head. One or two may be given 
every one or two hours for three or four hours. 

9. Calomel (1-10 grain), or Calomel and Soda, one hundred of. One 
may be given every hour until twelve or fifteen have been given. They 
act on the liver and increase the flow of bile. 

10. Cascara (three grains), one hundred of. These produce a mild 
action on the bowels and can be given at any time without producing 
ill effect. 

MISCELLANEOUS MEDICINES. 

Seidlitz Powders, Twelve. — 1. Each dose consists of two powders 
wrapped in papers of different colors to distinguish them. One powder 
of each color is dissolved in a third of a glass of water, separately, the 
two solutions are mixed and taken while effervescing. 

Cases of acute indigestion and acute constipation, and of headache 
dependent on these conditions, are often promptly relieved by their ad- 
ministration. 

Chlorinated Lime. — 2. One-half pound of chlorinated lime, commonly 
known as chloride of lime, in a hermetically sealed package. This is 
for disinfecting purposes, a solution of it being used in the strength of 
one to twenty parts, for pouring down the drain-pipes and into the 
utensils used for receiving the discharges of the patient. If economy of 
space is not an object a quart bottle of Piatt's chlorides or of electrozone 
will be found more convenient. 

Ground Mustard. — 3. One-quarter pound can of ground mustard. 
This is useful as an emetic, from one to four teaspoonfuls being stirred 
into a pint of warm water. Externally, as a counter-irritant, it is em- 
ployed in the form of poultices, either pure or mixed with two or three 
parts of flour, to which may advantageously be added the white of an 
egg. Cases in which there is an excess of blood in the head, usually pro- 
ducing headache, are benefited by a foot-bath, into which a tablespoonful 
of mustard has been stirred. 

Bicarbonate of Soda. — 4. Two ounces of bicarbonate of soda. In some 
forms of indigestion, a pinch of soda taken before meals will be of assist- 
ance, whereas other cases are more benefited by taking it after meals. 
In cases of burns where the skin is not broken, soda applied after moist- 
ening the surface often affords relief to the pain. The same may be said 
of the stings of bees and insects. When the urine is acid, as is often the 
case in rheumatism, and when there is an irritable bladder, a good-sized 



1206 THE IDEAL HOME MEDICINE CHEST. 

pinch of soda in a little water taken every hour will aid in restoring the 
normal condition. 

Chlorate of Potash. — 5. Two ounces of chlorate of potash. A sat- 
urated solution of this in water is of value as a gargle in sore throat and 
sore mouth. 

Boric Acid. — 6. Two ounces of powdered boric acid. This has mild 
antiseptic properties and is good to dust on open wounds, abrasions, and 
so forth. A teaspoonful in a cup of boiled water, first mixing it into a 
paste, before adding the entire bulk of water, is beneficial in mild cases of 
sore eyes, or inflamed lids. 

Vaseline. — 7. Two ounces of carbolized vaseline. This is also a good 
antiseptic dressing. In burns and open wounds it is healing and soothing. 

Zinc Ointment. — 8. Two ounces of benzoinated oxide of zinc oint- 
ment. This is soothing and healing, though less antiseptic than the 
former. In many of the milder forms of skin diseases and as a dressing 
for open wounds when the healing process is nearly completed this may 
be used. 

Toothache Plasters. — 9. One box of toothache plasters. These are 
small plasters containing red pepper and other ingredients, which are 
applied to the gum of the aching tooth and often with marked relief. 

10. Mustard Plasters. — These can be secured in any quantity. They 
are simply moistened with warm water and applied when needed. 

11. Absorbent Cotton and Lint Bandages. — These can be used for 
many conditions and are especially useful in cases of accident. 

12. Antiseptic Gauze Bandages — These can be procured in various 
widths and are invaluable in dressing wounds, cuts, etc., or in applying 
to an injury or fracture. 

13. Cold Cream, two ounces of. This is a pleasant and effective 
application for rough skin, cold-sores, etc., or as a mild application for 
any condition. 

Implements. — In addition to the drugs and remedies above enumer- 
ated there are a number of appliances which should be in every medicine 
chest, the mere mention of which will in most instances be all that is 
required : 

One pair of sharp scissors about four and a half inches long. 

One glass piston syringe, preferably with soft rubber tip, to contain 
about two teaspoon fuls. 

One medicine dropper. 

One roll of prepared lint for dressings. 



MISCELLANEOUS MEDICINES. 1207 

One-quarter pound absorbent cotton. 

Six roller bandages, each three inches wide and five yards long, in 
aseptic packages, obtainable at supply stores for physicians' instruments, 
or at drug stores. 

One graduated medicine glass, marked to indicate teaspoonful, des- 
sertspoonful, tablespoonful and wineglassful. 

One box prepared mustard plasters. 

One spool adhesive plaster, one or two inches wide. To be used only 
on perfectly clean, dry surface. 

One fountain syringe. 

One hot-water bag. 

One clinical thermometer, self-registering. 

One bundle of yucca wood, a material for splints. This is prepared 
in thin strips three and a half by eighteen inches, is a porous light wood, 
which, when moistened, can be made to conform to any shape desired, 
and when allowed to dry will retain that shape. 

One alcohol lamp or one appliance to rest over the gas fixture for 
heating liquids. 

Accommodation of Medicines and Appliances — A small cabinet, or a 
shelf in a closet, or preferably a wooden box, should be provided. If the 
latter, the articles described under implements should be kept in a tray or 
drawer about four inches deep, the smaller appliances being in a separate 
section or box. 

The medicines should be below the tray, the liquids in one section, 
the solids in another. 

A box about twelve by eighteen inches, inside measurement, and ten 
inches high will accommodate all the articles described. It should be pro- 
vided with lock and key, but the latter should be attached to the handle of 
the chest or be in such an accessible place that it will not be mislaid. 



PART II OF BOOK IX 



Is a chapter on Food Hygiene, giving food com- 
positions, the relative digestibility of various foods 
and the time required to prepare them in different 



ways. 

Baking, Time Required for 1219 

Beef 1217 

Boiling, Time Required for 1218 

Bread, White Wheaten 1215 

Bread 1212 

Butter 1215 

Cheese 1215 

Chocolate 1213 

Cocoa 1213 

Corned Beef 1218 

Cow's Milk 1215 

Digestion, Table of 1213 

Eggs 1217 

Yolk 1217 

White 1217 

Foods and their Digestion 121 1 

Food Compositions 1215 

Food Hygiene 121 1 

Foods, Strength Derived from va- 
rious 1220 

Foods, Warmth Derived from Va- 
rious 1220 

Fruits 1212 

Ham, Smoked 1217 



Indian Corn 1216 

Maize 1216 

Meat 1212 

Milk 1212 

Milk, Cow's 1215 

Nutrition in Various Foods 1219 

Oatmeal 1216 

Peas 1216 

Pork, Salt 1217 

Potato 1216 

Poultry 1218 

Required Time for Boiling 1218 

Rice 1216 

Roasting, Time Required for 1219 

Salt Pork 1217 

Smoked Ham 1217 

Strength derived from Various 

Foods 1220 

Table of Digestion 1213 

Time Required for Baking 1219 

Time Required for Roasting 1219 

Vegetables 1212 

Warmth Derived from Various 

Foods 1220 



1209 



Home Administration of Medicine 



PAET II. 
FOODS AND THEIR DIGESTION 



FOOD HYGIENE. 

The world is fast awakening to the realization of the fact that in- 
efficiency and crime are closely connected with under-nourishment. Many 
of the cures effected in hospitals are the results of living under proper 
hygienic conditions and not the least of these is the right kind and amount 
of food. Every mother should study the needs of her child and furnish 
as near as in her power the proper nourishment for his growing body. 

The amount of food that an individual requires varies with the size 
of the individual and the kind of work he is doing. A clerk or a book- 
keeper requires much less food than one who has walked behind the plow 
all day. 

Some years ago a Canadian workman received an injury to the 
stomach which enabled Dr. Beaumont to make a series of experiments 
and observations upon the process of digestion which have been of great 
value. Dr. Beaumont's list of foods arranged in the order of their digesti- 
bility is as follows : Bice, tripe, whipped eggs, sago, tapioca, barley, boiled 
milk, raw eggs, lamb, roasted and baked potatoes, fricasseed chicken. 
Rice in one hour, fricasseed chicken in two and three-quarter hours, roast 
beef in three hours. A mixed diet is absolutely necessary for man. 
Many people suffer from excess of animal food — especially is this true 
of Americans — but since the cost of meat has advanced so greatly it is 
hoped the diseases caused by excessive meat diet may diminish. People 
living upon strictly vegetable diet have too small an amount of albuminous 
matter for any degree of muscle. The Chinese and Japanese are often 
cited as proof to the contrary, but while they live principally upon rice, 
their diet is supplemented by eggs, fish, pork and chicken. 

1211 



1212 FOOD AND THEIR DIGESTION. 

The nutritive value of meat is due to the presence of the proteids, 
fats and mineral salts, the carbohydrates existing only in very small 
quantities. 

Meat properly roasted or broiled is more easily digested than when 
boiled or fried. Red meats contain a large amount of nitrogenous sub- 
stance which is irritating to the kidneys. It is therefore prohibited to 
rheumatic patients and those suffering from diseases of the kidneys. 

Milk becomes a source of danger unless handled with the greatest of 
care. To obtain pure milk it is essential that the cow be not diseased, 
that the dairy is clean, and the methods of milking are clean. Pasteur- 
ized milk is the only safe method of receiving it into the home. And every 
conscientious mother investigates the source of the milk supply furnished 
her family. Cases of milk poisoning, many of them fatal, are due to the 
presence of certain bacteria found in unclean milk. Milk bottles should 
be inspected and milk cans washed in boiling water and afterwards ex- 
posed to the sun and air. Ice cream freezers should be sweet and clean, 
especially free from rust. More cases of ptomaine poisoning have been 
the result of rusty freezers than from any other cause. The regulations 
regarding milk have greatly improved in cities during recent years, but 
much remains to be done in the rural districts along that line. 

Bread is the most generally used food known. Wheat being the 
nutritious cereal and containing gluten, is the best adapted to bread mak- 
ing. It should not be too white as that shows a lack of gluten. Good 
flour holds together in a mass when squeezed by the hand and retains 
the impressions of the fingers longer than poor flour, which is sticky and 
will spread itself upon the board instead of remaining in a round shape. 
Bread must be white, sweet and spongy. Damp, mouldy bread causes 
serious digestive disturbances. Baking powders containing alum should 
be avoided. The combination of bircarbonate of soda with sour milk is 
a wholesome "leaven" and better to use than baking powders. 

Vegetables. — In preparing vegetables care should be taken in clean- 
ing them properly. Germs of infectious diseases, such as typhoid fever, 
are found in some fertilizers and vegetables washed in polluted water 
may also be a source of infection. 

Fruits when ripe are wholesome and easily digested. Children should 
be encouraged in eating apples and prunes, especially before going to 
bed. Many times they serve as laxatives without the aid of medicines. 
Bananas and figs are the most nutritious fruits and are staple articles 
of food in the Southern countries. 



TABLE OF DIGESTION. 



1213 



Cocoa and Chocolate contain about 50 per cent, of fat and are most 
nourishing beverages. They should be used with milk for children in- 
stead of tea and coffee, both of which are absolutely wrong to give a 
child under twelve years of age. 



TABLE OF DIGESTION. 



ALIMENTS. 



Form of Prepara- I Time Required for 
tion. Stomachical Digestion. 

Raw 2 hours 

Raw 2 hours, 

Raw ' i hour, 

Boiled ' 2 hours 

Broiled I '3 hours 

Boiled I |2 hours, 

Boiled 3 hours, 

Roasted ' 3 hours 

Roasted 3 hours, 30 minutes 

Broiled ' 3 hours 

Broiled j 2 hours, 

Broiled j I3 hours, 

Fried I |4 hours 

Boiled ' 4 hours, 

Boiled ! ,3 hours, 

Boiled 1 hour, 

Baked I 3 hours, 

Baked ' 3 hours, 

Melted ( [3 hours, 

Raw I [2 hours, 

Raw I [2 hours, 

Boiled I \2 hours 

Baked \ 4 hours, 30 minutes 

Baked I J3 hours 

Boiled I 2 hours, 

Boiled I ! 3 hours, 

Fried ' '4 hours, 

Raw I '3 hours, 

Fricassee I '3 hours, 

Boiled [ 2 hours, 

Boiled ( I2 hours 

Baked I 3 hours, 

Roasted | 2 hours, 

Roasted ' 4 hours 

Boiled ' 4 hours, 30 minutes 

Hard boiled 3 hours 

Soft boiled 3 hours, 

Fried ! '3 hours, 

Roasted I '2 hours, 



Apples — mellow 

Apples — sour, hard 

Apples — sweet, mellow 

Barley 

Bass — fresh 

Beans — pod 

Beans and Green Corn 

Beef — fresh, lean, rare 

Beef — fresh, lean, dry 

Beef — fresh steak 

Beef — with salt only 

Beef — with mustard, and so forth 

Beef 

Beef — old hard, salted 

Beets 

Brains — animal 

Bread — corn 

Bread — wheat, fresh 

Butter 

Cabbage — head 

Cabbage — with vinegar 

Cabbage 

Cake — corn 

Cake — sponge 

Carrot 

Cartilage 

Catfish — fresh 

Cheese — old, strong 

Chicken 

Codfish — cured, dry 

Corn (green) and Beans 

Custard 

Duck — domesticated 

Duck — wild 

Dumpling — apple 

Eggs — fresh 

Eggs — fresh 

Eggs — fresh 

Eggs — fresh 



50 minutes 
50 minutes 



30 minutes 
45 minutes 



45 minutes 
30 minutes 

15 minutes 
45 minutes 
45 minutes 
15 minutes 
30 minutes 
30 minutes 
30 minutes 
30 minutes 



30 minutes 
15 minutes 
15 minutes 
30 minutes 
30 minutes 
45 minutes 

45 minutes 
45 minutes 



30 minutes 
30 minutes 
15 minutes 



1214 



FOOD AND THEIR DIGESTION. 



ALIMENTS. 



'Form of Prepara- 


Time Required for 


tion. 


Stomachical Digestion. 


Raw 


2 hours 


Whipped 


i hour, 30 minutes 


Fried 


3 hours, 30 minutes 


Boiled 


4 hours 


Roasted ' 


4 hours 


Boiled 


2 hours, 30 minutes 


Roasted 


2 hours, 30 minutes 


Fried 


4 hours 


Boiled 


2 hours, 30 minutes 


Boiled ' 


2 hours 


Boiled 


2 hours, 40 minutes 


Hashed 


2 hours, 30 minutes 


Boiled 


2 hours 


Raw 


2 hours, 15 minutes 


Roasted 


3 hours, 15 minutes 


Broiled 1 


3 hours 


Boiled 


3 hours 


Raw ! 


.(2 hours, 55 minutes 


Roasted ! 


3 hours, 15 minutes 


Stewed 


3 hours, 30 minutes 


Boiled 


2 hours, 30 minutes 


Roasted \ 


2 hours, 30 minutes 


Boiled ' 


1 hour 


Roasted ! 


5 hours, 15 minutes 


Boiled 


4 hours, 30 minutes 
'4 hours, 15 minutes 


Fried 


Broiled 


3 hours, 15 minutes 


Raw ! 


3 hours 
3 hours 


Stewed 


Boiled 


3 hours, 30 minutes 


Roasted 


2 hours, 30 minutes 


Baked 


3 hours, 20 minutes 


Boiled 


1 hour 


Boiled 


[1 hour, 45 minutes 


Boiled 


4 hours 


Broiled 


3 hours, 20 minutes 


Boiled 


1 hour, 30 minutes 


Boiled 


3 hours 


Boiled 


4 hours 


Boiled 


3 hours 


Boiled 


4 hours, 15 minutes 


Boiled 


3 hours, 20 minutes 


Boiled 


3 hours, 30 minutes 


Boiled 


5 hours, 30 minutes 


Boiled 


4 hours, 30 minutes 


Boiled ! 


\2 hours 


Boiled 


5 hours, 30 minutes 



Eggs — fresh 

Eggs — fresh 

Flounder— fresh 

Fowls — domestic 

Fowls — domestic 

Gelatin 

Goose — wild 

Heart — animal 

Lamb — fresh 

Liver — beef's, fresh 

Marrow — animal, spinal 

Meat and Vegetables 

Milk 

Milk 

Mutton — fresh 

Mutton — fresh 

Mutton — fresh 

Oysters — fresh 

Oysters — fresh 

Oysters — fresh 

Parsnips 

Pig — suckling 

Pig's-feet — soused 

Pork — fat and lean 

Pork — recently salted 

Pork — recently salted 

Pork — recently salted 

Pork — recently salted 

Pork — recently salted 

Potatoes — Irish 

Potatoes — Irish 

Potatoes — Irish 

Rice 

Sago 

Salmon — salted 

Sausage: — fresh 

Soup — barley 

Soup — bean 

Soup — beef, vegetables and bread 

Soup — chicken 

Soup — marrow bones 

Soup — mutton 

Soup — oyster 

Suet — beef, fresh 

Suet — mutton 

Tapioca , 

Tendon — boiled 



FOOD COMPOSITIONS. 



1215 



ALIMENTS. 



Form of Prepara- 
tion. 

Boiled 

Boiled 

Fried 

Roasted 

Boiled 

Roasted 

Boiled 

Broiled 

Fried 

Warmed 

Broiled 



Time Required for 
Stomachical Digestion. 



Tripe — soused 

Trout — salmon, fresh 

Trout — salmon, fresh 

Turkey — domestic 

Turkey — domestic 

Turkey — wild 

Turnips 

Veal — fresh 

Veal — fresh 

Vegetables and Meat — hashed 
Venison — steak 



i hour 
i hour, 
i hour, 
2 hours, 
2 hours, 

2 hours, 

3 hours, 

4 hours 
4 hours, 
2 hours, 
i hour, 



30 minutes 
30 minutes 
30 minutes 
25 minutes 
18 minutes 
30 minutes 

30 minutes 
30 minutes 
35 minutes 



FOOD COMPOSITIONS 

Cow's Milk.— In 100 parts- 
Water 86.8 

Albuminoids 4 

Fats 3.7 to 4.50 

Sugar 4.8 

Salts 0.7 

Butter — In 100 parts — 

Fats 88 

Albuminoids . 3.3 

Water 6 

Salts (variable) 2.7 

Cheese. — In 100 parts — 

Fats 24.3 

Albuminoids 33.5 

Water . 36.8 

Salts 5.4 

White Wheaten Bread. — In 100 parts — 

Carbohydrates 50.2 

Albuminoids (nitrogenized matters) 7.5 

Salts 1.6 

Fats 1.5 

Water 39.2 



1216 FOOI> AND THEIR DIGESTION. 

Oatmeal. — In 100 parts — 

Water 15 

Albuminoids 12.6 

Tats 5.6 

Carbohydrates 63 

Salts 3 



Rice — In 100 parts- 
Water 10 

Albuminoids 5 

Fats 0.8 

Carbohydrates 83. 

Salts 0.5 



Maize, Indian Corn. — In 100 parts — 

Water 13.5 

Albuminoids 10 

Fats 6.7 

Carbohydrates 64.5 

Salts 1.4 



Peas.— In 100 parts- 
Water 15 

Albuminoids 22 

Fats 2 

Carbohydrates 53 

Salts 2.4 



Potato — In 100 parts- 
Water . 74 

Albuminoids 2 

Fats 0.16 

Carbohydrates 21 

Salts 1 



FOOD COMPOSITIONS. 1217 

Egg. — Ten per cent, of weight deducted for shell. 

Water 73.5 

Albuminoids 13.5 

Fats 11.6 

Salts 1.4 

Eggs, Yolk- 
Water 51.5 

Albuminoids 15 

Fats 30 

Salts . 1.5 

Eggs, White 

Water 84.5 

. Albuminoids 13.5 

Fats 3 

Salts 1.3 

Beef. — Little fat ; best quality. 

Water . ; . 74.4 

Albuminoids ... f ... 20.5 

Fats 3.5 

Salts 1.6 

Beef — Roast or boiled, with drippings. 

Water 54 

Albuminoids 27.6 

Fats 15.45 

Salts . 2.95 

Pork, Salt 

Water 44.1 

Albuminoids 26.1 

Fats i 7 

Salts 22.8 

Smoked Ham. — 

Water 27.8 

Albuminoids . 24 

Fats 36.5 

Salts 10.1 

77 



1218 FOODS AND THEIR DIGESTION. 

Poultry 

Water 74 

Albuminoids 21 

Fats 38 

Salts 1.2 

(Letheby.) 

Chicago Corned Beef. — 

Water 52.2 

Albuminoids 23.3 

Fats 14 

Salts 4 

TIME REWIRED FOR BOILING. 

(Much depends upon the freshness and age of the articles.) 

For each pound of corned beef 30 minutes 

For each pound of beef 15 to 30 minutes 

For each pound of veal 15 to 20 minutes 

For shoulder of mutton weighing 5 to 6 pounds 1 hour 

For leg of mutton, for each pound 20 minutes 

For leg of lamb 15 minutes 

For tongue of beef 4 hours 

For ham, for each pound V2 hour 

For turkey, for each pound 20 minutes 

For brill 10 to 15 minutes 

For turbot (4 to 5 pounds) 20 to 30 minutes 

For haddock 15 to 30 minutes 

For mackerel 20 to 30 minutes 

For salmon, to each pound 8 minutes 

For skate 30 to 60 minutes 

For whiting 5 to 15 minutes 

For cod (only simmer) 1 hour 

For fish in general, to each pound 10 minutes 

For carrots 1 hour 

For turnips, parsnips, cabbage, seakale 1 hour 

For cauliflower, onions, beans (young) 1 hour 

For peas (young), squash (spring) Vi hour 

For dried peas 2 hours 

For winter squash (steam) 2 hours 

For oyster-plant 1 hour 

For beets (young) 1 to 2 hours 

For beets (old) 3 to 8 hours 

For asparagus (young) Vi hour 

For asparagus (old) 1 hour 

For artichokes 1 hour 

For winter carrots, parsnips, turnips and cabbage 2 hours 

For corn 10 to 15 minutes 



PERCENTAGE OF NUTRITION IN FOOD. 1219 



TIME REQUIRED FOR ROASTING. 

For beef (rare), to each pound 10 minutes 

For beef (well-done), to each pound 15 to 20 minutes 

For mutton, to each pound 15 minutes 

For veal, to each pound 20 minutes 

For turkey, to each pound 10 to 12 minutes 

For duck (game) y 2 hour 

For duck (tame) 1 hour 

For capon — 50 to 60 minuses 

For fowl 60 minutes 

For pigeon 15 to 30 minutes 

For pheasant 35 minutes 

For partridge, woodcock or plovers 15 minutes 

For grouse, snipe, small birds 20 minutes 

For larks 6 minutes 

For hare 1V2 hours 

For rabbits .20 to 60 minutes 

For goose 2 hours 

TIME REQUIRED FOR BAKING. 

For potatoes (with or without skins) 1 hour 

For egg-plant and tomatoes 1 hour 

For omelet 15 to 20 minutes 

For eggs (until they set) 15 to 20 minutes 

For shad . . 1 hour 

For cod. black fish and haddock, 4 pounds 1 hour 

For fish generally, 4 to 6 pounds I hour 

For clams 20 minutes 

PERCENTAGE OF NUTRITION IN VARIOUS ARTICLES OF FOOD. 

Raw Cucumbers 2 Raw Beef 26 

Raw Melons 3 Raw Grapes 27 

Boiled Turnips 4Y2 Raw Plums 29 

Milk 7 Broiled Mutton 30 

Cabbage 7Y2 Oatmeal Porridge 75 

Currants 10 Rye Bread 79 

Whipped Eggs 13 Boiled Beans 87 

Beets 14 Boiled Rice 88 

Apples 16 Barley Bread 88 

Peaches 20 Wheat Bread 90 

Boiled Codfish 21 Baked Corn Bread 91 

Broiled Venison 22 Boiled Barley 92 

Potatoes 22 1 A Butter 92 

Fried Veal 24 Boiled Peas 93 

Roast Pork 24 Raw Oils 95 

Roast Poultry 26 



1220 



FOODS AND THEIR DIGESTION. 



WARMTH AND STRENGTH DERIVED FROM VARIOUS ARTICLES OF 

FOOD AND DRINK. 



Grains of Strength Yielded by One 
Pound of 7,000 Grains. 

Grains. 

Beer or Porter 1 

Parsnips 12 

Turnips 12 

Whey 13 

Greens 14 

Skimmed Milk 34 

New Milk . 35 

Buttermilk 35 

Barley 70 

Rice 70 

Bacon 78 

Rye Bread 89 

Baker's Bread 90 

Pearl Barley 91 

Fresh Pork 108 

Seconds Flour 120 

Cornmeal 125 

Fresh Fish 129 

Cocoa 130 

Oatmeal 140 

Mutton 140 

Fresh Beef 172 

Beef Liver 200 

Split Peai 250 

Cheddar Cheese 310 

Skim Milk Cheese 360 



Grains of Warmth Yielded by One 
Pound of 7,000 Grains. 

Grains. 

Whey 150 

Turnips 238 

Beer and Porter 315 

Buttermilk 335 

Skimmed Milk 351 

New Milk 378 

Carrots 399 

Parsnips .. 425 

Potatoes 770 

Fresh Fish 980 

Beef Liver 1,220 

Red Herrings M55 

Baker's Bread 1,990 

Fresh Beef 2,300 

Molasses 2,300 

Skim Milk Cheese 2,350 

Cheddar Cheese 2,550 

Seconds Flour ! 2,700 

Rye Bread 2,700 

Rice 2,750 

Barley Meal 2,780 

Indian Meal 2,800 

Sugar 2,900 

Fresh Pork 3 ,100 

Bacon 4,200 

Butter 4,700 

Lard 4,800 

Drippings 5,500 



PART III OF BOOK IX 

Gives the various weights and measures used in 
medicine, tables of doses and several statistical tables. 



Administering Laudanum 1224 

Approximate Equivalents, Table of.. 1 124 

Average Pulse Rate 1225 

Birth Table 1227 

Body, Composition of 1228 

Death-rate Table 1226 

Dentition Table 1226 

Drug, Fractional Doses of 1225 

Expectation of Life at Various 

Ages 1229 

Female Death-rate Table 1226 

Fractional Doses of a Drug .1225 

Laudanum, Administering 1224 

Length of Life .in Various Occupa- 
tions 1227 

Length of Life, Table of 1227 

Life, Expectation of at Various 

Ages 1229 

Liquids 1223 

Male Death-rate Table 1226 

Man, Stature of 1228 

Man, Weight of 1228 

Marriage Table 1227 

Measures in Metric System 1225 

Measures, Table of 1223 



Metric System 1225 

Milk Teeth 1226 

Permanent Teeth 1226 

Pulse Rate 1225 

Regulating Doses of Medicine 1224 

Solids 1223 

•Stature of Man 1228 

System, Metric 1225 

Table for Administering Laudanum . 1224 

Approximate Equivalents 1224 

Birth 1227 

Death-rate 1226 

Death Statistics 1227 

Dentition 1226 

Doses of Medicine 1224 

Marriage 1227 

Weights and Measures 1223 

Teeth 1226 

Milk 1226 

Permanent 1226 

Various Occupations, Length of Life 

in 1227 

Weight of Man 1228 

Weights in Metric System 1225 

Weights, Table of 1223 



1221 



Home Administration of Medicine 



PAKT III. 
TABLES OF WEIGHTS AND MEASURES 



Table of Weights and Measures Used in the Preparation of Medicines- 
Doses and So Forth. 

SOLID. 

20 grains equal 1 scruple equals 20 grains. 
60 grains equal 1 drachm equals 3 scruples. 
480 grains equal 1 ounce equals 8 drachms. 
5760 grains equal 1 pound equals 12 ounces. 
In some places the use of the terms scruple and drachm have 
been discarded; and where formerly wine measure was employed, what 
is known as Imperial measure is now used. 

LIQUID. 

In mixing medicines measures of capacity are now frequently used. 
The following tables of Minims and their equivalents will be found useful : 
60 minims equal 1 fluid drachm equals 60 minims. 
480 minims equal 1 fluid ounce equals 8 fluid drachms. 
9600 minims equal 1 pint equals 16 fluid ounces 
76800 minims equal 1 gallon equals 8 pints. 
A minim is the smallest liquid measure, being equal to about one 
drop. The minim, however, is an exact measurement, being l-60th part 
of a fluid drachm ; and it is indicated on all properly graduated medicine 
glasses, while the drop varies somewhat according to the consistency of 
the fluid, and is also affected by the vessel or utensil from which the medi- 
cine is dropped, as for instance one medicine dropper may have a larger 

1223 



1224 TABLES OF WEIGHTS AND MEASURES. 

opening than another and the quantity of medicine will vary accordingly. 
It follows that when exact measurement is required it is always 
best to use the minim instead of the drop. 

A TABLE OF APPROXIMATE EQUIVALENTS. 

A tumbler contains about 8 fluid ounces. A teacup contains about 
4 fluid ounces. A wineglass contains about 2 fluid ounces or 4 tablespoon- 
fuls. A tablespoon contains about one-half a fluid ounce or 4 fluid drams. 
A dessertspoon contains about one-fourth a fluid ounce or 2 fluid drams. 
A teaspoon contains about one fluid dram. 

One teaspoonful equals 60 to 80 drops. Four large tablespoonfuls 
equal one-half gill. Eight large tablespoonfuls equal one gill. Sixteen 
large tablespoonfuls equal one-half pint. 

The sizes of spoons vary considerably and therefore cannot be relied 
upon for accurate measurements. Where this is necessary graduated 
glass must be used. 



TABLE FOR REGULATING THE DOSES OF MEDICINE 

Take the dose for an adult as one teaspoonful: 

1 year old dose 5 drops 

2 years old dose 7 drops 

3 years old dose 10 drops 

4 years old dose 15 drops 

7 years old dose 20 drops 

14 years old dose 30 drops 

20 years old dose 40 drops 

From 20 to 6b years old dose 60 drops 



GRADUATED TABLE FOR ADMINISTERING LAUDANUM. 

For a child at birth, or 1 month old % to 1 drop 

Under a year old Vi to 3 drops 

From 1 to 2 years 1 to 5 drops 

From 2 to 5 years 2 to 8 drops 

From 5 to 10 years 5 to 15 drops 

From 10 to 15 years 10 to 20 drops 

At 15 years 15 to 20 drops 

For an adult 25 to 30 drops 



UNUSUAL DOSES OF A DRUG. 1225 

METRIC SYSTEM OF WEIGHTS AND MEASURES. 

1 kilogram equals 2.2 avoirdupois pounds. 

500 grams equal 17 avoirdupois ounces plus 279 grs. 

453.6 grams equal 16 avoirdupois ounces (1 pound). 

31.1 grams equal 1 troy ounce (480 grs.). 

30 grams equal 1 avoirdupois ounce plus 25 grs. 

28.3 grams equal 1 avoirdupois ounce (437.5 grs.). 

1 gram equals 15.43 grs. 

0.1 gram (1 decigram) equals 1^ grs. 

0.065 gram equals 1 gr. 

0.01 gram (1 centigram) equals 1-6 gr. 

0.001 gram (1 milligram) equals 1-65 gr. 

1 liter equals 33.8 fluid ounces. 

946 cc. equal 32 fluid ounces (1 quart). 

500 cc. equal 16.9 fluid ounces. 

473 cc. equal 16 fluid ounces (1 pint). 

100 cc. equal 3.38 fluid ounces. 

30 cc. equal 1 fluid ounce. 

15 cc. equal 4 fluid drachms. 

1 cc. equals 16.2 minims. 

PULSE RATE (Average). 

Foetus 150-130 per minute. 

New-born infant 140-130 per minute. 

Under 1 year 130-115 per minute. 

Under 2 years 115-100 per minute. 

2-7 years 100- 90 per minute. 

14-21 years . 85- 75 per minute. 

21-65 years 75- 65 per minute. 

In old age 85- 70 per minute. 

In health the pulse rate varies not only with the age, but is affected 
by such conditions as sex, temperament, excitement, food and temperature. 

ADMINISTRATION OF UNUSUAL FRACTIONAL DOSES OF A DRUG. 

Dr. M. S. Aaronson, of New York, has devised a rule whereby one 
may readily administer any fractional dose of a drug, starting out with 
one of the standard tablets of known strength. Thus, if one has a tablet 



1226 



TABLES OF WEIGHTS AND MEASURES. 



of morphine containing one-eighth of a grain, and if it is desired to ad- 
minister one-sixty-sixth of a grain of this drug, the procedure is as fol- 
lows: Take sixty-six minims of water and in this dissolve the tablet. 
Eight minims of this solution contains the required dose. This rule is 
applicable in the administration of any fractional dose, whether or not the 
denominator of the fraction is a multiple of the denominator of the frac- 
tion represented in the tablet. 

DENTITION TABLE (Average). 

Milk Teeth. — Dentition usually begins at the sixth or seventh month 
and should be completed by the second year. 

Central incisors, lower, 6th month; upper, 7th month. 
Lateral incisors, upper, 9th month ; lower, 10th month. 
First molars, 12th month. 
Second molars, 2nd year (may be later). 
Permanent Teeth 

First molars 6^ years. 

Lower central incisors 7 years. 

Upper central incisors 8 years. 

Lateral incisors 9 years. 

First bicuspid 10 years. 

Second bicuspid 11 years. 

Canines 12 years. 

Second molars 13 years. 

Third molars (wisdom) 17-25 years, (or later.) 

TABLE SHOWING THE DEATH-RATE PER 1,000 OF EACH SEX IN EACH 
OF THE THREE CONDITIONS OF LIFE. 



AGES. 


Males. 


Females. 




Unmarried. 


Married. 


Widowert. 


Unmarried. 


Married. 


Widow$. 


20-25 

25-30 

30-35 

35-40 

40-45 

45-50 

50-55 

55-60 

60-65 

65-70 


12.88 
10.17 
n.51 
1315 
16.62 
19.60 
25.80 
32.10 
45.92 
58.50 


8.92 
6.24 
6.82 

7.52 

9-55 
11.47 
15.61 
21.50 
32.60 
4480 


49.60 
21.84 
19.17 
1750 
18.89 
22.20 
26.80 
34-17 
47.50 
62.97 


8.32 
9.02 
9.87 
IO.87 
13.28 
I57I 
20.97 
26.OO 
40.52 
58.30 


992 

8.98 

936 

9.29 

IO.I4 

IO.69 

i4.II 

19.29 

30.75 

45-30 


12.31 
23.62 
l6.00 
15.03 
12.73 
I330 
15.20 
24.47 
37-07 
5350 



INSTRUCTIVE HEALTH TABLES. 



1227 



BIRTH, MARRIAGE, AND DEATH STATISTICS. 

The following interesting table gives a comparative view of the fertility of marriages, 
the legitimacy and illegitimacy of births, and the mortality in city and country in 
the various European States : 



COUNTRIES. 


Children to 
One Marriage. 


Infant 
Mortality. 


Adult Mortality, 


Fertility of 
Marriage. 


Illegitimate to 
Legitimate Birhts. 




City. 


Country. 


City. 


Country. 


City. 


Country. 


CUy. 


Coun- 
try 


CUy. 


Country. 


France 

Netherlands. . 
Belgium .... 

Sweden 

Denmark 

Schleswig . . . 
Holstein .... 

Saxony 

Hanover 

Prussia 


3.16 
3.91 
3.80 
2.99 
3.04 
3.50 
3.37 
4.60 
2.93 
4.00 


3.28 
4.32 
4.17 
4.19 
3.34 
3.69 
3.88 
4.13 
3.65 
4.44 


*35.69 
36.25 

38.86 
29.66 
27.42 
29.92 
39.88 
28.70 
36.02 


*28.56 
28.90 

24.50 
22.68 
23.42 
25.29 
36.22 
26.47 
29.47 


1:21.51 
1:35.55 
1:34.35 
1:28.95 
1:37.41 
1:35.17 
1:38.73 
1:31.10 
1:38.52 
1:27.97 


1:42.21 
1:43.03 
1:44.31 
1:46.86 
1:49.77 
1:48.49 
1:44.15 
1:34.70 
1:41.17 
1:34.46 


2.03 

2.49 

1.83 
2.14 
2.54 
2.36 
2.77 
2.08 
2.56 


2.34 
3.07 

3.16 
2.58 
2.83 
2.90 
2.64 
2.68 
3.13 


*15.13 

7.7 
14.59 
27.44 
16.45 

8.38 
15.50 
15.39 
17.42 

9.80 


*4.24 
2.84 
5.88 
7.50 

10.06 
6.37 
8.74 

14.64 
9.06 
6.60 



The 



* Per cent. 

AVERAGE LENGTH OF LIFE IN VARIOUS OCCUPATIONS. 

Report of Registration of the State of Massachusetts shows that the average 
length of life of the various trades and professions has been as follows : 



Occupations. 



Farmers 

Millers 

Sawyers 

Physicians 

Hatters 

Clock and Watchmakers 

Carpenters and Joiners 

Blacksmiths 

Sailmakers 

Woodturners 

Combmakers 

Masons 

Butchers 

Tanners 

Cabinetmakers 

Gunsmiths 

Carriagemakers 

Harnessmakers 

Brickmakers 

Woolsorters 

Leatherdressers 

Laborers 

Musical Instrument Makers.. 

Tailors 

Architects 

Bakers 

Dressmakers (women) 

Seamen 

Stonecutters 

Coppersmiths 

Silver and Goldsmiths 

Dyers 

Mechanics 

Painters 



Years. 



65.19 
57-43 
56.67 
55.08 
54-55 
5443 
5331 
5331 
52.84 
52.55 
51.38 
50.48 
50.29 
50-05 
48.65 
48.57 
48.38 
48.36 
47-99 
47.55 
47.41 
47-39 
4732 
47.19 
47.15 
46.76 

46.49 
46.33 
46.30 
46.07 
4546 
45-35 
45.13 
45.05 



Occupations. 



Weavers 

Artists 

Shoemakers 

Brushmakers 

Furnace Men 

Founders 

Shoecutters 

Pianofortemakers 

Glasscutters 

Civil Engineers 

Cigarmakers 

Engineers 

Musicians 

Tinsmiths 

Expressmen 

Nailmakers 

Machinists 

Jewelers 

Servants (women) 

Teamsters 

Bookbinders 

Upholsterers 

Barbers 

Pail and Tubmakers . . . 

Cutlers 

Operatives 

Printers 

Engineers and Firemen 

Drivers 

Milliners 

Glassblowers 

Plumbers 

Carvers 

Operatives (women) 



Years. 



44.65 
44.56 
44-45 
4340 
43.05 
42.73 
42.62 
42.50 
42.39 
42.34 
41.59 
41.57 
41.19 
40.06 

40.94 
40.80 
40.80 
40.29 
40.19 
40.13 
3994 
3978 
3977 
39.50 
3923 
38.92 

38.57 
38.21 
38.16 
3730 
37.8i 
3543 
33.84 
27.98 



1228 



TABLES OF WEIGHTS AND MEASURES. 



AVERAGE WEIGHT AND STATURE OF MAN. 



Males. 




Females. 




Age. 


Feet. 


Pounds. 

7.06 

25.01 

31.38 

38.80 

49-95 

49-77 

75.8i 

96.40 

116.56 

127.59 

13246 

140.38 

140.42 

139.96 

136.07 

I3L27 

127.54 

127.54 


Age. 


Feet. 


Pounds. 


o years 

2 years 

4 years 


1.64 
2.60 
304 
3-44 
4.00 
4-36 
4.72 
5.07 
5.36 
5-44 
5-49 
5.52 
5.52 
5-49 
5.38 
5.32 
5.29 
5.29 


years 

2 years 

4 years 

6 years 

9 years 


1.62 
2.56 
300 
3.38 
3.92 
4.26 
4.60 
4.92 
510 
5.13 
5.16 
5.i8 
5.i8 
5-04 
4-97 
4-97 
4-94 
4-94 


6.42 

23.53 
28.67 

35.29 
47.10 
56.57 
72.65 
89.04 


6 years 

9 years 


ii years 

13 years 


11 years 

13 years . 


15 years 


15 years 


17 years 


17 years 


104.34 
112.55 


18 years 


18 years 

20 years 

30 years 


20 years 

30 years 


115.30 
119.82 


40 years 


40 years 


121.81 


50 years 


50 years 


123.86 


60 years 

70 years 


60 years 

70 years 


119.76 
113.60 
108.80 
108.81 


80 years 

90 years 


80 years 

90 years 









COMPOSITION OF THE HUMAN BODY. 



Elements. 



1. Water, which is found in every part of the body, and 

amounts to 

2. Fibrine, and like substances, found in the blood, and 

form the chief solid materials of the flesh 

3. Phosphate of lime, chiefly in bones and teeth, but in all 

liquids and tissues 

4. Fat, a mixture of three chemical compounds, and dis- 

tributed all through the body 

5. Osseine, the organic framework of bones ; boiled, gives 

gelatine. Weighs 

6. Keratine, a nitrogenous substance, forming the greater 

part of hair, nails and skin. Weighs 

7. Cartilagine resembles the osseine or bone, and is a 

nitrogenous substance, the chief constituent of car- 
tilage, weighing 

8. Hemoglobine gives the red color to the blood, and is a 

nitrogenous substance containing iron, and weighing 

9. Albumen is a soluble nitrogenous substance found in 

the blood, chyle, lymph and muscle, and weighs 

10. Carbonate of lime is found in the bones chiefly, and 

weighs 

11. Kephalin is found in nerves and brain, with cerebrine 

and other compounds 

12. Fluoride of calcium is found in teeth and bones, and 

weighs 

13. Phosphate of magnesia is also in teeth and bones, and 

weighs 

14. Chloride of sodium, or common salt, is found in all 

parts of the body, and weighs 

15. Cholesterin, glycogen and inosite are compounds con- 

taining hydrogen, oxygen and carbon, found in 
muscle, liver and brain and weighing 

16. Sulphate, phosphate and salts of sodium, found in all 

tissues and liquids 

17. Sulphate, phosphates and chloride of potassium are also 

in all tissues and liquids 

18. Silica, found in hair, skin and bone 



Pounds. 


Ounces. 


109 


O 


15 


IO 


8 


12 


4 


8 


! 4 


7 


4 


2 


1 


8 


1 


8 


1 


1 


1 


1 





13 





7 





7 





7 





3 





2 















Grains. 

O 
O 

o 
o 

350 



o 
o 
o 
o 
o 

175 

o 
o 



107 

300 
30 



154 



EXPECTATION OF LIFE AT VARIOUS AGES. 



1229 



EXPECTATION OF LIFE AT VARIOUS AGES. 



Age. 


Male. 


Fern. 


Age. 


Male, 


Fern. Age. 


Male. 


Fern. 


Age. 


Male. 


Fern. 


o year 


3991 


41.85 


25 years 


36.12 


37-04 


50 years 


19.54 


20.75 


75 years 


6.49 


6.93 


I year 


46.65 


4731 


26 years 


35-44 


36.39 


51 years 


18.90 


20.09 


76 years 


6.15 


6.56 


2 years 


48.83 


49.40 


27 years 


3477 


35-75 


52 years 


18.28 


19.42 


77 years 


5.82 


6.21 


3 years 


49.61 


50.20 


28 years 


34-IO 


35-io 


53 years 


17.67 


18.75 


78 years 


5.51 


5-88 


4 years 


49.81 


50.43 


29 years 


3343 


34-46 


54 years 


17.06 


18.08 


79 years 


521 


5.56 


5 years 


49.71 


50.33 


30 years 


32.76 


33.8i 


55 years 


16.45 


17-43 


80 years 


4-93 


5.26 


6 years 


49.39 


50.00 


31 years 


32.09 


33.17 


56 years 


15.86 


16.79 


81 years 


4.66 


4.08 


7 years 


48.92 


49.53 


32 years 


31.42 


32.53 


57 years 


15.26 


l6.I7 


82 years 


441 


4-71 


8 years 


48.37 


48.08 


33 years 


30.74 


31.88 


58 years 


14.68 


15.55 


83 years 


4-17 


4-45 


9 years 


47-74 


48.35 


34 years 


30.07 


3123 


59 years 


14.10 


14.94 


84 years 


3-95 


4.21 


io years 


47.05 


47.67 


35 years 


29.40 


30.59 


60 years 


13.53 


14.34 


85 years 


3-73 


3-98 


II years 


46.31 


46.95 


36 years 


28.73 


29.94 


61 years 


12.96 


I375 


86 years 


3-53 


3-76 


12 years 


45-54 


46.20 


37 years 


28.06 


29.29 


62 years 


12.41 


W7 


87 years 


3-34 


3-56 


13 years 


44.76 


4544 


38 years 


27.39 


28.64 


63 years 


11.87 


I2.60 


88 years 


3.16 


336" 


14 years 


43-97 


44-68 


39 years 


26.72 


27.99 


64 years 


11.34 


12.05 


89 years 


3.00 


3.18 


15 years 


43.18 


43.00 


40 years 


26.06 


27.34 


65 years 


10.82 


II.5I 


90 years 


2.84 


301 


16 years 


42.40 


43.14 


41 years 


25.39 


26.69 


66 years 


10.32 


IO.98 


91 years 


2.69 


2.85 


17 years 


41.64 


42.40 


42 years 


2473 


26.03 


67 years 


9.83 


10.47 


92 years 


2-55 


2.70 


18 years 


40.90 


4I.67 


43 years 


24.07 


25.38 


68 years 


9.36 


9-97 


93 years 


2.41 


2-55 


19 years 


40.17 


40.97 


44 years 


2341 


24.72 


69 years 


8.00 


948 


94 years 


2.29 


2.42 


20 years 


3948 


40.29 


45 years 


22.76 


24.06 


70 years 


8.45 


9.02 


95 years 


2.17 


2.29 


21 years 


38.80 


39.63 


46 years 


22.11 


23.40 


71 years 


8.03 


8.57 


96 years 


2.06 


2.17 


22 years 


38.13 


38.98 


47 years 


21.46 


22.74 


72 years 


7.62 


8.13 


97 years 


1-95 


2.06 


23 years 


3746 


38.33 


48 years 


20.82 


22.08 


73 years 


7.22 


7.71 


98 years 


1.85 


1.96 


24 years 


36.79 


37-68 


49 years 


20.17 


21.42 


74 years 


6.85 


7>3i 


99 years 
100 years 


1.76 
1.68 


1.86 
1.76 



PART IV OF BOOK IX 

Gives more than one hundred standard medical 
prescriptions and simple formulas for many diseases. 



Abscesses 1233 

Acute Diarrhoea 1236 

Acute Dysentery 1237 

Acute Rheumatism 1242 

Amenorrhea 1243 

Asthma 1233, 1245 

Bed, Wetting of 1244, 1248 

Bilious Headache 1238 

Biliousness 1233 

Bleeding from Lungs 1246 

Boils 1233, 1246 

Breast, Inflammation of 1239 

Bronchitis 1234 

Bronchitis, Acute 1234 

Bunions 1234 

Burns 1234 

Carbuncle 1234 

Catarrh 1234 

Catarrh, Nasal 1234 

Catarrh, Faucial 1235 

Chilblains 1235 

Cholera, Sun 1235 

Cholera Infantum 1235 

Cholera Morbus 1235, 1246 

Chronic Diarrhcea 1237 

Chronic Dysentery 1237 

Chronic Rheumatism 1242 

Colic, Infantile 1236 

Conjunctivitis 1243 

Convulsions, Infantile 1236 

Constipation 1236, 1246 

Croup 1246 

Croup, Simple 1236 

Diarrhoea 1246 

Acute 1236 

Chronic 1237 

Diphtheria 1237 

Dropsy 1246 

Dysentery 1247 



Acute ! 1237 

Chronic 1237 

Dyspepsia, Flatulent 1237 

Gastric 1237 

Nervous 1237 

Earache 1238, 1247 

Erysipelas 1238 

Eyes, Sore 1243 

Faucial Catarrh 1235 

Fits, Infantile 1236 

Flatulence 1238 

Flatulent Dyspepsia 1237 

Gastric Dyspepsia 1237 

Gout 1247 

Gravel 1247 

Hay Fever 1238 

Headache, Bilious 1238 

Nervous 1238 

Heart-Burn 1239, 1247 

Hiccough 1239 

Heat Rash 1241 

Hematemesis 1242 

Hemoptysis 1242 

Hoarseness 1247 

Incontinence of Urine 1244 

Infantile Colic 1236 

Infantile Convulsions 1236 

Inflammation of the Bowels 1247 

Inflammation of Breast 1239 

Inflammation of Kidneys 1239 

Insomnia 1243 

Influenza 1239 

Jaundice 1239 

Kidneys, Inflammation of 1239 

La Grippe 1239 

Leucorrhea 1244 

Lumbago 1240 

Lungs, Bleeding from 1246 

Malaria 1240 



1231 



1232 



INDEX TO PART IV OF BOOK IX. 



Marasmus 1240 

Measles 1240 

Menses, Suppressed 1243 

Mumps 1241 

Muscular Rheumatism 1242 

Nasal Catarrh 1234 

Nervous Dyspepsia 1237 

Nervous Headache 1238 

Neuralgia 1241, 1248 

Pertussis 1245 

Piles 1248 

Pleurisy 1241 

Pneumonia 1241 

Prickly Heat 1241 

Pyrosis 1245 

Quinsy 1243 

Rheumatism, Acute 1242 

Chronic 1242 

Muscular 1242 

Ringworm . . . 1242 

Round Worms 1245 

Scalds 1234 

Scarlet Fever 1243 

Scrofula 1248 



Simple Sore Throat 1248 

Sleeplessness 1243 

Sore Eyes 1243, 1248 

Sore Throat 1243 

Simple 1248 

Spasms, Infantile 1236 

Spitting of Blood (Lungs) 1242 

Stomach 1242 

Stomach Worms 1245 

Sun Cholera 1235 

'Suppressed Menses 1243 

Tape Worm 1245, 1248 

Tetter 1248 

Throat, Sore 1243 

Toothache 1244 

Urine, Incontinence of 1244 

Vomiting 1244 

Water Brash 1245 

Wetting the Bed 1244, 1248 

Whites 1244 

Whooping-cough t 1245 

Worms, Round 1245 

Stomach 1245 

Worms, Tape 1245 



Home Administration of Medicine 



PART IV. 
MEDICAL PRESCRIPTIONS 



The following prescriptions are prepared and used by B. F. Scholl, 
M.D., Ph.G., Philadelphia, Pa. The doses are for adults except where 
otherwise mentioned. See footnote. 



ABSCESSES (BOILS). 



LATIN. 



Sulph. calcis 2 grains 

Sacch. lactis 20 grains 

Mft. Cht. No. XX. One powder every 
hour or two. For children, two or three 
times a day. 



ENGLISH. 

Sulphide of lime 2 grains 

Sugar of milk 20 grains 

Make 20 powders. Take one powder 
every hour or two. For children, two 
or three times a day. 



ASTHMA. 

Ammonia bromid 3 drachms Bromide of ammonia 3 drachms 

Ammonia chlorid 1% drachms Chloride of ammonia 1V2 drachms 

Lobelia tinct 3 drachms Tincture of lobelia 3 drachms 

Spts. aeth. comp 1 ounce Com. spirits of ether 1 ounce 

Syrp. acacia 2V1 ounces Syrup of gum arabic .... 2^4 ounces 

Mft. Take a teaspoonf ul every hour Take a teaspoonful every hour during 

during paroxysm. paroxysm. 



BILIOUSNESS. 



Podophyllin 6 grains 

Aloin 6 grains 

Ex. nucis vomicae 6 grains 

Ex. belladonna 3 grains 

Mft. Div. in pil. No. XXIV. Sig.— 
Take one or two pills at night, followed 
in morning by a dose of Rochelle salts. 



Podophyllin 6 grains 

Aloin 6 grains 

Ex. nux vomica 6 grains 

Ex. belladonna 3 grains 

Divide into 24 pills. Take one or two 
pills at night, followed in morning by 
dose of Rochelle salts. 



Children's Doses : Between one and two years, one-seventh of an adult dose ; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 

78 1233 



1234 



MEDICAL PRESCRIPTIONS. 



BRONCHITIS (ACUTE). 



LATIN. 



ENGLISH. 



Liq. ammon. acetatis i ounce 

Syrp. ipecac 2 drachms 

Syrp. pruni virg I ounce 

Syrp. acacia - 2 ounces 

Aqua dest 3 ounces 

Dose : Tablespoonful every two or 
three hours. 



Liq. acetate of ammonia ... 1 ounce 

Syrup of ipecac 2 drachms 

Syrup of wild cherry.... 1 ounce 

Syrup of gum arabic 2 ounces 

Water 3 ounces 

Dose : Tablespoonful every two or 
three hours. 



BRONCHITIS. 



Ammon. chlor 1V2 drachms 

Ammon. carb 8 grains 

Mist. Glycyrrh Co 4 ounces 

Sig: Two teaspoonfuls every 3 or 4 
hours. 



Chloride of ammonia . . . 
Carbonate of ammonia . 

Brown Mixture 

Two teaspoonfuls every 



1% drachms 
8 grains 
4 ounces 
3 or 4 hours. 



BUNIONS. 



Iodine tinct 2 drachms 

Belladonna tinct 2 drachms 

Mft. Apply twice a day with camel's- 
hair brush. 



Tincture of iodine 2 drachms 

Tincture of belladonna 2 drachms 

Apply twice a day with camel's-hair 
brush. 



BURNS AND SCALDS. 



Soda bicarb 2 ounces 

Aqua dest 1 pint 

Mft. Apply if skin is not broken. 

Acid carbolic 8 grains 

Vaseline 2 ounces 

Mft. Apply on lint where skin is 
broken. 

Aqua calcis 4 ounces 

01. lini 4 ounces 

Locally. 



Bicarbonate of soda 2 ounces 

Water 1 pint 

Apply if skin is not broken. 

Carbolic acid 8 grains 

Vaseline 2 ounces 

Apply on lint where skin is broken. 

Limewater 4 ounces 

Linseed oil 4 ounces 

Locally. 



CARBUNCLE. 



Resorcin 2 drachms 

Lanoline 1 ounce 

Mft. Apply on lint. 



Resorcin 2 drachms 

Lanoline 1 ounce 

Apply on lint. 



Liquor antisepticus alk 6 ounces 

Sig : Use freely in an atomizer to the 
nose and throat. 



CATARRH. 

Alkaline antiseptic solution 6 ounces 

Use freely in an atomizer to the nose 
and throat. 



CATARRH (NASAL). 



Acid carbolic liq 30 minims 

Soda bicarb 1 drachm 

Soda biboras 1 drachm 

01 ycerina Vi ounce 

Aq. rosae 3% ounces 

Mft. To be used with atomizer four 
or five times a day. 



Liq. carbolic acid 30 

Bicarbonate of soda 1 

Borax 1 

Glycerine Vi 



minims 

drachm 

drachm 

ounce 

ounces 



Rose water 

To be used with atomizer four or five 
times a day. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



MEDICAL PRESCRIPTIONS. 



1235 



CATARRH (FAUCIAL). 



LATIN. 



Soda salicylate 2 drachms 

Soda biboras 3 drachms 

Glycerina 4 drachms 

Aq. rosas 5V2 ounces 

Mft. A dessertspoonful in one pint of 
water and used with atomizer to throat. 



ENGLISH. 



Salicylate of soda 2 drachms 

Borax 3 drachms 

Glycerine 4 drachms 

Rose water 5 Ms ounces 

A dessertspoonful in a pint of water 
and used with atomizer to throat. 



CHILBLAINS. 



Camphor 75 grains 

Alcoholis 3 drachms 

Glycerina 5 drachms 

Mft. Apply several times daily. 



Camphor 75 grains 

Alcohol 3 drachms 

Glycerine 5 drachms 

Apply several times daily. 



CHOLERA (SUN). 



Tinct. opii 1 ounce 

Tinct. capsici 1 ounce 

Tinct. rhei. aromat 1 ounce 

Aq. menth. pip 1 ounce 

Camphora spts 1 ounce 

Sig. — Take 20 to 40 drops in water 
every two or three hours. 



Laudanum 1 ounce 

Tine, of cayenne pepper 1 ounce 

Tine, of rhubarb aromatic .... 1 ounce 

Peppermint water 1 ounce 

Spirits of camphor 1 ounce 

Take 20 to 40 drops in water every 
two or three hours. 



CHOLERA INFANTUM. 



Ex. belladonna fid 50 drops 

Tinct. opii camph iMs drachms 

Soda sulphate 15 grains 

Syrp. limonis 2 ounces 

Sig. — A teaspoonful every two or 

three hours to a child one year old. In- 
crease or lessen with age. 

Bismuth subnit 32 grains 

Tr. card, co Ms drachm 

Glycerine 1 drachm 

Aqua mentha vir ad 2 ounces 

Teaspoonful every 2 or 3 hours. 



Fid. extract of belladonna, 50 drops 

Paregoric 1V2 drachms 

Sulphate of soda 15 grains 

Syrup of lemons 5 ounces 

A teaspoonful every two or three 

hours for a child one year old. Increase 
or lessen with age. 

Subnitrate of bismuth 32 grains 

Comp. tinct. of cardamon. . . . Ms drachm 

Glycerine 1 drachm 

Spearmint water to make 2 ounces 

Teaspoonful every 2 or 3 hours. 



CHOLERA MORBUS. 



Spts. chloroformi 30 minims 

Heroin M$ grain 

Camphora spts 20 minims 

Aq. menth. pip 1 ounce 

Sig. — A teaspoonful every hour. 



Chloroform 30 minims 

Heroin M$ grain 

Spirits of camphor 20 minims 

Peppermint water 1 ounce 

A teaspoonful every hour. 



Children's Doses : Between one and two years, one-seventh of an adult dose : 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 



1236 



MEDICAL PKESCRIPTIOI^S. 



COLIC (INFANTILE). 

LATIN. ENGLISH. 

Assafetida tinct 15 drops Tincture of assafetida 15 drops 

Cinnamoni tinct 30 drops Tincture of cinnamon ....30 drops 

Syrp. rhei. aromat 3 drachms Syr. rhubarb aromatic 3 drachms 

Soda bicarb 20 grains Soda bicarbonate 20 grains 

Aq. dest iV 2 ounces Water 1% ounces 

Sig. — Half a teaspoonful every two or Half a teaspoonful every two or three 

three hours. hours. 



CONVULSIONS (INFANTILE) 



Ammonia bromid 40 grains 

Potass, bromid 30 grains 

Ex. gelsemium fld 20 drops 

Ex. valerian fld 20 drops 

Aq. dest 1 ounce 

Sig. — Half a teaspoonful for a child 
every two or three hours. 



Bromide of ammonia 40 grains 

Bromide of potash- 30 grains 

Fluid ext. of gelsemium .... 20 drops 

Fluid ext. of valerian 20 drops 

Water 1 ounce 

Half a teaspoonful for a child every 
two or three hours. 



CONSTIPATION 



Aloin 2 grains 

Ext. Bella 2 grains 

Ext. nucis vom 4 grains 

Ext. cascara sagrada 16 grains 

Div. in pil. No. XVI. Sig.— One at 
night. 

Aloes soc 20 grains 

Gambogue 10 grains 

Saponis 5 grains 

Podophyllin 2V2 grains 

Leptandrin ingrains 

Ol. capsici 1 drop 

Mft. Div. in pil. No. XII. Sig.— 
Take one three times a day. 



Aloin 2 grains 

Extract of belladonna 2 grains 

Extract of nux vomica 4 grains 

Extract cascara 16 grains 

Make 16 pills. Take one at night. 

Aloes 1 20 grains 

Gamboge 10 grains 

White soap 5 grains 

May-apple 2V2, grains 

Leptandrin 1 V2 grains 

Oil capsicum 1 drop 

Make 12 pills, and take one three 
times a day. 



CROUP (SIMPLE). 



Give teaspoonful of syr. ipecac as an 
emetic, then — 

Vin antim 2 .drachms 

Syrp. papaveris "V2 ounce 

Syrp. tolu 2 drachms 

Aq. dest 1 ounce 

Sig. — A teaspoonful every hour or two 
for a child one year old. Increase or 
lessen with age. 



Give teaspoonful of syr. ipecac as an 
emetic, then — 

Wine of antimony 2 drachms 

Syrup of poppies % ounce 

Syrup of tolu 2 drachms 

Water 1 ounce 

Teaspoonful every hour or two for a 
child one year old. Increase or lessen 
with age. 



DIARRHCEA (ACUTE) 



Tinct. opii deod 15 drops 

Bismuth subnit 2 drachms 

Syrp. simplex V2 ounce 

Mist, cretse \Vi ounces 

Sig. — A teaspoonful every two or 
three hours to a child one year old. 



Tine, opium, deodorized.. 15 drops 
Subnitrate of bismuth ... 2 drachms 

Simple syrup V2 ounce 

Chalk mixture 1% ounces 

A teaspoonful every two or three 
hours to a child one year old. 



Children's Doses : Between one and two years, one-seventh of an adult dose ; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen year*? one-half. 



MEDICAL PRESCRIPTIONS. 



1237 



DIARRHCEA (CHRONIC), 



LATIN. 



Ex. ergot 20 grains 

Ex. nucis vom 5 grains 

Ex. opii 10 grains 

Mft. Div. in pil. No. XX. Sig.— 
One pill every three or four hours. 



ENGLISH. 



Aqueous ext. of ergot 20 grains 

Extract of nux vomica 5 grains 

Extract of opium 10 grains 

Make 20 pills. Take one pill every 
three or four hours. 



DIPHTHERIA. 



Call physician and give antitoxin early in the case 
membranous croup. 

Potash chlor 20 grains 

Tinct. ferri chlor 2 drachms 

Glycerina 1 ounce 

Aq. rosae 1V2 ounces 

Sig. — Apply to throat every hour. 



This will also apply to 



Chlorate of potash 20 grains 

Tine, chloride of iron 2 drachms 

Glycerine 1 ounce 

Rose water 1Y2 ounces 

Apply to throat every hour. 



DYSENTERY (ACUTE). 



Cupri sulph Y2 grain 

Magnesia sulph 1 ounce 

Acid sulph. jd.il. 1 drachm 

Aq. dest 4 ounces 

Sig. — A teaspoonful every hour or 
two. 



Sulphate of copper V2 grain 

Epsom salts 1 ounce 

Sulphuric acid, diluted 1 drachm 

Water 4 ounces 

A teaspoonful every hour or two. 



DYSENTERY (CHRONIC), 



Vin ipecac 1 ounce 

Sig. — One drop every hour when 
stools are slimy. 



Wine of ipecac 1 ounce 

One drop every hour when stools are 
slimy. 



DYSPEPSIA (FLATULENT), 



Bismuth subnit 1 drachm 

Magnesia % drachm 

Pv. belladonna 1 grain 

Pv. zingiber 3 grains 

Mft. Cht. No. X. Sig.— One every 
three hours in aq. menth, pip. 



Subnitrate of bismuth 1 drachm 

Magnesia V2 drachm 

Powdered belladonna 1 grain 

Powdered ginger 3 grains 

Make 10 powders. Take one every 
three hours in peppermint water. 



DYSPEPSIA (GASTRIC). 



Soda sulph. gran 1 ounce 

Soda bicarb 1 ounce 

Pv. cinchona 1 ounce 

Sig. — A teaspoonful in half a glass of 
water before and after meals. 



Sulphate of soda, gran 1 ounce 

Bicarbonate of soda 1 ounce 

Powdered chinchona 1 ounce 

A teaspoonful in half glass of water 
before and after meals. 



DYSPEPSIA (NERVOUS). 



Bismuth sub. carb 3 drachms 

Pulv. aromatic 1 drachm 

Mft. Cht. No. XII. Sig.— One before 
each meal. 



Subcarbonate bismuth 3 drachms 

Aromatic powder 1 drachm 

Make 12 powders. Take one before 
each meal. 



Children's Doses : Between one and two years, one-seventh of an adult dose 
between two and six years, one-quarter; between six and twelve years, one-third 
between twelve and fifteen years, one-half. 



1238 



MEDICAL PRESCRIPTIONS. 



EARACHE. 



LATIN. 



Atrcpia sulph 1Y2 grains 

Heroin % grain 

Glycerina I ounce 

Mft. Place one or two drops in ear 
on absorbent cotton two or three times 
a day. 



ENGLISH. 



Sulphate of atropia i% grains 

Heroin % grain 

Glycerine i ounce 

Place one or two drops in ear on ab- 
sorbent cotton two or three times a 
day. 



ERYSIPELAS. 



Ichthyol . V2 ounce 

Ether sulph 2 drachms 

Glycerina 2 drachms 

Mft Apply locally. 



Ichthyol y 2 ounce 

Ether 2 drachms 

Glycerine 2 drachms 

Apply locally. 



FLATULENCE. 



Pulv. columbae Y2 ounce 

Pulv. zingiber % ounce 

Aq. bulliens 1 pint 

Senna fol 1 drachm 

Mft. infusion. Sig. — Take a wine- 
glassful three times a day. 



Powdered columbae V2 ounce 

Powdered ginger % ounce 

Hot water 1 pint 

Senna leaves . . ._ 1 drachm 

Make an infusion. Take a wineglass- 
ful three times a day. 



HAY FEVER. 



Adrenalin or adnephrin 1 to 3,000 to 
be used in an atomizer to the nose 3 to 
6 times a day. 



Adrenalin inhalant or anesthoric 
cream applied to the nostril. 



HEADACHE (BILIOUS). 



Ammonia brom 3 drachms 

Caffeine cit 30 grains 

Spts. ammon. aromat 1 drachm 

Elix. guarana 4 ounces 

Aq. rosae 4 ounces 

Sig. — A teaspoonful every half hour 
until relieved. 



Bromide of ammonia 3 drachms 

Citrate of caffeine 30 grains 

Aromatic spts. of ammonia 1 drachm 

Elixir guarana 4 ounces 

Rose water 4 ounces 

A teaspoonful every half hour until 
relieved. 



HEADACHE (NERVOUS), 



Strontium Bromide 2 1 ,L drachms 

Tr. nucis vom 1 drachm 

Tr. card, co 6 drachms 

Syrupus 1 ounce 

Aqua ad 4 ounces 

Zinci phosphide 3 grains 

Ex. nucis vom 10 grains 

Confec. rosne q. s. 

Mft. Div. in pil. No. XXX. Sig.— 
One after each meal. 



Bromide of strontium .... 2Y2 drachms 

Tinct. of nux vomica 1 drachm 

Comp. tinct. of card 6 drachms 

Syrup 1 ounce 

Water to make 4 ounces 

Phosphide of zinc 3 grains 

Ext. of nux vomica 10 grains 

Confection of roses . . . Sufficient quantity 
Make 30 pills. Take one after each 
meal. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



MEDICAL PRESCRIPTIONS. 1239 

HEART-BURN. 

LATIN. ENGLISH. 

Soda bicarb I drachm Bicarbonate of soda I drachm 

Pulv. rhei V2 ounce Powdered rhubarb V2 ounce 

Spts. menth. pip 2 drachms Spirits of peppermint 2 drachms 

Aq. dest 4 ounces Water 4 ounces 

Sig. — A tablespoonful after meals. A tablespoonful after meals. 

HICCOUGH. 

Zinci valer 8 grains Valerianate of zinc 8 grains 

Ex. belladonna 3 grains Ext. of belladonna 3 grains 

Mft. Div. in pil. No. XII. Sig. — Make 12 pills. Give one every three 

Give one every three or four hours as or four hours as required, 
required. 

INFLAMMATION OF BREAST. 

Ung. belladonna 1 ounce Ointment of belladonna 1 ounce 

Pulv. camphora 1 drachm Powdered camphor 1 drachm 

Mft. and apply to breast. Mix together and apply to breast. 

INFLUENZA (LA GRIPPE). 

Quinia sulph 32 grains Quinine ^2 grains 

Phenacetin 32 grains Phenacetin 32 grains 

Caffeine 8 grains Caffeine 8 grains 

Aloin 2 grains Aloin 2 grains 

Mft. cap. No. XVI, div. Sig. — One Make 16 capsules and take one every 

every three or four hours. three or four hours. 

Potass, bromid'. 1 drachm Bromide of potash 1 drachm 

Ammon. chlorid 50 grains Chloride of ammonia 50 grains 

Syrp. scillae 2 drachms Syrup of squills 2 drachms 

Mist, glycyrrhiza comp. .. 2% ounces Brown mixture 2Y2 ounces 

Sig. — Take a teaspoonful every two Take a teaspoonful every two hours, 
hours. 

JAUNDICE. 

Hydrg. chlor. mite 6 grains Calomel 6 grains 

Pulv. rhei 3 grains Powdered rhubarb 3 grains 

Podophyllin % grain Powdered May-apple Vi grain 

Soda bicarb 8 grains Bicarbonate of soda 8 grains 

Mft. Cht. No. VI. Sig.— 'One every Make 6 powders. Take one every two 

two or three hours. or three hours. 



KIDNEYS (INFLAMMATION OF). 

Flor. scoparius tinct 7% drachms Tinct. flowers of broom.. yVi drachms 

Tinct. juniperi 2% drachms Juniper 2V2 drachms 

Aq. bulliens 2 pints Hot water 2 pints 

Mft. an infusion. Sig. — Take a wine- Make an infusion. Take wineglassful 

glassful four times a day. four times a day. 



Children's Doses: Between one and two years,_ one-seventh of an^adult dose; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



1240 



MEDICAL PRESCRIPTIONS. 



LUMBAGO. 



LATIN. 



Phenacetin 24 grains 

Salol 24 grains 

Caffeine 6 grains 

Mft. pil. No. XII. Div. Sig.— One 
every three or four hours. 

Potass, iodid 2 drachms 

Vin colch. sem 1 ounce 

Syrp. sarsapariila comp 1 ounce 

Aq. dest 1 ounce 

Sig. — A teaspoonful in water "every 
three hours. 



ENGLISH. 



Phenacetin 24 grains 

Salol 24 grains 

Caffeine 6 grains 

Make 12 pills. One every three or 
four hours. 

Iodide of potash 2 drachms 

Wine of colchicum seed .... 1 ounce 

Com. syr. of sarsapariila 1 ounce 

Water 1 ounce 

A teaspoonful in water every three 
hours. 



Tinct. iodine 2 drachms 

Tinct. aconit root 3 drachms 

Spts. chloroformi 4 drachms 

Tinct. sapo. camph 9 drachms 

Locally. 



Tincture of iodine 2 drachms 

Tincture of aconite root ... 3 drachms 

Chloroform 4 drachms 

Soap liniment 9 drachms 

Locally. 



MARASMUS. 



01. morrhuae 2 ounces 

Aq. calcis 4 drachms 

Syrp. calcis lactophos .... \Vi ounces 

Sig. — A teaspoonful three times a day 
for a child one year old. Increase or 
lessen with age. 



Cod-liver oil 2 ounces 

Limewater 4 drachms 

Syr. lactophosphate of lime 1V2 ounces 

A teaspoonful three times a day for 
a child one year old. Increase or lessen 
with age. 



MALARIA. 



Strych. sulph V2 grain 

Acid arsenious % grain 

Ferri pulv 15 grains 

Quinia sulph 15 grains 

Aloes soc 3 grains 

Mft. Div. in pil. No. XX. Sig.— Take 
one pill every three hours. 



Strychnine V2 grain 

Arsenious acid % grain 

Iron by hydrogen 15 grains 

Quinine 15 grains 

Aloes 3 grains 

Make 20 pills. Take one pill every 

ree hours. 



MEASLES. 



(For fever.) 

Tr. aconite rad 12 drops 

Liq. ammon. acet V-2 ounce 

Liq. Potass. Cit 1V2 ounces 

Syrupus 1 ounce 

Sig. — Teaspoonful every two or three 
hours for a child 2 to 6 years of age. 

Acetanilid 10 grains 

Quinia sulph 20 grains 

Soda salicylate to grains 

Mft.. mass and div. in cht. No. XV. 
Sig. — One every four hours. 



Tinct. of aconite root . .. . . 12 drops 

Spirits of minderus V2 ounce 

Sol. citrate of potash 1V2 ounces 

Syrup 1 ounce 

Take a teaspoonful every two or three 
hours for a child 2 to 6 years of age. 

Acetanilid 10 grains 

Quinine 20 grains 

Salicylate of soda 10 grains 

Make 15 powders. Take one every 

four hours. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



MEDICAL PRESCRIPTIONS. 



1241 



MUMPS. 



LATIN. 



Oleum camphorata 2 ounces 

Sig. — Bathe over the swelling. 

Quinia sulph 10 grains 

Potass, chlor 25 grains 

Tinct. aconite rad 10 drops 

Spts. nit. dulc 2% drachms 

Syrp. simplex 14 drachms 

Sig. — A teaspoonful every three hours 
for a child ten years old. Increase or 
decrease according to age. 



ENGLISH. 



Camphorated oil 2 ounces 

Bathe over the swelling. 

Quinine 10 grains 

Chlorate of potash 25 grains 

Tincture of aconite 10 drops 

Sweet spirits of nitre . . . 2% drachms 

Simple syrup 14 drachms 

A teaspoonful every three hours for 
a child ten years old. Increase or les- 
sen according to age. 



NEURALGIA. 



Quin. sulph 1 drachm 

Codeine % grain 

Acid arsenious 1^2 grains 

Aconit ex 15 grains 

Strych. sulph 1 grain 

Mft., mass and div. in pil. No. XXX. 
Sig. — Take one three or four times a 
day. 



Sulphate of quinine 1 drachm 

Codeine Vs grain 

Arsenious acid 1V2 grains 

Extract of aconite 15 grains 

Sulphate of strychnine . . 1 grain 

Make 30 pills. Take one three or four 
times a day. 



PLEURISY. 



Phenacetin 24 grains 

Quinia sulph 24 grains 

Caffeine 6 grains 

Mft. cap. No. XII, div. Sig.— One 
every three hours. 

Heroin % grain 

Acetate potass. . % ounce 

Tinct. verat. viride 25 minims 

Syrp. tolu */2 ounce 

Liq. potass, citratis 2V2 ounces 

Sig. — A teaspoonful every two hours. 



Phenacetin 24 grains 

Quinine 24 grains 

Caffeine 6 grains 

Make 12 capsules and give one every 
three hours. 

Heroin .... % grain 

Acetate of potash V2 ounce 

Tine, verat. viride 25 minims 

Syrup of tolu Vi ounce 

Liquor citrate of potash. . 2Y2 ounces 
A teaspoonful every two hours. 



PNEUMONIA. 

Potass, iodid 1 drachm Iodide of potash 1 drachm 

Ammonia mur 1^2 drachms Muriate of ammonia 1Y2 drachms 

Mist, glycyrrhiza comp 6 ounces Brown mixture 6 ounces 

Sig. — A tablespoonful every three A teaspoonful every two hours, 
hours. 



PRICKLY HEAT. 



Soda biboras 6 drachms 

Spts. camphora 6 grains 

Aq. rosae 6 ounces 

Mft. Bathe the parts, and between 
applications dust on pulv. lycopodium. 



Borax powder 6 drachms 

Spirits of camphor 6 grains 

Rose water 6 ounces 

Bathe the parts, and between applica- 
tions dust on lycopodium powder. 



Children's Doses : Between one and two years, one-seventh of an adult dose ; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 



1242 



MEDICAL PRESCRIPTIONS. 



RHEUMATISM (ACUTE). 



LATIN. 



ENGLISH. 



Acid salicylic 2Y2 drachms 

Sodii bicarb 2 drachms 

Vin. colch. sem 6 drachms 

Syrupus 1 ounce 

Aqua mentha pip. ad.... 2 ounces 

Sig. — Dessertspoonful every three or 
four hours. 

Sodii salicylate 2Y2 drachms 

Vin. colch. rad 3 drachms 

Tr. card, co 6 drachms 

Syrupus 1 ounce 

Aqua 2 ounces 

Sig. — Two teaspoonfuls every four 
hours. 



Salicylic acid 2Y2 drachms 

Baking soda 2 drachms 

Wine of colchicum seed... 6 drachms 

Syrup 1 ounce 

Peppermint water 2 ounces 

Dessertspoonful every three or four 
hours. 

Salicylate of soda 2% drachms 

Wine of colchicum root . . 3 drachms 
Comp. tinct. of cardamon.. 6 drachms 

Syrup 1 ounce 

Water 2 ounces 

Two teaspoonfuls every four hours. 



RHEUMATISM (CHRONIC). 



Potass, bicarb 2 drachms 

Acid salicylic 2 drachms 

Potass, iodid 2 drachms 

Tinct. colch. sem 3 drachms 

Syrp. aurant. cort 3 ounces 

Sig. — A dessertspoonful every three 
hours. 



Bicarbonate of potash . . 2 drachms 

Salicylic acid 2 drachms 

Iodide of potash 2 drachms 

Tine, of colchicum seed 3 drachms 

Syr. of orange peel 3 ounces 

A dessertspoonful every three hours. 



RHEUMATISM (MUSCULAR). 



Ammon. chlorid % ounce 

Ex. cimicifuga fld 2 ounces 

Syrp. acacia 1 ounce 

Aq. lauro-cerasi 1 ounce 

Sig. — A teaspoonful four times a day. 



Chloride of ammonia V2 ounce 

Ext. of blacksnake root 2 ounces 

Syr. of gum arabic 1 ounce 

Cherry-laurel water 1 ounce 

A teaspoonful four times a day. 



RINGWORM. 

Hydrag. C. C 10 grains Corrosive sublimate 10 grains 

Alcoholis 1 ounce Alcohol 1 ounce 

Ol. sinapis 1 drachm Oil of mustard 1 drachm 

Mft. lotion and apply several times Make lotion and apply several times 

a day. a day. 



SPITTING OF BLOOD (LUNGS) HEMOPTYSIS. 



Tinct. cinnamoni 2 drachms 

Tinct. digitalis 30 drops 

Ex. ergot fld 14 drachms 

Sig. — A teaspoonful every hour and 
then decrease. 



Tincture of cinnamon 2 drachms 

Tincture of digitalis 30 drops 

Fluid ext. of ergot 14 drachms 

A teaspoonful every hour and then de- 
crease. 



SPITTING OF BLOOD (STOMACH) HEMATEMESIS. 



Ferri et ammon. sulph 50 grains 

Aq. cinnamoni 4 ounces 

Sig. — A tablespoonful every two or 
three hours. 



Sulphate of iron and ammonia 50 grains 

Cinnamon water 4 ounces 

A tablespoonful every two or three 
hours. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 



MEDICxVL PEESCBIPTIONS. 



1243 



SORE EYES (CONJUNCTIVITIS). 
LATIN. ENGLISH. 



Acid boracic 8 grains 

Aq. camphora I ounce 

Aq. dest I ounce 

Mft. Bathe the eye several times a 
day. 



Boracic acid 8 grains 

Camphor water i ounce 

Distilled water i ounce 

Bathe the eyes several times a day. 



SUPPRESSED MENSES (AMENORRHEA). 



Tinct. ferri chlor 3 drachms 

Tinct. cantharides 1 drachm 

Tinct. guaiac ammon 1Y2 ounces 

Tinct. aloes V2 ounce 

Syrp. simplex 3% ounces 

Mft. A tablespoonful three times a 

day. v 



Tine, chloride of iron 3 drachms 

Tine. Cantharides 1 drachm 

Ammoniated tine, of guaiac 1V2 ounces 

Tincture aloes % ounce 

Syrup simple 3% ounces 

A tablespoonful three times a day. 



SLEEPLESSNESS (INSOMNIA). 



Potass, bromid 4 drachms 

Chloral hydrate 2 drachms 

Syrp. prunus virg 1 ounce 

Aq. dest 10 drachms 

Sig. — A teaspoonful at bedtime. 



Bromide of potash 4 drachms 

Hydrate of chloral 2 drachms 

Syr. of wild cherry 1 ounce 

Water 10 drachms 

A teaspoonful at bedtime. 



SORE THROAT (QUINSY). 



Tinct. guaiac 1% ounces 

Glycerina 1V2 ounces 

Sig. — A teaspoonful every hour or 
two. 



Tincture of guaiac 1V2 ounces 

Glycerine \ x k ounces 

A teaspoonful every hour or two. 



SCARLET FEVER. 



Tinct. ferri chlor 2 drachms 

Potass, chlor 3 drachms 

Syrp. simplex 4 ounces 

Sig. — A teaspoonful every hour to a 
child four or five years old. Increase or 
decrease according to age. 

Resorcin 2 drachms 

Vaseline 1 ounce 

Mft. Apply to skin to hasten des- 
quamation. 



Tine, chloride of iron 2 drachms 

Chlorate potash 3 drachms 

Simple syrup 4 ounces 

Teaspoonful every hour to child four 
to five years old. Increase or decrease 
according to age. 

Resorcin 2 drachms 

Vaseline 1 ounce 

Apply to skin to hasten desquamation. 



Children's Doses : Between one and two years, one-seventh of an adult dose ; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



1244 



MEDICAL PRESCRIPTIONS. 



LATIN. 



TOOTHACHE. 



Pulv. arsenious acid 30 grains 

Heroin % grain 

Menthol crystals 8 grains 

Glycerine Sufficient 

Mft. paste. Sig. — Apply to tooth on 
absorbent cotton. 



ENGLISH. 



Powd. arsenious acid 30 grains 

Heroin % grain 

Menthol crystals 8 grains 

Glycerine Sufficient 

Make paste. Apply to tooth on ab- 
sorbent cottom 



Creosotum 1 drachm 

Apply to the cavity of the tooth on 
cotton. 



Creosote 1 drachm 

Apply to the cavity of the tooth on 
cotton. 



VOMITING. 

Pepsinae 1 drachm Pepsin 1 drachm 

Acid hydrochlor dil 2 drachms Hydrochloric acid, diluted.. 2 drachms 

Aq. dest 6 drachms Water 6 drachms 

Sig. — Teaspoonful every two or three Teaspoonful every two or three hours, 
hours. 



WETTING OF BED (INCONTINENCE OF URINE). . 



Ergotin % grain 

Strych. sulph 1-200 grain 

Ext. bella 1-64 grain 

In each pill. One three or four times 
a day. 

Strych. sulph 1 grain 

Pulv. cantharides 2 g-ains 

Morph. sulph 1V2 grains 

Ferri redacti 20 grains 

Mft., mass and *div, in pil. No. XL. 

Sig. — One pill three times a day to a 
child ten years old. Increase or de- 
crease according to age. 



Ergotin Vz grain 

Sulphate of strychnine 1-200 grain 

Extract of belladonna 1-64 grain 

In each pill. One three or four times 
a day. 

Sulphate of strychnine 1 grain 

Powdered cantharides 2 grains 

Sulphate of morphia 1% grains 

Reduced iron 20 grains 

Make 40 pills. Give one pill three 
times a day to a child ten years old. 
Increase or decrease according to age. 



WHITES (LEUCORRHEA). 



Tri-Septic Douche Tablets No. 24. 
One or two dissolved in a pint of warm 
water as an injection night and morn- 
ing. 

Soda bicarb 1 drachm 

Tinct. belladonna 2 ounces 

Aq. dest 1 pint 

Mft. Use as a vaginal injection. 

Aristol 35 grains 

Camphora 35 grains 

Lupulin 35 grains 

Mft. suppositories No. XII. Insert 
one in vagina after each injection. 



Tri-Septic Douche Tablets No. 24. 
One or two dissolved in a pint of warm 
water as an injection night and morn- 
ing. 

Bicarbonate of soda 1 drachm 

Tincture belladonna 2 ounces 

Water 1 pint 

Use as a vaginal injection. 

Aristol 35 grains 

Camphor 35 grains 

Lupulin 35 grains 

Make 12 suppositories. Insert one in 
vagina after injection. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 



MEDICAL PRESCRIPTIONS. 



1245 



WATER-BRASH (PYROSIS). 

LATIN. ENGLISH. 

Quinia sulph. 12 grains Sulphate of quinine 12 grains 

Acid sulph. dil 2 drachms Sulphuric acid, diluted . . 2 drachms 

Spts. chloroform 2 drachms Chloroform 2 drachms 

Tinct. aurant. cort 1^ ounces Tine, of orange peel 1Y2 ounces 

Sig. — A teaspoonful in water every A teaspoonful in water every two or 

two or three hours. three hours. 



WHOOPING-COUGH 

Cocci 10 grains 

Potass, bicarb 1 drachm 

Ex. belladonna fld 10 drops 

Syrp. simplex 4 ounces 

Sig. — A teaspoonful every two or 
three hours for a child ten years old. 
Increase or decrease according to age. 



(PERTUSSIS). 

Cochineal 10 grains 

Bicarbonate of potash 1 drachm 

Fluid ext. of belladonna 10 drops 

Syrup simple 4 ounces 

Teaspoonful every two or three hours 
for a child ten years old. Increase or 
lessen according to age. 



WORMS 

Tinct. rottlera 1 drachm 

Ex. filix mas aeth 2 drachms 

Syrp. acacia 1 ounce 

Mft. Make 2 doses. Sig. — First in 
morning, two hours after half-ounce ol. 
ricini, and in half an hour the re- 
mainder. 



(TAPE). 

Kameela 1 drachm 

Male fern, ethereal ext 2 drachms 

Syrup of gum arabic 1 ounce 

Make 2 doses. Take first in morning; 
two hours after take dose of castor oil, 
and in half an hour the remaining dose. 



WORMS (ROUND AND STOMACH). 



Hyd. chlor. mite 10 grains 

Soda bicarb 10 grains 

Santonine 10 grains 

Pv. rhei 10 grains 

Mft. cht. No. VI. Sig. — One every 
three hours and then a purge. 



Calomel 10 grains 

Bicarbonate of soda 10 grains 

Santonine 10 grains 

Rhubarb 10 grains 

Make 6 powders. Take one every 
three hours and then a purge. 



SIMPLE REMEDY FORMULAS IN LATIN AND ENGLISH 

THE DOSES ARE FOR ADULTS, EXCEPT WHERE OTHERWISE 
MENTIONED. SEE FOOTNOTE. 

ASTHMA. 



LATIN. 



ENGLISH. 



Lobelia folia 1 teacupful Lobelia leaves 1 teacupful 

Aqua bulliens 1 pint Hot Water 1 pint 

Steep a half hour. Dose : One tablespoonful every fifteen to thirty minutes till free 
spitting of mucus is produced. 



Children's Doses: Between one and two years,_ one-seventh of an adult dose; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



1246 MEDICAL PRESCRIPTIONS. 

BOILS. 

LATIN. ENGLISH. 

Sulphur flores 6 tablespoonfuls Flowers of sulphur .. 6 tablespoonfuls 

Potass, bitartras 3 tablespoonfuls Cream tartar 3 tablespoonfuls 

Dose : One teaspoonful night and morning in syrup or molasses. 

BLEEDING FROM THE LUNGS. 

Pulv. sacch, alb 3 ounces Powdered sugar 3 ounces 

Acid gallic Vi ounce Gallic acid % ounce 

Mix. Dose : One teaspoonful three times a day. 

Or, 

Acid tannic 30 grains Tannin 30 grains 

Pulv. sacch. alb 1 drachm Powdered sugar 1 drachm 

Mix. Make ten powders and give one every ten minutes until relieved. 

CHOLERA MORBUS. 

Chloride sodium 3 teaspoonfuls Common salt 3 teaspoonfuls 

Piper nigrum 2 teaspoonfuls Black pepper 2 teaspoonfuls 

Acetum V-i teacupful Cider vinegar % teacupful 

Aqua bulliens % teacupful Warm water V2 teacupful 

Mix. Take tablespoonful every half hour until relieved. 

CONSTIPATION. 

Inf. senna comp 5 ounces Compound infusion of senna 5 ounces 

Potass, tart 1 ounce Tartrate of potash 1 ounce 

Tr. senna) of each 4 drachms Tincture of senna | of each.. 4 drachms 

Tr. jalap j Tincture of jalap J 

Syr. rhamni 3 drachms Syrup of buckthorn 3 drachms 

Dose: Take one-fourth part at once, and repeat the dose every half hour until 
it operates. 

CROUP. 

Pulv. alumen . . . : 2 teaspoonfuls Powdered alum 2 teaspoonfuls 

Treacle 1 tablespoonful Molasses 1 tablespoonful 

Aqua bulliens 1 teacupful Warm water 1 teacupful 

Dose : For child one to three years old, a dessertspoonful every five minutes till 
relieved; for older children, a tablespoonful. 

DIARRHCEA. 

Rubus villo3us 2 quarts Ripe blackberries 2 quarts 

Saccha alba 1 pound White sugar 1 pound 

Carophyllus V2 ounce Cloves V2 ounce 

Pimenta V2 ounce Allspice % ounce 

Boil all together. When cold press and strain. Add a pint of good brandy. 
Dose : A teaspoonful to wineglassful every two to four hours. 

DROPSY. 

Pulv. jalapa 10 grains Powdered jalap 10 grains 

Potass, bitartras 1 teaspoonful Cream tartar 1 teaspoonful 

Aqua sacch 1 wineglassful Sweetened water 1 wineglassful 

Take whole, once every four hours, until copious discharges are produced. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter; between six and twelve years, one-third; 
between twelve and fifteen years, one-half. 



MEDICAL PRESCRIPTIONS. 124^ 

DYSENTERY. 

LATIN. ENGLISH. 

Amylum 2 ounces Thin boiled starch 2 ounces 

Tinct. opii 20 drops Laudanum 20 drops 

Use as an injection every six to twelve hours. 

Tinct. rhei 1 ounce Tincture rhubarb 1 ounce 

Tinct. opii 2 drachms Laudanum 2 drachms 

Dose : One teaspoonful every three hours. 



EARACHE. 

Succus alium 2 teaspoonfuls Onion juice 2 teaspoonfuls 

Ol. olivae 2 teaspoonfuls Sweet oil 2 teaspoonfuls 

Tinct. opii 1 teaspoonful Laudanum 1 teaspoonful 

Mix, and drop from four to six drops warm in affected ear. Repeat in half an 
hour if necessary. 

GOUT. 

Pulv. ulmus 2 tablespoonfuls Powdered slippery elm 2 tablespoonfuls 

Wheat bran 3 tablspoonfuls Wheat bran 3 tablespoonfuls 

Mix with a weak solution of vinegar and apply warm to the affected parts. 



GRAVEL. 

Pyrus rad I quart Apple root tea 1 quart 

Holland gin 1 pint Holland gin 1 pint 

Sacch. alb . . . 8 ounces White sugar 8 ounces 

Small teacupful three times a day. 



HEART-BURN. 

Soda bicarb Vi teaspoonful Baking soda Vi teaspoonful 

Aqua V2 teacupful Water V2 teacupful 

Take same after each meal. 

HOARSENESS. 

Armoricia 2 ounces Horseradish, grated 2 ounces 

Acetum % pint Cider vinegar % pint 

Mel I gill Strained honey 1 gill 

Put the horseradish in the vinegar, let stand twelve hours, add the honey and heat 
it nearly to boiling. Strain and bottle. Adult dose, a teaspoonful four times a day till 
relieved. 

INFLAMMATION OF THE BOWELS. 

01. ricini 3 ounces Castor oil 3 ounces 

01. olivae 2 ounces Olive oil 2 ounces 

Ol. terebinthinae 2 teaspoonfuls Oil of turpentine 2 teaspoonfuls 

Adult dose, one tablespoonful every three or four hours. 



Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 



1248 MEDICAL PRESCRIPTIONS. 

NEURALGIA. 

LATIN. ENGLISH. 

Ex. belladonna. Vi ounce Extract belladonna %. ounce 

Vaseline 2 ounces Vaseline 2 ounces 

Mix. Rub on affected parts several times a day. 

PILES. 

Vaseline I tablespoonful Vaseline I tablespoonful 

Sulph. flores i drachm Flowers of sulphur . . . I drachm 

Mix, and apply as an ointment three times a day. 

SIMPLE SORE THROAT. 

Pulv. alumen lYz teaspoonfuls Powdered alum i%. teaspoonfuls 

Aqua i gill Water I gill 

Make gargle and use every hour. 

SCROFULA. 

Rumex crispus I pound Yellow dock root I pound 

Stillingia rad I pound Stillingia root I pound 

Taraxacum rad I pound Dandelion root I pound 

Sarsaparilla rad I pound Sarsaparilla root \. i pound 

Sassafras rad V-i pound Sassafras root Vi pound 

Aqua 4 gallons Water 4 gallons 

Cut the roots fine. Boil slowly till reduced to four quarts. Strain and add five 
pounds white sugar, stirred in with gentle heat. Then add eight drachms iodide of 
potash. Dose: Two tablespoonfuls three times a day. 

SORE EYES. 

Soda biboras 2 grains Borate of soda 2 grains 

Aq. camph i ounce Camphor water I ounce 

Mix. Drop one or two drops in eye four times a day. 

TETTER. 

01. terebinthinae I ounce Turpentine ' I ounce 

Hydrarg. ox. rub 3 drachms Red Precipitate 3 drachms 

Vaseline 4 ounces Vaseline 4 ounces 

Mix. Apply twice a day to affected parts. 

TAPEWORM. 

01. terebinthinae 1 teaspoonftil Turpentine 1 teaspoonfnl 

01. ricini I teaspoonfnl Castor oil 1 teaspoonful 

Lactis 1 teacupf ul Milk 1 teacupfnl 

Mix, and for adult take at one dose. If not successful, repeat next day. 

WETTING THE BED. 

Ergot fluid ex 1 ounce Spurred rye 1 ounce 

Dose: Ten to fifteen drops three times a day. 

Children's Doses: Between one and two years, one-seventh of an adult dose; 
between two and six years, one-quarter ; between six and twelve years, one-third ; 
between twelve and fifteen years, one-half. 



PART V OF BOOK IX 

Describes the very newest remedies, their proper- 
ties, doses and manner of using. 



Acetozone 1251 

Adalin 1251 

Afsal 1251 

Agaricin 1251 

Agurin 1251 

Akaralgia 1251 

Alboline 1251 

Ammonol 1251 

Anasarkin 1251 

Antifebrin 1251 

Antiphlogistine 1251 

Apetol 1252 

Apioline 1251 

Argyrol 1252 

Aristol 1252 

Aspirin 1252 

Atophan 1252 

Avenine 1252 

Baume Analgesique 1252 

Betol 1252 

Blandine Liquid 1251 

Borolyptol 1252 

Cann-aven 1252 

Capsolin 1252 

Caroid 1255 

Cellasin 1252 

Chola-sal 1252 

Collargolum 1252 

Copa-kava 1252 

Corydallis 1252 

Creolin 1252 

Cystogen 1253 

Dioxogen 1253 

Epinephrin 1253 

Europhen 1253 

Formalin 1253 

Formin 1253 

Glycoline ' 1251 

Hedonal 1253 

Helmitol 1253 

Hemabaloids 1253 



Hemostyptic 1253 

Hermotone 1253 

Heroin 1253 

Hydrassan 1253 

Hydrastis .* 1253 

Iatrol 1253 

Ichthalbin 1253 

Ichthyol 1253 

Ingluvin 1254 

Iodex 1254 

Kaolin 1254 

Labronium 1254 

Lactone 1254 

Lactopeptine 1254 

Laxol 1254 

Lymph Orchitis Compound 1254 

Lysol 1254 

Melachol 1254 

Melubrin 1254 

Mercauro 1254 

Methylene Blue 1254 

Morrhual , 1254 

Napthal Bismuth 1254 

Neosalvarsan 1255 

Nephritin 1255 

Neurotina 1255 

Oil of Cassia 1255 

Omoform 1255 

Ovoferrin 1255 

Panopepton 1255 

Papain 1255 

Papoid 1255 

Peptonoids Liquid 1255 

Phenacetin 1255 

Phenol Phthalein 1255 

Phycologen 1255 

Piperazine 1255 

Pituitrin 1255 

Pollantin 1255 

Protargol 1252 

Rheumalgine 1255 



79 



1249 



1250 



INDEX TO PART V OF BOOK IX. 



Saletin 1256 

Salo Santol 1256 

Salvarsan 1256 

Scarlet Red 1256 

Staphisagria-specific 1256 

Stypticin 1256 

Sulphonol 1256 

Tablogestin 1256 

Taka Diastase 1256 



Theobrimine Sodium 125 1 

Theobromine 1256 

Tri-Septic Douche Tablets 1256 

Trionol 1256 

Trypsogen 1256 

Urotropin 1253 

Vaseline 125 1 

Yohimbin 1256 



Home Administration of Medicine 



PART V. 
NEW REMEDIES 



Acetozone. — A germicide used frequently in typhoid fever, internally, 
thirty grains to the half gallon, given two to four ounces every four hours. 
Locally, diluted with boric acid, in surgery and gynecology. 

Adalin — Colorless and odorless powder. Sedative and hypnotic, pro- 
moting sleep. Dose, five to ten grains in water one hour before retiring. 

Afsal. — A yellowish-white powder used in rheumatism in thirty to 
sixty grain doses during twenty-four hours. 

Agaricin. — A white powder recommended for night sweats in phthis- 
ical subjects. Dose, one to one and one-half grains at night. 

Agurin or Theobrimine Sodium. — Dose, five to ten grains, as a diur- 
etic, three or four times a day. 

Akaralgia. — A granular, effervescent laxative containing salicylate 
of soda and magnesia sulphate. Used as a migraine and antirheumatic. 

Albolene, Blandine Liquid, Vaseline, Glycoline A refined liquid 

petroleum under various trade names. Used as oil sprays for catarrhal 
conditions of the nose, and also given internally in doses from two to four 
teaspoonfuls three times a day for chronic constipation. 

Ammonol. — A composition similar to acetanilide comp. Used for neu- 
algia, etc. 

Anasarkin — Tablets containing extract of sambucus, scilli picrin, etc., 
used as a diuretic. 

Antifebrin is an American trade name, and in Germany the official 
title for acetanilide. 

Antiphlogistine — A clay poultice containing glycerine, oil of winter- 
green, boric acid, etc., used locally for sprains and various inflammations. 

Apioline. — Prepared from parsley seed. Prescribed in amenorrhea 
and dysmenorrhea. 

1251 



1252 NEW REMEDIES. 

Apetol. — Composed of nux vomica, gentian, columba, quassia, etc., 
a bitter tonic useful in exciting the flow of gastric juice, aiding digestion 
and improving the appetite. 

Argyrol, Protargol, Collargolum — Silver in organic combination. 
Used instead of nitrate of silver for various local conditions, especially 
gonorrhoea and purulent eye diseasse. 

Aristol — Similar to iodide of thymol. Used locally as a dusting 
powder for ulcers, ulcerating sores, etc. 

Aspirin. — A derivative of salicylic acid. White powder in soluble 
form. Used in all conditions in which the salicylates are used. Rheu- 
matism, gout, neuralgias, sciatica, etc. Dose, five grains repeated. 

Atophan — Indicated in gout, acute and chronic rheumatism, gonor- 
rheal rheumatism, sciatica, lumbago, etc. Dose, seven to ten grains three 
or four times a day with water. 

Avenine — An extract of oats used as a nerve tonic in sexual condi- 
tions. 

Baume Analgesique. — A combination of menthol, salicylate of methyl, 
and lanoline. Used locally for rheumatism, neuralgia, migraine, sprains, 
herpes zoster and many ailments of greater or less importance. m 

Betol. — Also known as naphthalol. Used in gonorrheal cystitis, ar- 
ticular rheumatism, etc. 

Borolyptol. — A liquid antiseptic for local and internal use, contain- 
ing eucalyptus, myrrh, benzoin, etc. 

Cann-Aven. — A combination in pill form for the treatment of seminal 
emissions, nervous debility, spermatorrhoea, impotence, etc. 

Gellasin. — A ferment derived from Fungi — said to be curative in 
diabetes and various forms of malnutrition. 

Capsolin. — A counter-irritant ointment, containing camphor, oil of 
turpentine, oleoresin of capsicum. Used locally in neuralgia, pleurisy, etc. 

Chola-Sal — A pill or capsule used in the treatment of gall stones and 
diseases of the gall duct and bladder. 

Copa-Kava — A pill composed of oil of santal copaiba, kava-kava, etc. 
A combination valuable in the relief of gonorrhoea, gleet, cystitis, and all 
irritating conditions of the bladder and prostate. 

Corydallis. — Specific medicine, used in syphilis owing to its alter- 
ative effect; also employed in scrofulous and tubercular diseases. It 
relieves periosteal skin pains and syphilis nodes. 

Creolin. — A saponified coal tar. Used locally as a germicide disin- 
fectant and deodorant. 



ICHTHALBIBT. 1253 

Dioxogen. — A trade name for peroxide of hydrogen solution. 

Epinephrin. — Also known as adrenalin, etc. A powerful astringent, 
hemostatic and heart stimulant. Applied to a bleeding surface or nose 
bleeding it will control the bleeding at once. In hay fever, in a solution 
in water or oil, used with an atomizer three to six times a day, it affords 
wonderful relief to the patient, making him comfortable and shortening 
the disease. It is also used as a heart stimulant in small doses, but should 
be given under the direction of a physician. 

Europhen. — Yellowish-brown powder. Used locally for venereal 
sores, chancres, ulcers, etc. 

Formalin. — A solution of formaldehyde gas. Employed as a disin- 
fectant and deodorant, especially in contagious diseases. Poisonous. 

Hedonal. — A white powder sparingly soluble in water, used as a mild 
hypnotic. Dose 10 to 20 grains. 

Helmitol, Cystogen, Formin, Urotropin. — These are various names 
given to the urinary antiseptic hexamethylane-tetramine. They are used 
in five to ten grain doses dissolved in water, for cystitis, acute and 
chronic conditions of the bladder from prostatic enlargement, also in 
gonorrhoea. 

Hemabaloids — An iron tonic combined with bone marrow, given in 
teaspoonful doses. 

Hemostyptic. — A fluid extract of ergot and golden seal, used intern- 
ally for hemorrhage in thirty drop doses three times a day. 

Heroin. — A trade name for acetyl morphine used as a sedative in 
cough mixture and to relieve pain. 

Hermotone. — Contains the active principles of the thyroid and other 
secretory organs used in the treatment of neurasthenia, presenility and 
sexual weakness. 

Hydrastis. — Colorless. Used as an injection in gonorrhoea alone or 
combined with various astringents. 

Hydrassan. — A mixture of phenacetin chlorides of mercury, arsenic, 
etc., used in chronic syphilis. 

Iatrol. — A combination of iodine, etc., used instead of iodoform 
(odorless) as a local antiseptic. 

Ichthalbin. — A compound of ichthyol and albumen a gray-brown 
odorless powder for internal used instead of ichthyol. Dose 10 to 30 
grains. 

Ichthyol. — Consists largely of ammonium salts of sulphonic acid ob- 



1254 NEW REMEDIES. 

tained from the fossil remains of fish, a thick brown liquid used mostly 
in various skin diseases and gynecological affections. 

Ingluvin. — A pepsin obtained from the gizzard of the chicken, a 
digestive and used in vomiting of pregnancy. 

Iodoformal. — A compound iodine powder used as a local antiseptic. 

Iodex. — A non-staining iodine ointment containing 5 per cent, of 
iodine, used instead of iodine. 

Kaolin — White earth, used as a base for catapiasm of kaolin and 
also used as an absorbent dusting powder. 

Kinazyme. — An extract of the spleen, liver and pancreas used to in- 
crease weight in malnutrition and wasting diseases. 

Labronium — Has been found valuable in cases in which the bromides 
have been used. Hysteria, nervous sleeplessness, epilepsy, etc. 

Lactone. — Tablets used to prepare buttermilk from fresh milk, one 
tablet converting one quart of milk into buttermilk in thirty-six hours. 

Lactopeptine. — A compound digestive powder composed of pepsin, 
pancreatin, lactic acid, etc. 

Laxol — The trade name for a flavored and sweetened castor oil. 

Lymph Orchitis Compound. — An organic preparation used in impo- 
tence, presenility, neurasthenia, etc. 

Lysol. — Disinfectant and germicide. When mixed with water it is 
used for cleansing wounds, ulcers, etc., also on floors and for washing 
bedding. 

Melachol. — A compound solution of phosphate of soda, nitrate of 
potash and citric acid used as a laxative. 

Melubrin — In pill or powder form possessing the medicinal activity 
of the salicylate, effective in sub-acute and chronic forms of rheumatism 
and as an antineuralgic. The dose is from seven and a half to fifteen 
grains three or four times a day. 

Mercauro. — A solution of the bromides of mercury, arsenic and gold. 
Alterative and antisyphilitic. Dose, 10 drops three times a day. 

Methylene Blue. — An aniline product used as an urinary disinfect- 
ant, frequently used in combination for gonorrhoea. 

Morrhual. — An extract of cod liver oil put up in capsules and used 
in similar cases as cod liver oil. 

Napthal Bismuth Same as orphol. 



RHEUMALGINE. 1255 

Neosalvarsan. — Similar to salvarsan or 606 used in syphilis. 

Nephritin. — Employed in Bright's Disease and other disturbances of 
the kidneys. 

Neurotina. — A tablet containing nux vomica, iron, sawpalmetto, etc., 
used in sexual neurasthenia. 

Oil of Cassia — This oil is said to be effective in curing Barber's Itch 
and is also said to be good in allaying the poisonous effects of poison ivy, 
but it is essential that the true oil be used. 

Omoform. — A fine, odorless, yellowish powder used as a substitute for 
iodoform. 

Ovoferrin — A mild form of organic- iron in liquid form. 

Panopepton — A liquid food. 

Papain, Papoid, Caroid.- — Vegetable pepsins obtained from the juice of 
the pawpaw. Dose 2 to 5 grains. 

Peptonoids Liquid. — A liquid food containing protein and carbohy- 
drates from beef, wheat, etc., used especially in fever cases. 

Phenacetin — White, odorless and tasteless powder, useful for the 
allaying of fevers, also as an analgesic for the relief of headaches, neur- 
algias, etc. Dose, two to five grains. 

Piperazine — Used in cases of gout and rheumatoid arthritis, gravel 
and renal calculus. Dose, ten to twenty grains twice a day with an abun- 
dance of water. 

Phycologen — A name applied to a line of vaccines used hypoder- 
mically in rheumatism, gonorrhoea, etc. 

Phenol Phthalein — Used as a laxative and cathartic. A tasteless 
powder. Can be given to children as well as adults in doses from one to 
three or four grains. It produces watery stools. It is also given in pill 
form and in various combinations. 

Pituitrin. — A stimulant to the uterus and used by physicians during 
labor when the pains have ceased and the labor is slow. 

Pollantin — A name applied to hay fever serum, 

Ehenmalgine. — Rheumalgine is diuretic, a urinary antiseptic, a sol- 
vent for uric acid deposits and promotes the elimination of septic pro- 
ducts through both great channels, the urinary and alimentary tracts. It 
is of established value in the treatment of acute articular and chronic 
rheumatism, muscular pains, lumbago, sciatica, migraine of the rheu- 
matic, gout and nervous irritability of the gouty or "lithemic." Whether 
they are due to auto-infection resulting from faulty elimination or to uric 



1256 NEW REMEDIES. 

acid diathesis. Kheumalgine is an efficient and rational treatment for 
rheumatic disorders. Dose, one to three tablets three or four times a day. 

Salo Santol. — A combination of Santol oil and Salol used in gonor- 
rhoea. 

Saletin. — A trade name for aspirin. 

Salvarsan or 606, used as a specific in syphilis. 

Scarlet Red — Used in 5 to 10 per cent, ointment on ulcers and 
wounds free from edematous swelling. 

Staphisagria-Speeific — Used to allay irritation about the prostate 
gland and testicles and to check prostatorrhcea and spermatorrhoea. A 
nerve stimulant for gloomy forebodings. Exercises a specific action upon 
the reproductive organs. Quiets irritation of the testes and strengthens 
their function. 

Stypticin. — Used in hemorrhage, especially uterine. 

Sulphonol. — Hypnotic and sedative. Dose, five to ten grains for the 
production of sleep. 

Taka Diastase. — A brownish nearly tasteless powder used in indiges- 
tion due to starchy foods. 

Theobromine — An alkaloid found in cocoa, etc., used as a diuretic. 

Tri-Septic Douche Tablets. — Antiseptic, cleansing, healing. For 
leucorrhoea, inflammation of the uterus and vagina. ITon-poisonous. 
Freely soluble in water, odorless and will not stain. 

Tablogestin. — Used to relieve torpid or inactive liver and intestinal 
putrefaction. Also used in the treatment of catarrh of the bile tract and 
the prevention of gall stone formation. 

Trionol. — Hypnotic and sedative. White powder soluble in hot 
water. Used in five to ten grain doses for insomnia. 

Trypsogen Used in diabetes mellitus in connection with diet for 

that condition. 

Yohimbin A remedy for impotency, an alkaloid obtained from 

yohim behe bark. It is said to combat sexual impotency. Its effect is 
more marked when the trouble is due to a functional disturbance asso- 
ciated with a constitutional disease, as obesity, nephritis, or in sexual 
neurasthenics. 



BOOK X 

Treats of the home administration of simple reme- 
dies for many ills. It tells you what to do in case 
of sickness and the absence of the doctor. 



Abscess 1259 

Ague 1259 

Alcoholism 1259 

Anemia 1259 

Angina Pectoris 1259 

Apoplexy 1259 

Apthae 1260 

Asthma 1260 

Backache 1261 

Barber's Itch 1261 

Bed Wetting 1282 

Bile, Deficiency of 1262 

Bilious Fever 1261 

Biliousness 1262 

Bites and Stings 1262 

Bladder, Inflammation of . . 1262, 1283 

Bladder, Irritable 1262 

Bleeding from Lungs 1262 

Bleeding from Nose 1262 

Bleeding from Stomach 1263 

Blood Poisoning 1263 

Blood Purifier 1263 

Boils 1263 

Bowels, Inflammation of 1283 

Brain Fever 1263 

Bright's Disease 1263 

Bronchitis 1263 

Bunion 1263 

Burns and Scalds 1263 

Cancer 1263 

Catarrh 1264 

Carbuncles 1264 

Catch in the Breath 1264 

Chafing 1265 

Change of Life 1265 

Chapped Hands 1265 

Chapped Face 1265 

Chest, Pains in 1265 

Chicken-pox 1265 

Chilblains 1265 



Chills and Fever 1265 

Choking 1266 

Cholera Infantum 1266 

Cholera Morbus 1267 

Colds 1267 

Cold Feet 1267 

Cold, Feverish 1268 

Cold in Head 1268 

Colic 1268 

Infantile 1269 

Painter's 1269, 1288 

Constipation 1269 ' 

Convulsions 1270 

Corns 1271 

Cough 1271 

Cramps in Stomach 1271 

Croup 1272 

Diabetes 1272 

Diarrhoea 1272 

Diphtheria 1273 

Dizziness 1273 

Dropsy 1273 

Dysentery 1273 

Dyspepsia 1273 

Earache 1274 

Eczema 1274 

Epileptic Fits 1270 

Erysipelas 1274 

Fainting 1275 

Falling of Palate 1275 

Felons 1275 

Fever Sores 1275 

Fever and Ague 1265, 1275 

Fistula 1275 

Freckles 1276 

Frost Bites 1276 

Frozen Limbs 1276 

Gall Stones 1276 

Giddiness 1277 

Glands, Enlarged 1277 



1257 



1258 



INDEX TO BOOK X. 



Gleet 1277 

Goitre 1277 

Gonorrhoea 1277 

Gravel 1277 

Hay Fever 1278 

Headache " 1278 

Heart 1280 

Heartburn 1280, 1294 

Heatstroke 1281 

Hemorrhage 1281 

Hiccoughs 1282 

Hives 1282 

Hoarseness 1282 

Hysteria 1282 

Heart-failure 1281 

Incontinence of Urine 1282 

Indigestion 1282 

Infantile Fits 1270 

Inhalation of Noxious Vapors 1283 

Insect Stings 1294 

Insomnia 1283 

Intermittent Fever 1265 

Itch 1283, 1291 

Itching of Anus 1283 

Jaundice 1283 

Kidney Disease 1284 

La Grippe 1284 

Lead Colic 1284 

Leucorrhea 1285 

Liver Complaint 1286 

Lockjaw 1286 

Loins, Pains in 1286 

Lumbago 1286 

Malaria 1286 

Measles 1286 

Melancholia 1286 

Membranous Croup 1286 

Menses, Suppressed 1286 

Menstruation, Excessive 1287 

Mumps 1287 

Nausea 1287 

Nervousness 1287 

Nettle Rash 1287 

Neuralgia 1287 

Night Sweats 1288 

Nipples, Sore 1288 

Offensive Breath 1288 

Palpitation of Heart 1288 

Peritonitis 1288 

Perspiration, Odor from 1288 

Piles 1288 



Pleurisy 1289 

Pneumonia 1290 

Polypus 1290 

Proud Flesh 1290 

Putrid Sore Throat 1290 

Quinsy 1290 

Rheumatism 1290 

Ring-worm 1291 

Rupture 1291 

Salivation 1291 

Scabies (Itch) 1291 

Sciatica 1291 

Scrofula 1292 

Scurvy 1292 

Shingles 1292 

Sick Stomach 1287, 1292 

Sleeplessness 1292 

Small-pox . . 1292 

Sore Eyes 1292 

Sore Mouth 1293 

Sore Throat 1290, 1294 

Sour Stomach .' 1294 

Spleen, Enlarged 1274 

Sprains 1294 

St. Vitus' Dance 1294 

Stings of Insects 1294 

Stomach, Inflammation of 1283 

Sun Stroke 1281, 1294 

Sunburn 1294 

Tonsilitis 1294 

Toothache 1294 

Tympanites 1295 

Ulcer 1295 

Urine 1295 

Varicose Veins 1295 

Vertigo 1277 

Vomiting 1295 

Warts 1295 

Warts, How to Remove 1295 

Water Brash 1296 

Wen 1296 

Whooping-cough 1296 

Whites 1285 

Womb, Falling of the 1296 

Womb, Ulceration of the 1297 

Worms 1297 

Pin 1298 

Round 1298 

Tape 1297 

Wounds, Healing of 1298 



Book X 



What to do in the Absence of a Doctor 



HOME ADMINISTRATION OF MEDICINES 



SIMPLE KEMEDIES FOR MANY ILLS. 

Abscess. — Make a mixture of equal parts of rosin and sugar, and 
apply for sereral days till broken; if not, poultice hourly with flaxseed 
meal or bread and milk or hop poultice, or an ointment of oleate of mer- 
cury and morphia may be used. 

Ague. — Give full doses of quinine. 

Alcoholism. — Remove the cause and give half teaspoonful of com- 
pound tincture of cinchona, with about three drops of tincture nux vomica 
every three hours, or give pill dipsomania. 

Amenorrhea. — Use warm sitz baths and take five grains chloride of 
ammonia every three hours. 

Anemia. — Sponge body morning and evening with a solution of rock 
salt and whiskey and give iron and quinine as tonic — four grains of re- 
duced iron and half grain of quinine — three times a day. Pepto Mangan 
is also an excellent tonic. 

Angina Pectoris. — Inhale the fumes of chloroform or ether, or nitrite 
of amyl tears, one broken in handkerchief and inhale, and give one- 
twentieth grain of arsenic every three or four hours. 

Apoplexy. — This state is caused by the rupture of a blood vessel 
within the skull and consequent escape of blood and pressure on the brain, 
or by the clogging of a blood vessel, thus cutting off the blood supply to 

1259 



1260 SIMPLE HOME REMEDIES. 

some part of the brain. The result is the same in either case : a part of 
the brain ceases to perform its functions owing to pressure of the clot. 
If the clot be small the effect will be slight ; if it be large the effect will be 
grave if not fatal. The sufferer loses consciousness, sometimes falling as 
if felled by a heavy blow, sometimes becoming insensible more slowly. In 
well-marked cases, no effort will arouse the patient from insensibility. 
The face is flushed and the pupils of the eyes generally dilated, or one 
may be dilated and one contracted. Breathing is slow and labored ; snor- 
ing may occur; cheeks are often puffed out with each respiration, the 
air being blown through the lips. Pulse is slow, full and hard. Paralysis 
is an important symptom and must be looked for. Paralysis generally is 
only on one side — the face, arm and leg on the same side being commonly 
affected. The mouth is usually drawn away from the affected side of the 
face. 

Treatment. — Lay patient down, head and shoulders slightly raised ; 
loosen clothing about neck and body ; wrap cracked ice in a towel and place 
it on the head, or wrap head in wet cloths and keep them cold until 
arrival of the doctor. If without medical advice for long period, empty 
the bowels by giving an injection of soap and warm water, at the same 
time giving a cathartic, castor oil or salts, if the patient can swallow. 
Keep the patient quiet. Do not give any stimulant. 

Apthae. — See Sore Mouth. 

Asthma. — Make strong solution of saltpetre and saturate pieces of 
blotting paper and dry. When a paroxysm is felt ignite a piece of the 
paper and inhale the smoke. This acts most quickly, alleviating distress- 
ing symptoms and shortens the paroxysm. 

No fixed formula can be always depended upon ; for a remedy which 
will benefit one case will often prove useless in another. 

Treatment. — 1. One of the best preparations is: 



Iodide of potash i% drachms 

Spirits Ether Co 3 drachms 

Syrup of wild cherry 4 ounces 

Two teaspoonfuls in water three times a day. 



2. Another remedy, highly recommended, is thus prepared : 



Lobelia leaves I teacupful 

Hot water '.* i pint 



BILIOUS FEVER. 1261 

Steep one-half hour. Take one tablespoonful at a dose every fifteen to thirty 
minutes until free spitting of mucus is produced. 

3. For very urgent cases the following is generally satisfactory, but 
must be used with caution : 

Ether % teaspoonful 

Laudanum 10 drops 

Water , I wineglassful 

To be taken only once, or at most twice, and if second dose is given, it must not 
be sooner than six hours after the first dose. 

Backache. — Apply a mixture of one part of turpentine to two parts of 
sweet oil to the back two or three times a day. Use mixture warm. 
Chloroform liniment is also recommended. 

Barbers' Itch. — Excellent results have been received with the follow- 
ing treatment: Thoroughly wash the affected area with good soap and dry. 
Then apply a mixture of equal parts of alcohol and solution of peroxide 
of hydrogen, to which has been added bichloride of mercury, in the pro- 
portion of four grains to the ounce. The hydrogen peroxide seems to help 
carry the more powerful antiseptic into the infected areas about the hair- 
follicles. 

Treatment. — 1. In addition to the citrine ointment and vaseline 
recommended for ringworm, the following will be found excellent for bar- 
ber's itch, and an almost infallible cure for common itch: 

Plain vaseline 4 ounces 

Sulphur 2 ounces 

Sal ammoniac, powdered 2 drachms 

Mix and apply daily, after cleansing the part thoroughly with castile soapsuds. 

2. Another good ointment is composed of : 

Plain vaseline 2 ounces 

Venice turpentine % ounce 

Red precipitate V-i drachm 

Apply in same manner. Great care should be taken not to expose affected parts 
to cold draughts while ointment is in use, especially if the affected surface is large. 

Bilious Fever. — Take about ten drops of the fluid extract of wild 
indigo-root in a little water, once in four hours. After a day or two com- 
mence with one grain of cinchonidia. To be taken every three hours. 



1262 SIMPLE HOME REMEDIES. 

Biliousness — Use the juice of half a lemon each morning before 
breakfast. Boil two ounces of quassia root in one pint of water and 
strain. Take a teaspoonful every four hours for a week or two. 

Bile, Deficiency of. — Give one grain of mercury and chalk (gray pow- 
der) three times a day. 

Bites and Stings. — Apply a solution of saltpetre, one or two teaspoon- 
f uls to a cup of water. 

Treatment. — The irritation and itching caused by the bites and 
stings of insects, such as the mosquito, bee, hornet, and so forth, are re- 
lieved by the prompt application of spirits of ammonia (hartshorn), or of 
the juice from common plantain. For treatment of snake bites and other 
poisoned wounds, see Poisons and Antidotes. 

Bladder, Irritable — Bicarbonate of soda ; sweet spirits of nitre. 

Bladder, Inflammation of — Give a mixture of one ounce tincture cu- 
bebs, one ounce tincture buchu and two drachms sweet spirits of nitre. 
Half a teaspoonful in water every two or three hours. Another remedy 
is an infusion of pipsissewa root, one ounce to pint of boiling water, and 
give wineglassful three or four times a day. Keep parts well warm with 
poultices and so forth over bladder. Drink plentifully of hot tea, which 
is an excellent remedy. 

Bleeding from the Lungs. — Treatment. — -1. The most common rem- 
edy, and one usually effective, is common salt, which should be eaten 
freely, a teaspoonful at a time, until relief is obtained ; or half teaspoon- 
ful of fluid extract of ergot, repeated. 

2. In obstinate cases, the patient should be kept perfectly quiet, and 
this powder given : 

Gallic acid 6o grains 

Powdered sugar I drachm 

Make ten powders and give one every ten minutes. 

[1ST. B. — Since spitting blood may be only a symptom of a much more 
serious trouble, a physician should always be called in when obtainable.] 

Bleeding from the Nose — Inject a strong solution of alum, made with 
one-quarter teaspoonful of alum to half teacup of water, into each nostril, 
and place cotton saturated with same to nostril. Apply cold to the nose. 

When obstinate, take cobweb or grated salt beef, hard and dry, and 
push it into the nostril as far as possible. External pressure from thumb 



CANCEE. 1263 

and finger, continued fifteen or twenty minutes, will also be of benefit. 

Another good method is to apply cold water or ice to forehead, also 
to back of the neck ; or locally adnephrin applied on cotton. 

Bleeding from the Stomach. — This is often a serious condition and a 
physician should be consulted at once. 

Blood Poisoning. — Quinine sulphate, one scruple ; tincture chloride of 
iron, one and one-half drachms ; simple syrup, two ounces ; make mixture 
and give half teaspoonful four times a day. 

Blood .Purifier. — Sarsaparilla tea, a tablespoonful three or four times 
a day. Cream of tartar, half a teaspoonful night and morning in water. 

Boils. — A quick poultice for a boil may be made of equal parts of 
soap and brown sugar, spread on a cloth and faithfully applied. The 
following powder may be taken internally to cleanse the system of im- 
purities : Six tablespoonfuls of flowers of sulphur and three tablespoonfuls 
of cream of tartar, well mixed and one teaspoonful taken each morning 
and night in syrup or molasses. 

Brain Fever. — Give from five to twenty drops of the following mix- 
ture every hour or two during the excitement: Tincture aconite root, 
thirty drops; tincture yellow jasmine, two drachms; sweet spirits nitre, 
one drachm; simple syrup, two ounces. Consult physician. 

Bright's Disease. — Use skimmed milk freely, both at meals and be- 
tween, and apply soothing fomentation to small of back, as infusion of 
hops with laudanum; and Bascham's Mixture, tablespoonful three times 
a day. Consult physician. 

Bronchitis. — To a pint of flaxseed tea add the juice of two lemons 
and about three tablespoonfuls of sugar, and take a teaspoonful every 
half hour until relieved. If desired, you can add a small quantity of 
chloride of ammonia. Another remedy is to encircle the chest with flax- 
seed poultice and give three drops of aconite with ten drops sweet spirits 
of nitre, every two or three hours. 

Bunion. — Apply adhesive plaster to part; put about a half teaspoon- 
ful of salicylic acid to two tablespoonfuls of lard and apply morning and 
night. 

Burns or Scalds — Put a teaspoonful of alum in a pint of water, and 
bathe parts frequently. Keep the parts well wet with this solution, which 
extracts the heat in a remarkable manner and soothes the patient into a 
calm and refreshing sleep. Apply equal parts of limewater and linseed oil. 

Cancer. — Give a tablespoonful of sarsaparilla tea, made with two 
ounces of sarsaparilla root in quart of water boiled to pint ; and apply to 



12T64 SIMPLE HOME REMEDIES. 

cancer growth a poultice made of carrots scraped of mashed cranberries. 
Consult a physician. 

Carbuncles. — Carbuncles are much more serious than boils. Consult 
Index for full discussion of. As temporary relief to pain, etc., apply one 
part tincture belladonna with two parts glycerine, and over this apply a 
warm poultice. Other treatments are: 

1. To draw or ripen them, a poultice of poppy leaves is very effi- 
cacious. 

2. Equally effective is a poultice made of sassafras root and slippery 
elm bark, boiled together, and the decoction thickened by stirring in 
cornmeal. 

3. Linseed and slippery elm decoction, mixed with a little charcoal 
and yeast, used as a warm application, or lotion, seems to lessen pain and 
inflammation. 

4. Carbuncles which head slowly should be opened with a knife, not 
by sticking, but by two transverse incisions. Menthol ethereal, solution, 
10 to 50 per cent., applied by camel's-hair brush, aborts boils, carbuncles 
and inflammatory gatherings. 

Catarrh. — Use a mixture composed of one teaspoonful of common 
salt, a teacup of milk and half pint of warm water as injection for 
nostrils three times a day; or same quantity of borax can be substituted 
for the salt or alkaline antiseptic solution. 

This results from neglected or repeated attacks of the acute form, 
or following measles, scarlet fever, and so forth. There is a constant 
offensive discharge from the nose and nasal passages, pain in the eyes 
and head, sneezing, loss of appetite, and so forth. 

Treatment. — A snuff composed of 

Bloodroot 2 ounces 

Bayberry root \Vi ounces 

Peruvian bark 2 ounces 

Borax, pulverized V2 ounce 

finely pulverized and mixed, should be kept on hand and constantly snuffed 
into the nostrils. The bowels must be kept open by taking occasional 
simple purgatives. Strength should be kept up by the use of tonic pills. 

Locally use to the nose and throat liquor antisepticus alk. with an 
atomizer three or four times a day. 

Catch in the Breath — Cold sponging for infants waking with a catch 
in the breath at -night. 



CHILLS AND FEVER. 1265 

Chafing. — Use powdered cornstarch freely after bathing and drying 
(well) the parts, or talcum powder. 

Treatment. — Afflicts children and fleshy persons. Usually all that is 
required is washing well with castile soap and cold water, and anointing 
with plain vaseline. A solution, to be used twice a day in connection with 
frequent washing in cold water, is composed of: 



Pure water 2 gills 

Powdered borax 1 teaspoonful 

Sulphate of zinc % teaspoonful 

Apply by means of a soft rag several times daily. After drying well, dust the 
parts with wheat flour or cornstarch, powdered magnesia or talcum powder. 



Change of Life — For flushings, and so forth, three grains of bromide 
of potash every three hours. For headaches apply a mixture of two 
ounces of ammonia and common salt, three ounces of alcohol and thirty- 
two ounces of water. 

Chapped Hands and Face. — Apply a mixture of one-third glycerine 
and two-thirds rosewater two or three times a day, or cold cream. 

Chest, Pains in. — When not from inflammation, apply iodine oint- 
ment. 

Chicken-Pox. — Keep child in darkened room and give nitre water as 
'drink, and one drop of aconite every two hours for two or three days. 

Chilblains. — Apply lime water to part affected several times a day. 
Another remedy is the application of balsam of Peru ointment or iodine 
ointment. 

Treatment. — 1. The first treatment for frosted feet, to be applied at 
once, before the feet are "thawed out," is rubbing with snow and bathing 
them in ice-cold water. Let the normal blood-heat be restored very grad- 
ually, and continue the cold water treatment for some hours. Do not 
apply external heat of any kind. 

2. For chilblains, the best treatment is frequent bathing in cold water 
and in a strong decoction of white oak bark. Bandaging the parts loosely 
with flannels saturated with crude petroleum has cured many cases. These 
are probably the best remedies, although many others have been tried with 
varying success. 

Chills and Fever, Fever and Ague, Intermittent Fever. — Treatment. — 
1. Upon the first indications of a chill, the following powder will be 
found useful: 

80 



1266 SIMPLE HOME REMEDIES. 

Sulphate of quinine 30 grains 

Extract of podophyllin, pulverized 30 grains 

Cayenne pepper, pulverized 1 drachm 

Charcoal, pulverized 1 drachm 

Mix thoroughly and divide into twenty powders. Dose for an adult is two 
powders, taken every two hours, until chill has ceased and the hot stage begins. 

2. After first powder is taken, patient may be placed in a warm bath 
and given hot chamomile or mint tea, with a copious sprinkling of cayenne 
pepper. In place of the warm bath, patient may be covered np warmly 
in bed and dry heat applied (by means of hot bricks, and so forth) along 
the spine to the extremities, over the pit of the stomach, and so forth. 

3. In the third stage (sweating) patient should be gently stimulated, 
if great weakness exists, with a little whiskey toddy, warm brandy or some 
similar drink. Between the ague fits, which may occur every other day, 
or once in three days, once in four days, or irregularly, give : 

Sulphate quinine 30 grains 

Sulphuric acid 30 drops 

Pure water 1% ounces 

Mix in a bottle and shake well. Dose for an adult: One teaspoonful every two 
hours, or every hour, if necessary. 

4. A good preventive of chills and fever is the following : 

Good rye whiskey 4 ounces 

Pulverized rhubarb 1 drachm 

Pulverized Peruvian bark 1 ounce 

Mix in a large bottle, and let it stand for some days. Take a good tablespoonful 
of the decoction three times a day during the continuance of aguish symptoms. 

Choking. — In children who choke with liquids from their birth, from 
one to two grains bromide of potash every two or three hours. 

Cholera Infantum. — Give one-fourth grain of gray powder (mercury 
and chalk) every hour or two, with lime water and milk for vomiting. 
Warm poultice to abdomen and bowels. 

The following mixture also has been used with great success, in early 
stages especially: 

Prepared chalk 10 grains 

Subnitrate of bismuth 10 grains 

Paregoric 1V2 teaspoonfuls 

Syrup of ginger 5 teaspoonfuls 

Gum arabic mucilage 5 teaspoonfuls 



colds. 1267 

Mix. Dose for child one year old, one-half teaspoonful two to six times a day, 
usually not oftener than once in five or six hours. Vomiting may be relieved by giving 
small pieces of ice, if the child is old enough to swallow them. This treatment will 
often bring relief, but if it does not, give a teaspoonful of flaxseed tea or slippery 
elm tea, with (for a child four to six weeks old) one drop of laudanum, once in two 
or three hours. 

Cholera Morbus — A handy preparation to have in the house for such 
conditions is the Squibbs' Mixture, composed of laudanum, one ounce ; tr. 
capsicum, one ounce ; spirits camphor, one ounce ; chloroform, three 
drachms. Alcohol enough to make fi.\e ounces. Dose, thirty to sixty 
drops in warm water. Locally apply mustard to the abdomen. 

Another remedy, highly prized by many, is: 

Common salt 3 teaspoonfuls 

Black pepper 4 teaspoonfuls 

Cider vinegar Vi teacupful 

Warm water V2 teacupful 

Mix all together and take the whole dose, a tablespoonful at a time. If the first 
cupful is rejected, take another at once. 

When stomach is settled take a powder composed of : 

Powdered peppermint leaves V2, ounce 

Powdered cloves V2 ounce 

Pulverized rhubarb 1 ounce 

Mix well together. Dose : One teaspoonful every thirty minutes, or less fre- 
quently after one or two doses. Hot fomentations applied to the stomach and ab- 
domen are not out of place at any stage of cholera morbus. 

Colds. — Mix ten drops of spirits of camphor with a pint of hot water. 
Sip the whole of it as hot as it can be taken. Avoid draughts till the 
free perspiration has carried the cold off. Quinine and Dover's powder ; 
open bowels. Among other remedies the following may be mentioned : 
Sweet spirits of nitre and paregoric, a half teaspoonful of each for an 
adult, or sulphate of quinine, eight or ten grains to check; carbolized 
vaseline to inner surface of nostrils; if well developed inhale vapor of 
boiling water in which is a teaspoonful of paregoric. 

Cold Feet.- — Make solution of two teaspoonfuls of borax in quart of 
warm water, and soak feet thoroughly at bedtime, and wear woolen socks 
for sleeping. Bathe feet in cold water and rub dry with a rough towel. 
Essence of ginger, paregoric and water bag are also used to advantage. 



1268 SIMPLE HOME REMEDIES. 

Cold, Feverish. — At commencement a warm bath will cut short the 
attack, remove the aching pains and relieve the hoarseness. 

Cold in Head. — Take at beginning ten drops of camphor every two 
hours and inhale spirits of ammonia, with warm bath at night. 

This common complaint will frequently run its course and disappear 
in four or five days, but may be cut short by care and simple remedies. 

Treatment. — In the first place take a saline purgative, such as a 
dose of Epsom salts — or a seidlitz powder. x\t bedtime soak the feet in 
hot mustard water and take ten grains of Dover's powder. Cover up 
warm in bed and "sweaj; it out." The use of quinine — say one two-grain 
pill every three hours, or the following, will be effective: 

Phenacetin 24 grains 

Quinine 24 grains 

Caffeine 6 grains 

Make twelve pills. One every three hour" 

Colic. — Give ten to fifteen drops of asafoetida every half hour until 
relieved. Chamomile tea, a teaspoonful every ten or fifteen minutes. 
In case of children or infants give from one-half to two grains of carbonate 
of ammonia every hour or two until relieved and apply fomentations of 
all kinds or spirits of chloroform, two to five drops, with one or two drops 
of laudanum. 

Treatment. — 1. To relieve the pain give an injection of thin starch 
containing twenty to thirty drops of laudanum. To relieve the consti- 
pation give a Seidlitz powder, or a tablespoonful of castor oil, to which 
may be added a half teaspoonful or less of spirits of turpentine. The ap- 
plication of warm fomentations to the abdomen, or a mustard plaster wet 
with vinegar is also recommended. Soaking the feet in hot water is also 
of benefit. Colic is a very painful disorder, but seldom or never ter- 
minates fatally. 

2. One of the best general remedies for colic, diarrhoea, pain in the 
stomach and bowels is the following cordial: 

Gum myrrh V2 ounce 

Ground nutmeg % ounce 

Cayenne pepper V2 ounce 

Good brandy or whiskey 1 quart 

Pulverize the myrrh, nutmeg and pepper together; put them into a two-quart 
bottle ; add the brandy or whiskey and cork tightly. Let it stand ten days or more, 
shaking frequently, then strain and bottle for use. Dose for an adult: One teaspoon- 
ful. An excellent and harmless remedy for colic, pain in the stomach and bowels, and 



SOAP INJECTION. 1269 

very useful in diarrhoea. This preparation ought to be kept in the house constantly. In 
using this for colic do not neglect the use of a purgative also, such as a dose of castor 
oil or salts. 

Colic, Infantile. — Relief is sometimes afforded by stirring a teaspoon- 
ful of salt in a large glass of water and giving a teaspoonful every five 
minutes. It is also a good preventive of colic, sour stomach and con- 
stipation, and for such purposes should be given three or four times a day. 

Colic, Painter's. — Give ten grains of alum every hour until relieved ; 
then tablespoonful of epsom salts. 

Constipation. — Drink glass of cold water before and eat orange after 
breakfast each morning, or five grains of ext. cascara at night, or twenty 
drops of the fluid extract cascara sagrada night and morning. In some 
cases one-sixth of a grain of belladonna at bedtime affords relief or a sup- 
pository of two grains of the extract. Two or three grains of rhubarb 
with a grain or two of carbonate of soda are also frequently efficacious. 
Salted mineral waters before breakfast are oftentimes valuable. A table- 
spoonful of tincture of aloes and two tablespoonfuls of soap liniment 
mixed and rubbed over the bowels Hve minutes daily is said to have bene- 
ficial results. A tea made of slippery elm taken daily in half-teacupful 
doses or a teaspoonful of flaxseed in cup of boiling water for few minutes 
and then strained. 

Soap Injection. — Cut a piece of yellow soap two or three inches 
long and of the thickness of the little finger, making the same pointed 
at one end. If this is introduced into the bowel and held there for a 
few moments it will produce a good evacuation; or make a strong soap- 
suds, to which add a tablespoonful of glycerine or use a glycerine sup- 
pository. 

The following is well adapted for frequent or daily use in habitual 
constipation, but is hardly so active as the preceding: 

Powdered senna 2 ounces 

Powdered licorice 2 ounces 

Powdered fennel 1 ounce 

Flowers of sulphur I ounce 

White sugar 6 ounces 

Mix and pulverize well together. Dose: One teaspoonful in one-half glass of 
water well stirred up. For children, reduce the dose in proportion to age. When 
there are dropsical or congestive symptoms add a teaspoonful of cream tartar to each 
dose to stimulate the removal of the fluids from the system. 



1270 SIMPLE HOME REMEDIES. 

Habitual constipation is hard to cure, and calls for strict observ- 
ance of dietary regulations. Coupled with a proper diet and mode of 
life one of the following will often affect a cure : 

A good purgative biscuit is made as follows: Powdered jalap, one 
teaspoonful; flour, eight tablespoonf uls ; sugar, twelve tablespoonfuls ; 
powdered ginger, half teaspoonful; make twelve biscuits; one may be 
eaten once or twice a day according to effect desired. For children three 
years old and infants one-third the quantity. 

Convulsions. — Epileptic. — Causes. — The causes of this strange dis- 
ease are but imperfectly understood, and no infallible remedy has yet 
been disccovered. 

Treatment. — 1. Total abstinence from rich and animal food, with 
hygienic modes of living constitute the best defense of an epileptic patient. 

2. When adults are laboring under the paroxysm little in general can 
be or ought to be done, except bringing the patient into the fresh air, 
taking off what may be around the neck and baring the chest, together 
with the more imperative duty of preventing the patient from doing him- 
self any injury. If the paroxysm be prolonged greatly, the application of 
cold to the head may be of some service. The inhalation of ammonia or 
chloroform has been found useful. Internally the mixed bromides often 
affords relief. 

Convulsions — Infantile Fits. — Causes. — Indigestion, worms or the ir- 
ritation of teething are the usual causes of fits in childhood, or "spasms," 
as they are called. 

Treatment. — 1. Place the child in a warm mustard bath, say about 
two teaspoonfuls of mustard to one bucketful of water, and at the same 
time apply cold water to the head; this will relax the spasm and allow 
you to take steps to remove the cause of the trouble. If the child is teeth- 
ing and the gums are hot and swollen they should be lanced and allowed 
to bleed freely. 

2. If indigestion or constipation seems to be the cause, give from 
fifteen to thirty drops of castor oil, in gruel, and an injection of warm, 
soapy water. Sometimes a simple emetic should be first given. 

3. If you have reason to suspect that the child has worms, proceed as 
directed in article on worms, which see. To prevent the recurrence of the 
spasms the bowels must be kept reasonably free by giving small doses of 
castor oil daily. The warm bath, with cold water on the head, rarely fails 
to give instant relief from the severe and threatening symptoms. It 
should be applied at once, when spasm commences. 



CRAMPS IX STOMACH. 1271 

4. The following is an excellent remedy for infantile convulsions: 

Chloroform Vi drachm 

Bromide of potash %. drachm 

Tincture of cardamom % ounce 

Spearmint water 2V2 ounces 

Shake well and give one-half teaspoonful in water to child one year old ; smaller 
children a proportionate dose. 

Corns.— Apply kerosene oil to part each night. Apply turpentine to 
part each night, or salicylic acid twenty grains to one-half ounce simple 
cerate. 

Cough. — Flaxseed tea, a teaspoonful every ten or fifteen minutes. A 
mixture of lemon and sugar is very efficacious. Take small quantity every 
ten or fifteen minutes. Other remedies are : Tablets of "Brown Mixture ;" 
syrup of ipecac ; aromatic spirits of ammonia ; paregoric. In chronic 
cough, ten grains of alum in teaspoonful of water and spray throat with 
same, or spray throat with wine of ipecac. 

This form of a cold may originate in the throat and chest, or may 
be caused by the spreading downward of unchecked nasal catarrh. 

Treatment. — 1. Treatment in first stages is similar to that given for 
nasal catarrh (preceding) or for bronchitis, with a saline purgative. If 
the cough becomes troublesome use : 

Muriate of ammonia \Vi drachms 

Fluid extract of licorice 4 drachms 

Syrup of wild cherry bark I ounce 

Water I Vi ounces 

Dose : A teaspoonful every two hours, according to severity of symptoms. 

2. If the cough still continues after three or four days, make a cough 
mixture composed of: 

Syrup of squills 6 drachms 

Syrup of wild cherry 6 drachms 

Heroin % grain 

Cyanide of potassium Vi grain 

This should be compounded by an apothecary and thoroughly mixed. Dose for 
adult, one teaspoonful every six hours. This mixture is very effective, but must be 
used with caution, as it contains ingredients which are poisonous in overdoses. 

Cramps in Stomach. — Make mustard poultice, with white of egg in- 
stead of water, and apply same to bowels, and give Squibbs' Mixture. Hot 
water bags often afford relief. Paregoric and also laudanum relieve pain, 
but must be used with great caution. 



1272 SIMPLE HOME REMEDIES. 

Croup. — A most insidious and sometimes fatal affection if treatment 
is not immediately applied. Turpentine stupes applied to front of throat 
and breast have proved most effective, saving many lives thereby. The 
stupes should be made with one-third turpentine and two-thirds water, as 
hot as can be borne, and apply the same on flannel cloths every few mo- 
ments until relief is obtained. It quickly acts upon the breathing tubes, 
cleaning them out, and enables the little sufferer to breathe easily, clearly 
and with safety. Give syrup of ipecac frequently until vomiting is pro- 
duced. This condition should not be confounded with diphtheria. Other 
remedies are: 

1. Fat bacon applied to the throat, as in sore throat, is recom- 
mended as a remedy for croup. Its action can be helped by taking inter- 
nally a few drops of kerosene oil on sugar. 

2. Mix a teaspoonful of alum with the white of one egg, and 
give a teaspoonful every few minutes until free vomiting occurs. Give 
one-quarter teaspoonful of syrup of ipecac every ten minutes until free 
vomiting occurs. 

Diabetes. — In this disease there is an excessive flow of yellowish, 
sweet urine, with frequent calls to void it. 

Treatment. — 1. A tea of water-hoarhound, drunk freely, is an ex- 
cellent remedy. Or, in place of the tea, a teaspoonful of the tincture may 
be taken four or five times a day. 

2. A tea of common chickweed, drunk freely for some time, is also 
mentioned as an excellent remedy. Salicylate of soda in five-grain doses 
is most efficacious. 

3. A purely milk diet, in copious quantities, has been found to result 
favorably. 

4. One-quarter grain doses of codeine three times a day. No sugar 
should be used in the diet. 

Diarrhoea. — Take half ounce of blackberry root and boil in pint of 
water about fifteen minutes, strain and give teaspoonful every hour or 
two until relieved ; or fluid extract, dose iive to ten drops in a little water ; 
one-half to one teaspoonful of paregoric in water. Other remedies are: 

1. An infusion of chamomile, prepared by steeping four to six heads 
of chamomile flowers in a cup of boiling water for an hour, and giving 
a teaspoonful hourly. Avoid solid food uutil bowels are all right. 

2. Tablets of chalk mixture, of subnitrate of bismuth, or of pepsin; 
paregoric, laudanum. 

o. Give starch injection with half a teaspoonful of laudanum for 



dizziness. 1273 

adult; for child only a few drops, and one drop of the wine of ipecac 
every hour, especially if vomiting be present, or half a grain of gray 
powder (mercury and chalk) every hour or two. 

4. A good blackberry cordial, such as the following, is often found 
to be a preventive and specific for summer complaint, diarrhoea, etc. : 



Ripe blackberries 2 quarts 

Sugar, white 1 pound 

Cloves and allspice % ounce of each 

Boil all together. When cold, press out and strain the juice and add a pint of 
good brandy. This makes a pleasant drink, and may be taken in quantities from a 
teaspoonful to a wineglassful every two to four hours. Be careful not to take too 
much astringent medicine and thereby check the diarrhoea too suddenly. 



Diphtheria — Spray the throat with peroxide of hydrogen. Give 
small doses of calomel repeated. Call a physician and use antitoxin. 

Dropsy — Make a tea or infusion of half an ounce of skull cap root 
to one quart of water, and boil to pint. Take wineglass of same three or 
four times a day. Or the same quantity of grapevine root, made in same 
manner, and taken as above. Bascham's Mixture, dessertspoonful three 
times a day. 

The following prescription has been found of value: 

Fluid Extract Digitalis 20 drops 

Fluid Extract Belladonna 30 drops 

Fluid Extract Buchu 1 ounce 

Dose: Four drops in water every four hours. 

Dysentery — Take an ounce of dewberry root and boil in quart of 
water to one pint, and give half wineglass of same every two or three 
hours until discharges diminish. Ten grains of subnitrate of bismuth 
frequently. See Diarrhoea. 

Dyspepsia, — Small doses bicarbonate soda before meals and do not 
eat' any fried food. Pepsin tablets. Three grains of bismuth, with five 
grains of charcoal, to be taken before meals, and three grains pepsin in a 
little water after meals. Half teaspoonful of compound tincture cinchona, 
with five drops tincture of mix vomica in a little water, taken three times 
a day, is very beneficial. 

Dizziness — Give five drops of tincture of gelsemium four times a 
day. 



1274 SIMPLE HOME REMEDIES. 

Earache — Inflammation of the Ear. — Treatment. — 1. Beware of in- 
jections into the ear, or the use of any and all instruments. Either of 
the preparations here described will almost surely give relief: 

2. A drop or two of chloroform on cotton and placed in the ear and 
heat applied. 

Sweet oil 2 teaspoonf uls 

Laudanum I teaspoonful 

Mix. Lie with head resting on the side opposite the inflamed ear, and drop from 
a warm teaspoon from four to six drops of this mixture into the affected ear; then 
stop with cotton. \ 

3. Another, equally good, is: 

Onion juice 2 teaspoonfuls 

Sweet oil 2 teaspoonfuls 

Laudanum I teaspoonful 

Mix and use as above directed. Be sure to apply warm, not below blood heat. 
To get the onion juice, roast one or two large onions and press out the juice. It is 
a good plan to soak the feet in hot water and take an active cathartic if bowels are 
in the least constipated. 

Eczema. — 1. Chronic eczema (skin disease) may be treated success- 
fully by an ointment of pitch and turpentine melted together ; an ounce of 
each. Add an ounce of vaseline and two drachms of red precipitate. 
Mix all well and apply as a salve, or ichthyol and zinc ointment. 

2. A good eczema wash is made of an ounce each of bruised blood 
root and yellow dock, steeped well in a pint of alcohol and half pint of 
vinegar. 

3. A paste of sulphur and lard applied to the affected skin morning 
and evening is recommended as a good eczema cure. 

4. Apply ichthyol, one drachm; zinc ointment, one ounce. If itch- 
ing ten drops of carbolic acid can be added. A cold potato poultice, with 
a small quantity of camphor, has proven most beneficial. 

Enlarged Spleen. — Give quinine and the tincture of the chloride of 
iron — one-half grain of quinine and ten drops of the tincture of iron — 
three times a day, and apply morning and night over the enlargement 
the compound iodine ointment. 

Erysipelas. — Put about a tablespoonful of baking soda in one pint of 
water and bathe parts several times a day. Keep parts well bathed with 
witch hazel. Other remedies are: 

1. Boil white navy beans, mash and add cornmeal to make poultice. 
Apply hot and change frequently. 



FISTULA. 1275 

2. A wash containing two parts of borax to five of water is effec- 
tual in subduing inflammation; also an ointment of three grains of 
morphine, two drachms of green vitriol and one ounce of lard, applied 
several times a day. Tincture iron along the margin to prevent spreading. 

3. Take one teaspoonful of following mixture every two hours : One 
ounce each of glycerine, chloroform and tincture of iron. 

4. Give iive drops tincture of aconite every hour at commencement. 
Add a teaspoonful of tincture of digitalis to half a pint of boiling water, 
and apply by means of flannels wrung out of the decoction to parts. 

Exposure to Cold. — See Frost Bites. 

Fainting. — Aromatic spirits of ammonia; whiskey; keep head low, 
have clothing around neck and waist loose, and give plenty of fresh air. 
Sprinkle face with cold water. 

Falling of Palate or Uvula Make a strong decoction of white oak 

bark, and use as a gargle several times a day. 

Felons. — These painful inflammations usually occur on the fingers 
or hands. They are seated at the bone and begin with throbbing pain 
and great soreness and inflammation. 

Treatment. — 1. A good drawing poultice is made of brown soap 
and unslacked lime, into which a little alcohol has been introduced. 

2. The white of an egg and salt make an application which some- 
times serves to scatter the inflammation, or bread and milk poultice. 

3. Immerse the afflicted finger or hand in hot water frequently. 

4. Mix thoroughly half teaspoonful of powdered camphor and one 
egg and apply two or three times a day. 

Fever, Simple — Give about half a teaspoonful of sweet spirits of 
nitre in a little sweetened water every two or three hours for an adult, 
and smaller quantity to child, in proportion to age. Keep bowels well open 
with simple purgative. Ascertain temperature by clinical thermometer. 
98.6 degrees is normal; 99 to 101, slight fever; above this marked fever. 
Bathe with alcohol and water. 

Fever and Ague. — Make an infusion of one ounce of dogwood root 
boiled in one quart of water to one pint ; strain and give half wineglassful 
every two or three hours. Quinine in liberal doses. 

Fever Sores. — Make a decoction of clover blossoms, and apply to parts 
three or four times a day. Half ounce of clover blossoms to one pint of 
water, and boil about half an hour. Apply spirits camphor. 

Fistula. — Use as an injection a solution of witch hazel, diluted with 
water. 



1276 SIMPLE HOME REMEDIES. 

Freckles. — Treatment. — Freckles are sometimes removable and 
sometimes not. The following lotions are as good as any : 

Rain water 8 ounces 

Borax % ounce 

Mix and dissolve; wash part twice daily. 

Rose water 4 ounces 

Alcohol V2 ounce 

Hydrochloric acid V2 drachm 

Mix and apply with sponge or rag three times daily. Painting with tincture of 
iodine is sometimes effective. Generally speaking, it is best to leave the freckles alone. 

Frost Bites, Frozen Limbs, etc. — In severe winter weather any ex- 
posed or insufficiently clad part of the body is liable to become frozen, 
and this is especially likely with the extremities such as nose, ears, fingers, 
toes, etc. The parts first become blue, then purple and then white and 
stiff. When solidly frozen the part becomes as hard as stone and at the 
same time is very brittle so that, for instance, were you to strike a solidly 
frozen ear, it would break off. Freezing is apt to occur without the victim 
being aware of the fact. It may usually be prevented by rubbing any part 
which feels very cold, as this brings warm blood to the surface. The 
danger is when after being cold the part suddenly has no feeling. The 
object of treatment is to gradually restore circulation to the congealed part. 
Application of snow or cold water to the frozen part, gently rubbing and 
pinching it, is the most common method of restoration, but care must be 
taken in severe cases to do this so gently as not to break off any brittle 
part. Under no circumstances should dry heat be applied nor hot water, 
as either of these methods is apt to cause mortification of the frozen part ; 
but it is now recognized that the most efficacious treatment is that of 
commencing the thawing process with water that is merely warm and 
then gradually as the thawing takes place making the water warmer until 
it is as hot as may be borne. (See General Index for full discussion of 
this condition.) 

Gall Stones — Drink about one wineglassful of sweet oil at bedtime, 
followed in morning by cathartic, as seidlitz powder or cream of tartar, 
and phosphate of soda, teaspoonful each morning in wineglassful of water. 
This treatment to be pursued several weeks. Massage the part over the 
region of the liver lightly night and morning. Gall stones being very 
painful and dangerous, it would be well to consult Liver Colic. During 



GRAVEL. 1277 

attack ten grains of chloral every two or three hours until relieved, or 
tablespoonful of olive oil every two or three hours until relieved. Apply 
warm fomentations to seat of pain. 

Giddiness — Vertigo. — This is a symptom rather than a disease, and 
generally arises from a disordered stomach or (in women) a derangement 
of the menstrual functions. Ordinarily a good purgative, or sometimes an 
emetic, with hot foot-baths, will remedy the trouble. 

Glands, Enlarged. — Apply iodine ointment and give internally three 
grains of sulphide of calcium three times a day. 

Gleet. — To one ounce of Port wine add about ten grains of tannin, 
and use as an injection three or four times a day, or pills Copa-Kava. 

Goitre. — Apply the following several times a day: Extract of bella- 
donna, half drachm ; compound ointment of iodine ; two drachms ; vaseline, 
half ounce, or iodine peptogen. This treatment must be kept up for sev- 
eral months. 

Gonorrhea. — Treatment. — 1. This should be chiefly by injection 
into the urethra, and probably the best, especially for the earlier stages, is 
the following : 

Fluid extract hydrastis i ounce 

Distilled water 6 ounces 

Gum arabic, pulverized 2 drachms 

Mix and inject with proper syringe three or four times daily. 

2. Internally give pills of Copa-Kava. 

3. Observe care as to diet and so forth. Should the disease run into 
the chronic form, known as "gleet," we recommend the following in- 
jection : 

Sulphate of zinc io grains 

Sugar of lead 15 grains 

Water 4 ounces 

Gravel. — 1. Treatment of gravel in the acute form comprises the 
warm bath, suppositories of a grain of opium and one-sixth of a grain of 
belladonna, flaxseed tea, and the use of salty purgatives. 

2. In chronic gravel tea or fluid extracts of buchu are often used, 
and in stubborn cases five-drop doses of diluted nitromuriatic acid, or 
salicin in five-grain doses, thrice daily, may be given. 

3. Some recommend onion juice for gravel, in doses of a wineglassful 
morning and evening. 



1278 SIMPLE HOME REMEDIES. 

4. Relief is sometimes had from a mixture of two teaspoonfuls of 
powdered borax and five of cream of tartar, dissolved in a pint of water, 
the dose being two or three dessertspoonfuls four times a day. 

5. The juice of the garden beet, boiled to a syrup, and taken two to 
three times a day in doses of a wineglassful, is said to have valuable cura- 
tive efficacy. 

6. To one teaspoonful of powdered borax add about two tablespoon- 
f uls of cream of tartar and one pint of water ; of this mixture take four 
teaspoonfuls four or five times a day; also give ten grains of the bicar- 
bonate of potash three times a day to dissolve the calculi. Use water 
freely. See General Index for full article on Stone in Bladder (Calculus). 

7. Boil turnips, pour off the water into a jar and drink a cupful four 
times a day. 

Auxiliary Treatment. — A palliative of the spasm of pain is a 
warm bath or a wrapping of the patient in a blanket saturated with hot 
water. Keep the blanket hot by frequent applications of the water. 

Hay Fever. — If much irritation of eyes and nostrils, inject into nos- 
trils, three or four times a day, a mixture composed of ten grains of sul- 
phate of zinc, half teaspoonful of borax, and about four ounces of rose- 
water or use adnephrin in atomizer. A solution of cocaine with atomizer 
is useful ; also in the inhalation of spirits of camphor ; also spraying the 
throat with wine of ipecac. 

Headache. — Seidlitz powder ; tablets of bromide of potash ; aromatic 
spirits of ammonia ; elixir of valerianate of ammonia ; alcohol locally. 

Or two drops tincture of belladonna every hour or two. Hot sponge 
face, temples and neck. Bathe forehead with spirits of camphor and 
cologne. Apply mustard leaf to nape of neck, or cayenne pepper plaster. 
Five grains of carbonate of soda every two or three hours. 

This is generally a symptom of some other disorder, and can be re- 
lieved only by curing the primary trouble. There are five distinct kinds 
of headache, which may be described as follows : 

Sick Headache. — This is caused by some derangement of the stomach 
and liver and is apt to occur more or less regularly at intervals of two 
or four weeks. It is a most distressing form of the malady. The pain is 
often confined to the temples, or is most severe there; occasionally the 
back of the head seems most affected. There is really no trouble in the 
head; it is all in the digestive tract. The following method of treat- 
ment will usually cure : 

Treatment. — Soak the feet in hot water containing a handful of 



RHEUMATIC HEADACHE. 1279 

either mustard or salt ; at the same time give an emetic, such as two tea- 
spoonfuls of wine of ipecac ; or an infusion of lobelia (made by steeping 
two teaspoonfuls of the powdered leaves for twenty minutes in a half pint 
of boiling water) . Before taking this emetic, it is well to drink a half-pint 
or pint of some warm tea, like sage or pennyroyal. When free vomiting- 
has occurred, give patient a little gruel and let him rest in bed for two or 
three hours. Then give an active cathartic. 

Auxiliary Treatment. — Keep the bowels open by giving one or two 
cathartic pills every night for several days. Bathing the whole body with 
weak saleratus water often affords relief, in conjunction with this treat- 
ment ; also applications of cold water to the head when the heat is intense. 

Nervous Headache. — This form of headache denotes a weak, debili- 
tated condition of the nervous system, caused by long-continued illness, 
loss of blood, unwonted mental excitement, etc. There is more or less 
stupidity and confusion of ideas, sometimes dimness of vision, and a dull 
pain in the head. 

Treatment. — 1. The treatment is directed to toning up the system. 
Have the following prescription prepared by an apothecary: 

Extract of valerian 15 grains 

Sulphate quinine 10 grains 

Extract hyoscyamus 15 grains 

Cayenne pepper 5 grains 

Make into 15 pills and take one pill three times a day. 

2. In addition to this, it is advisable to get : 

Tincture of bloodroot 1 ounce 

Muriated tincture of iron 1 ounce 

Mix. Take ten drops in a gill of water three times a day. This adds tone and 
strength to the blood. 

Or ten to fifteen grain doses of bromide of potassium in water. 

Rheumatic and Sympathetic Headache. — In cases of fever of any 
kind the heated blood passing through the brain gives rise to pains in 
the head that may be relieved somewhat by the application of cold water 
or cracked ice, but cannot be cured without removing the primary trouble. 
Disease of the kidneys gives rise to headache, caused by insufficient elim- 
ination of the uric acid; women often suffer from headache during 
pregnancy. 

Treatment. — These forms of the malady can only be relieved by 



1280 SIMPLE HOME REMEDIES. 

cooling the head, as above directed. When a person is suffering from rheu- 
matism, it sometimes seems as if the pain jumps from the affected part 
to the head and back again at intervals. In such cases the employment 
of remedies for the original trouble is required. 

Chronic Headache. — Sometimes there appears a chronic form of head- 
ache, originating, perhaps, in some severe spell of sickness and persisting 
in spite of all remedies. This form is likely to affect some one part of the 
head, and whilst it may vary in intensity, is seldom entirely absent. 

Treatment. — The treatment consists of laxative medicines to keep 
the bowels always free, but without violent purging. Keep the feet warm 
and the circulation equalized. Diet must be plain and nourishing. A cer- 
tain form of chronic headache sometimes accompanies catarrh, and is re- 
lieved only by curing the catarrh. As a good general rule — keep the feet 
warm, the head cool, the skin clean and the bowels open. 

Plethoric Headache. — This type of headache most affects persons of 
full habit, and is caused by too great flow of blood to the brain. It can 
easily be recognized; stooping down and then raising the head gives a 
sense of fullness and pain; suddenly jarring or shaking the head aggra- 
vates the pain ; blowing or straining, or pressure on the neck gives rise to 
pain, with more or less giddiness. Sometimes the excess of blood in the 
brain indicates an over-supply all through the body; in other cases it 
is caused by a derangement of the circulation, other parts of the body 
suffering from an insufficient amount of blood. In the latter case the 
extremities will be cold, while the head is flushed and hot, with severe 
throbbing sensations. 

Treatment. — In such cases the feet and legs must be soaked in hot 
mustard water, with a sprinkling of cayenne pepper, and thoroughly 
rubbed with a coarse towel. Give an active hydragogue cathartic and 
repeat every three days, if necessary, until complete relief is obtained. 

Diet. — Diet should be light and unstimulating — fruits, oatmeal por- 
ridge, etc. 

Heart. — When violent and throbbing, two drops of aconite tincture 
every half hour until relieved. Mustard plaster over heart, also to neck. 
When very weak from accident, fright, loss of blood, etc., brandy and 
wine. Nitrite of amyl, five drops placed on handkerchief, and inhaled 
a few minutes. Large poultice applied to heart region. Hot applica- 
tions to calves of legs and soles of feet. 

Heartburn. — Give five drops of the tincture of nux vomica half an 
hour before each meal. 



HEMORRHAGE. 1281 

Heart-Failure. — Aromatic spirits of ammonia; whiskey; hot water 
bag and mustard plasters to extremities; if they are cold treat as in 
fainting. 

A mixture of one-half ounce of the fluid extract of digitalis and one- 
half ounce of the fluid extract of Stramonium given in doses of three 
drops every four hours, has been found of value. 

Heatstroke or Sunstroke. — This is induced by exposure to excessive 
heat, either with or without direct rays of the sun. There are certain 
general symptoms of its oncoming which should serve as a warning — head- 
ache, a sense of weakness at the pit of the stomach, a weakness of the 
knees, dizziness and sometimes vomiting and disturbed vision. These 
symptoms may gradually merge into unconsciousness or without warning 
the stricken one may suddenly collapse and lie insensible. A character- 
istic condition is the intense, burning dry heat of the face, head and body. 
The face itself becomes red and flushed ; the pulse is full and rapid ; con- 
vulsive twitchings of various parts of the body are frequently observed. 

Treatment.— Endeavor at once to reduce the heat of the body. Un- 
dress the patient, wrap the body in a sheet and keep the sheet wet with 
cold water by frequent sprinkling. Continue this until consciousness re- 
turns and the body feels cool. If after becoming conscious the patient 
relapses into unconsciousness, the cold water process must be repeated. If 
impossible to immediately follow the above treatment, then wring out 
cloths in ice water, or coldest to be had, and place them on the head, back 
of the neck and around the wrists. 

Hemorrhage, Nose. — A strong solution of alum or the powder sniffed 
up the nostrils. Compress the facial artery of the upper jaw near the 
nose. Apply ice bag to spine, upper part of neck, and give one drop tinc- 
ture of aconite every hour. 

Hemorrhage, Lungs. — Give half a teaspoonful of common salt every 
hour or two until hemorrhage abates unless nausea be produced. Five 
to ten drops of turpentine may be given in sAveetened water every two 
hours. Fluid extract of ergot is also indicated. Apply ice bag to spine, 
middle part of back and lower part of neck. Perfect rest is essential. Ice 
should be sucked constantly. 

Hemorrhage, Stomach. — Ice to be constantly sucked. Give two drops 
of the tincture of witch hazel every two or three hours. Perfect rest. 

Hemorrhage, After Childbirth. — Insert pieces of ice into the vagina 
and rectum, also inject into vagina four ounces of the perchloride of iron 

81 



1282 SIMPLE HOME REMEDIES. 

with twelve ounces of water, and give ten drops fluid extract of ergot every 
two hours. 

Hiccoughs — Put about quarter of a teaspoonful of cinchona bark, 
powdered, in two ounces of peppermint water, and give a teaspoonful 
every five or ten minutes till relieved; or a teaspoonful of mustard in 
four ounces of boiling water, taken when cool ; or three drops each tincture 
camphor and aqua ammonia in wineglass of water. 

Hives — Causes. — These irritating visitations, generally upon chil- 
dren, are mostly due to indigestion, or partaking of certain disagreeing 
foods, or extremes of heat and cold. 

Treatment. — 1. To allay itching, rub with flour; buckwheat is the 
best. 

2. Sassafras or saffron tea is a good internal remedy, since it pro- 
motes perspiration and lessens irritation. 

3. Bathing with diluted vinegar is a good treatment. 

4. Small doses of salts three times a day. 

5. Locally carbolic acid, twenty drops to a pint of water, or a table- 
spoonful of baking soda to a pint of water. 

Hoarseness — A mixture of scraped horseradish, with a small propor- 
tion of wheaten flour, use of this a small quantity several times a day. 
Or the juice of one lemon, with sufficient sugar to saturate, and take 
teaspoonful of same several times a day, or a small piece of borax dis- 
solved in mouth and swallowed slowly, or chloride of ammonia in five- 
grain doses. 

Hysteria. — Elixir of valerianate of ammonia. 

Incontinence of Urine, "Bed Wetting." — Ten drops tincture belladonna 
three times a day. The child should drink but little some hours before 
going to bed, and should be wakened in the middle of the night to pass 
water. 

Indigestion. — An exclusive diet of fruit for several days is found 
efficacious in most cases of indigestion. This diet is excellent in dyspepsia 
and constipation. 

Indigestion, Acute. — Dyspepsia, heartburn, a functional derange- 
ment of the stomach with pain, a sense of distension and gas, regurgita- 
tion of food, headache, and frequently perspiration. "Regulation of the 
diet is of great importance, and for the acute symptoms bismuth 10 
to 20 grains, essence of peppermint, one-half teaspoonful in water, 
bicarbonate of soda, and if pain is severe one or two teaspoonfuls of 



JAUNDICE. 1283 

paregoric in hot water. The after treatment consist in keeping the bowels 
open and you may take the following: 

Subnitrate of bismuth 2Y2 drachms 

Fluid Extract cascara 4 drachms 

Compound tincture cardamom 6 drachms 

Glycerine 4 drachms 

Peppermint water 4 ounces 

Inflammation of Bladder. — Make an infusion of pipsissewa root, one 
France to pint of boiling water, and give wineglassful three or four times 
a day. Keep parts well warm with poultices, and so forth, over bladder. 
Drink plentifully of hop tea, which is an excellent remedy; also an infu- 
sion of cubebs and buchu. 

Inflammation of the Bowels. — Make poultice of flaxseed meal, and 
put on surface a mixture of equal parts of tincture of aconite root and 
laudanum, and apply to bowels, changing same every three hours. Per- 
fect quiet. Give no cathartics. Mucilaginous drinks : Gum arabic water, 
toast water, and so forth. 

Inflammation of Stomach. — Make decoction of hops or stramonium 
leaves, of either one ounce to pint of boiling water, and foment stomach 
and bowels several times a day. Apply mustard plaster. 

Inhalation of Noxious Vapors. — Remove patient from influence ; place 
in open air ; put two tablespoonfuls of turpentine in quart of boiling water 
and inhale vapor to counteract the deleterious effects of the poisonous gas. 

Insomnia — On going to bed, take some sound, as a clock-tick or the 
breathing of some one within hearing, and breathe long full breaths, keep- 
ing time to the sound. In a very short time you will fall asleep, without 
any of the painful anxieties attending insomnia. Endeavor to relax the 
body. 

Itch. — Apply sulphur ointment once a day for four days. See 
Scabies. 

Itching of Anus Make a solution of ten grains of borax to the ounce 

of hot water and apply freely to the anus, or apply ten drops of carbolic 
acid to a pint of water. 

Itching of the Skin Dust parts with mixture of equal parts borax, 

camphor and bismuth. 

Jaundice. — In attacks lasting three or four days, take one-third grain 
of gray powder (mercury and chalk) three or four times a day for three 
days, then take a seidlitz powder, or take twenty drops nitro-muriatic acid 
in wineglassful of water three times a day. 



1284 SIMPLE HOME REMEDIES. 

Treatment. — 1. The treatment is directed to cleaning up the bile 
duct, and forcing the bile into its proper channel. Probably the best 
remedy is this: Take a two-grain blue-mass pill twice daily for two or 
three days in succession — not longer. This is better than taking a larger 
dose once a day. If relief comes after one or two doses, take no more. 

2. As a substitute for this, the following purely vegetable pills can 
be substituted, and often with equal success: 

Extract taraxacum 40 grains 

Podophyllin 4 grains 

Leptandrin 10 grains 

Make into twenty pills. Dose: One pill four times a day. 

Or 3. Phosphate of soda daily before breakfast. 

Kidney Disease. — Make decoction of sheep-sorrel, one ounce to pint; 
boil, strain and cool. Give wineglassful three or four times a day. Or the 
same quantity of buchu leaves, made in same manner, and dose the same, 
and apply the spinal ice bag to kidneys. Have urine examined. Spirits 
of sweet nitre is indicated to promote action. 

Kidney Troubles — Saltpeter (nitrate of potash) in small doses in- 
creases the flow of urine and in some cases increases perspiration. In 
large doses it acts as a purge and irritates the stomach. 

La Grippe. — 1. Small pills made of asafoetida, and taken three times 
a day are recommended as a remedy for the grippe. Actea racemosa 
has been used with great success in doses of twenty drops of the tincture 
every three or four hours, or phenacetin and quinine in two-grain doses 
of each every four hours. 

2. Some use a tea of red pepper, or of cayenne, with great success. 
The dose is a teaspoonful in a cup of hot water, drunk slowly, before 
each meal and on retiring. Larger doses in proportion to the intensity of 
the disease. Sponging the face, temples and neck with water as hot as 
can be borne relieves the headache of grippe. 

Lead Colic. — Bicarbonate of magnesia, fifteen to twenty grains three 
times a day, or iodide of potash, three grains every three hours. 

Causes — This is about the worst form of colic, and is attended by 
obstinate constipation, most violent pains and more or less paralysis of 
the bowels and abdominal muscles. It is generally caused by inhaling 
the fumes arising from various preparations of lead, and the most fre- 
quent victims are painters and leadworkers. 

Symptoms. — The attack generally comes on gradually, the pain be- 



LEUC0RRHEA OR WHITES. 1285 

ginning in the stomach and slowly extending downward. After a time the 
distress seems centered about the navel, and, in severe cases, there are 
shooting pains through the abdomen, with spasms of the intestines and 
abdominal muscles. Nausea is usually present, there is some vomiting, 
thirst, anxiety ; the countenance is pale and contracted with pain ; pulse is 
rapid; abdomen may become knotted and sore to the touch; the bowels 
seem paralyzed and incapable of expelling their contents. Unless relief 
is obtained inflammation of the bowels will occur, and death is almost 
certain. 

Treatment. — 1. The first thing to be done is to relieve the constipa- 
tion by means of an active purgative, such as three to five of the antibilious 
pills (see Bilious Fever), and the application of hot fomentations over the 
whole abdomen. To relieve the spasm give an injection composed of: 



Thin boiled starch 2 tablespoonfuls 

Laudanum 30 to 40 drops 

Hypodermic injections of about one-eighth grain of morphia are also useful, but 
can be administered only by a physician. 



2. In extreme cases, when the cathartic does not act promptly, it is 
sometimes advisable to give from two to four drops of croton oil, on lump 
sugar; but this is a dangerous drug in the hands of any one except a 
physician. 

Leucorrhea or Whites. — 1. Alum, teaspoonful to pint of water as in- 
jection or teaspoonful of carbonate of soda, two ounces tincture belladonna, 
one pint of water, and give tincture chloride or iron, ten drops, three 
times a day. 

2. A decoction of white oak bark, used as an injection twice daily, is 
found very beneficial. Ounce of the bark to a pint of water. 

3. Cleanse the parts effectually with warm water by means of an 
injection. Then inject a full syringe of a mixture made by dropping a 
tablespoonful of extract of witch hazel into warm water. 

4. Yarrow-root tea, in doses of a teacupful three times a day, gives 
effectual relief. 

5. The Tri-Septic Douche Tablet is recommended. 

6. Blackberry tea is valuable as an enema. 

7. Oregon grape root has been highly recommended as a cure. Make 
a strong decoction by boiling an ounce of the root in a pint and a half of 
water down to one pint and take a wineglassful four times a day. 



1286 SIMPLE HOME REMEDIES. 

If the root cannot be obtained ask your druggist for Herberts Aquar 
folium, which is the Latin name of the Oregon Wild Grape Eoot. Of 
this fluid extract take one-half teaspoonful in water three times a day, 
and also put one teaspoonful in a cup of tepid water and use as a vaginal 
douche. Lie flat on the back in taking douche. 

Liver Complaint — Make infusion of dandelion tea, one ounce to one 
pint of boiling water, strain and cool, and give wineglassful morning and 
evening. Or use from one to three grains of may apple night and morn- 
ing for several weeks, followed occasionally by a light purgative, as seid- 
litz powder or rochelle salts, or a laxative liver pill at night. 

lockjaw. — Apply a warm poultice of flaxseed meal, saturated with 
laudanum and sugar of lead water, to the jaws and neck. Consult phy- 
sician at once. 

Loins, Pains in. — Apply belladonna or capsicum plaster to small of 
back ; also useful when pain is due to uterine diseases or piles. 

Lumbago. — A mixture of ice and salt applied to small of back, or 
back to be ironed, a piece of brown paper intervening. Give five grains 
saltpetre every two hours, or turpentine in fifteen-drop doses every three 
hours. Apply poultices very hot, then cover skin with flannel and oiled 
silk. 

Malaria. — Give one grain of quinine every three hours for several 
days; then ^.ve drops of Fowler's solution three times a day for about 
two weeks. Tablets of sulphate of quinine, preceded by small doses of 
syrup of ipecac to stimulate liver, may be administered, and seidlitz pow- 
ders given as a laxative. 

Measles. — Give two drops tincture of aconite every two hours, after 
carbonate of ammonia every three hours. Rub hands and feet with fat to 
remove heat and tightness produced by rash. Keep child in dark room. 
Warm mustard bath if rash recedes. Give nitre water as drink. 

Melancholia. — Use a pill composed of about three grains of asafetida 
three or four times a day; change of scene; bright surroundings, and so 
forth, or one grain of musk three or four times a day. 

Membranous Croup. — Give the patient a warm bath. Put a small 
piece of quicklime in a little water in a pitcher and place it so that the 
patient can breathe the fumes. Do this at quarter-hour intervals. The 
inhalation of the fumes from a cloth saturated with a mixture of salt and 
vinegar is said to be equally effectual. Consult a physician at once and 
use antitoxin. 

Menses, Suppressed — 1. Tho piice of the common beet has been found 



NEURALGIA. 1287 

to be an excellent remedy for suppressed or tardy menses. Boil the beets 
until thoroughly done, then remove the beets and boil the juicy water 
again until it assumes the form of a syrup. Take a cupful three or four 
times a day. 

2. Hot sitz bath with mustard a few days before the period. Ice 
applied to the lower portion of the spine increases the . amount of blood 
supplied to the pelvic organs and restores the monthly now. 

Menstruation, Excessive. — 1. The juice of one lemon taken three 
times daily will stop excessive menstruation when all other remedies 
fail, and regulate the system preparatory to the next flow. 

2. Tea of comfrey root boiled in sweet milk and drunk in half-tea- 
cupful quantities three times daily will check menses when too profuse. 
Sucking the juice of one of two lemons is a valuable remedy for excessive 
menstrual flow, or the pill uter-ova, one three times a day. 

Mumps. — Keep jaws warm with poultices or fomentations, and give 
half grain of gray powder every two or three hours to hasten the reduc- 
tion of swelling. 

Treatment. — Nothing is needed beyond rest and proper care, except 
an occasional dose of salts, or, if the pain is very severe, the application 
of a poultice, made from mullein leaves, with a sprinkling of laudanum 
or camphorated oil. 

Nausea or Sick Stomach — Drink a teacup of warm water every few 
minutes until free vomiting takes place, and apply a small mustard plaster, 
made with the white of egg instead of vinegar or water, to the pit of 
stomach, allowing same to remain an hour or two, as no blister will occur. 
Give cracked ice and fifteen drops aromatic spirits of ammonia. 

Nervous Headache. — See Headache. 

Nervousness. — Three grains bromide of potash every three or four 
hours, or elixir valerianate of ammonia, half teaspoonful every three or 
four hours. 

Nettle Rash. — Make a strong solution of common baking soda, about 
three teaspoonfuls to pint of water, and sponge or bathe body thoroughly. 

Neuralgia. — An affection of the nerves, causing at times most excru- 
ciating pain and suffering. Cold is its most frequent cause, although it 
may sometimes arise from disease of the sheath or covering of the nerves. 
Its most frequent seat is in the fifth pair of nerves which supplies the head, 
face, arms and so forth. A quick method of alleviating the same is to 
make pressure upon this nerve at its origin, just over and below the 
temple. Great relief is obtained by warm fomentations, especially one 



1288 SIMPLE HOME REMEDIES. 

made from the leaves of the eucalyptus plant. The fomentation is made 
by adding about one and a half ounces of the leaves to a pint of hot water, 
and apply fomentations of the same to part until relief is obtained. In- 
ternally the pill acetanilide comp. or gross neuralgia pill will relieve. 

Equal parts of tincture of belladonna, tincture of aconite root and 
laudanum applied to part affected, several times a day. Or make mixture 
of one teaspoonful of common black pepper, the yolk of one egg, make 
plaster and apply; renew if necessary. 

Neuralgia (of Face) — Use aconite liniment, care being taken that it 
does not enter the eyes. An infusion of capsicum pods, one handful to 
a pint of warm water, and applied on lint is most efficacious. Internally 
pill acetanilide comp. 

Night sweats. — Make a strong infusion of sage tea, and use a table- 
spoonful three times a day, with double dose at bedtime. Sponging body 
before retiring with alum or borax water often checks same, and induces 
refreshing sleep. Apply belladorfna ointment at night to chest, or tr. 
belladonna internally. 

Nipples, Sore. — Alum to harden nipples, or brandy and water, and 
washed off before child nurses. If cracked, apply glycerine with starch, 
or arnica ointment. 

Offensive Breath — Teaspoonful each of powdered myrrh and cam- 
phor and put in pint of water; use as a wash for mouth'. Look for the 
trouble in the teeth. 

Painters' Colic — Give patient a free purge of cream of tartar, about 
tablespoonful in a glass of water, and apply warmth to stomach and bowels. 

Palpitation of Heart. — Make an infusion of geranium root, half ounce 
in pint of boiling water; strain and cool and give wineglassful three or 
four times a day. Rest. Another treatment is to give two grains camphor 
every two or three hours, or two drops aconite every hour. Place feet in 
hot mustard bath. 

Peritonitis. — Apply turpentine stupes to abdomen. Cover abdomen 
with large poultice. 

Perspiration — To Remove Odor. — A frequent source of vexation to 
ladies and gentlemen is the unpleasant odor arising from perspiration. 
This may be entirely removed by adding one or two tablespoonfnls of 
hartshorn (spirits of ammonia) to each gallon of water used for bathing. 
Its excessive use, however, is not recommended, although no serious trouble 
can arise from it. 

Piles — Symptoms. — They consist of little tumors which form at the 



PLEURISY. 1289 

edge, or just inside of the fundament, and give rise to intense pain, espe- 
cially during evacuation. Very often their surfaces exude blood, in which 
case they are called "bleeding piles." When seated at the edge of the 
fundament they are not apt to bleed, and are called "blind piles." 

Treatment. — 1. When small, an ointment of ten grains of extract 
of belladonna, thirty grains of tannin, and tAventy grains of powdered 
opium, will generally relieve them. When large, protruding and very 
stubborn and painful, apply a solution of cocaine to the parts affected. 
Then gently press the tumors back into the rectum. The swelling will 
gradually diminish and the pain subside ; or apply hot witch hazel. 

2. A strong solution of salt injected two or three times a day has 
been found efficacious. The solution is to be weakened to suit the con- 
ditions of each particular case. Inject half a pint of cold water before 
going to stool each day. 

3. Some recommend the simple extract of Canada Pine (Pinus 
Canadensis) as a cure. It is applied by rubbing it on with the finger, two 
or three times a day. 

4. Calomel, half a teaspoonful, well beaten into lard, and used as an 
ointment, two or three times daily, is spoken of as an excellent cure. 

5. In some places cranberry juice is said to be used with good effect. 
It is used in the ordinary cooked form and eaten freely as a sauce. 

6. An ointment of white lead and linseed oil, well mixed and applied 
twice a day, has produced some very effectual and rapid cures. 

7. An ointment of tannin and glycerine, well mixed and applied once 
or twice a day, is a favorite remedy with some medical men. 

8. Smartweed root, about half an ounce, boiled with two ounces of 
lard, and apply to piles three or four times a day ; or a warm application 
of witch hazel. 

9. A cold water injection of about one-half a pint every morning 
before going to stool cures in many instances. In bleeding piles use 
injection of witch-hazel. Khubarb is most efficacious, a piece of about ten 
grains to be chewed or dissolved in the mouth nightly; or apply the fol- 
lowing ointment : Carbonate lead, one-half drachm ; tannin, twenty grains ; 
ceratum, one ounce. 

Auxiliary Treatment. — Avoid all liquors, tea, coffee and highly 
spiced foods. Take exercise. Bathe the parts frequently with cold water. 
Injections for the purpose of securing easy stool are of benefit. 

Pleurisy. — Make a decoction of prickly ash bark, one ounce to one 
pint of boiling water; cool and strain and give tablespoonful about four 



1290 SIMPLE HOME EEMEDIES. 

times a day, and apply poultices hot as can be borne, or spirits turpentine 
and sweet oil locally. Another internal treatment is the administration 
of two drops of tincture of aconite every hour. 

Pneumonia. — Give two drops tincture belladonna every hour. Apply 
hot mustard poultice to chest, or pack the chest with cloths wrung out of 
ice water, and renewed every hour. 

A poultice made of flaxseed meal, vinegar and onions placed across 
the chest and under the armpits has proven very succesful in some cases. 
The onions should be thoroughly boiled before using. Under no circum- 
stances permit the poultice to become cold. It must be carefully watched 
and renewed before it becomes cool. 

Polypus — Apply powdered poke root several times a day. This treat- 
ment must be pursued for some weeks, or have them removed by physician. 

Proud Flesh. — Apply to part powdered burnt alum until the flesh is 
entirely removed. 

Putrid Sore Throat — Make strong decoction of white oak bark, one 
ounce to pint, and use as a gargle several times a day, or a solution of 
borax, one drachm to one-half pint of water, or apply equal parts of iron 
and glycerine to the throat. 

Quinsy .^In inflamed tonsils, when they almost meet, mercury and 
chalk (gray powder), the third of a grain every hour, acts like magic. 
Cold compress used nightly to harden throat. Early 10-drop dose am- 
moniated tincture of guaiaci. 

Rheumatism. — 1. Make use of lemon juice freely. Use decoction of 
black snakeroot, one ounce to pint of boiling water; a tablespoonful four 
times a day. Wet cold compress, renewed every two hours, applied to 
painful joints, or oil of wintergreen. Wrap the parts in cotton. 

2. Among the many remedies found effective in rheumatism is ro- 
chelle salts. Dissolve a dessertspoonful in water and take every two 
hours. After twelve hours take once in four hours or five-grain doses 
salicylate of soda eyery four hours. 

3. Acid steam bath is most effective. Cold, wet compress applied 
to painful joints. The bicarbonate and citrate of potash in doses of five 
grains each three or four times a day. Drink freely of lemonade, or 
apply locally oil of wintergreen and cover with cotton. 

4. Baking Cure. — The application of hot, dry air as a therapeutic 
agent is regularly practiced in an increasing number of cases of gout, 
rheumatism, inflammation, obesity, senemia, and all forms of pain. The 
patient is placed in a specially devised oven which covers the entire 



SCALDS. 1291 

body except the head, and it is said that a temperature of 400 degrees 
Fahrenheit can be borne without danger. Sips of cold water are given 
during the process. It is claimed that persons have been able to walk 
after years of affliction with deforming rheumatism, and in certain cases 
chronic forms of disease have been cured. The treatment can be applied 
to an affected joint or the hand or foot. 

Rheumatism, Muscular. — Bicarbonate of soda ; camphorated soap lini- 
ment and hot water bag. 

Ring-Worm. — Make a strong solution of tobacco leaves, and apply 
to part until it entirely disappears, or use ointment of oleate of copper. 

Rupture. — Make poultice of lobelia anbl stramonium leaves, equal 
parts, and apply to part; renewing as often as necessary. In the reduc- 
tion of hernia the use of chloroform is obvious. Consult physician at once. 

Salivation. — Use as a wash for mouth mixture composed of the tinc- 
ture of cinchona, four ounces ; borax, one drachm ; water, six ounces. 
Wash mouth thoroughly several times a day. 

Salt Rheum — Use an astringent wash as alum, tablespoonful in pint 
of water, and keep bowels opened by cooling medicines, as cream of tartar, 
rochelle salts and so forth. 

Scabies (Itch). — The patient is to take a hot bath every second eve- 
ning, after which freely apply the following ointment before retiring. It 
is of importance that, after the disease has been cured, the clothing should 
be exposed to a heat of 212° F. in order to destroy any parasites which 
may adhere to them and thus prevent renewal of the affection. 

Betanaphthol . . , 20 grains 

Sulphur 1 drachm 

Peruvian balsam 1 drachm 

Oxide of zinc 1 ounce 

Make an ointment and apply twice daily to affected parts. 

Scalds. — See Burns. 

Sciatica. — As this is a form of neuralgia, the treatment should be by 
means of the following: 

Sulphate quinine 1 grain 

Phosphate iron 2 grains 

Strychnine 1-50 grain 

Have fifty of these pills made; take one after each meal. Specially useful in 
neuralgia and rheumatism, with good results. 



1292 SIMPLE HOME REMEDIES. 

The use of these tonics will tend toward a cure, but the disease is 
very obstinate, and strict observance of hygienic precautions is imperative. 
In this disease, as in lumbago, the use of belladonna plasters, which may 
be bought at any drug store, often contribute to relieve the intense pain. 

External Treatment. — The liniment as prescribed for rheumatism 
is also useful, and should be faithfully applied; or the liniment and oint- 
ment recommended for neuralgia may be employed with good results. 

Use of Opiates. — When it is necessary to administer opiates to subdue 
the intense pain, it should be done under the advice of a physician. In an 
emergency, a dose of from fifteen to twenty drops of laudanum may be 
administered, either on lump sugar or in a tablespoonful of water. 

Scrofula — Make a decoction of walnut leaves, one ounce to pint 
of boiling water, and give one tablespoonful four times a day ; or sulphide 
of lime in one-quarter to one-half grain doses, given after meals, is most 
efficacious. 

Scurvy. — Use a decoction of dogwood root, one ounce to pint of boil- 
ing water ; strain and cool and give tablespoonful four times a day. Give 
a vegetable diet. 

Shingles — Make solution of yerba rheuma, one ounce to pint of boil- 
ing water, and apply freely to part several times a day; or apply morn- 
ing and night an ointment prepared from the oleate of mercury or bella- 
donna ointment. 

Sick Stomach. — Tablets of lime water; tablets of subnitrate of bis- 
muth; aromatic spirits of ammonia. 

Sleeplessness. — Persons so affected will be benefited by the use of a 
pillow composed of hops, or cup of warm hop tea on retiring, or bathe 
with dilute alcohol ; or ten-grain doses of bromide of potassium or a tea- 
spoonful of tr. valerian. 

Small-Pox — At once give a wineglass of infusion of pitcher-plant, 
made with one ounce to pint of boiling water, three or four times a day. 
Consult a physician at once. 

Sore Eyes. — Boric acid. 

Treatment. — 1. In simple cases, where there is heat and pain in the 
eye, with some redness of lids and white of eye, this lotion is generally 
effective : 

Borate of soda 2 grains 

Camphor water 1 ounce 

Mix. One or two drops in eye four times a day; also, saturate a small piece of 
lint in this mixture and apply it over the eye. 



SORE MOUTH. 1293 

2. Another good lotion is composed of: 

Hydrastis (Golden Seal) root % ounce 

Best green tea % ounce 

Sulphate zinc, pulverized I drachm. 

Steep the root and tea for a few minutes in a pint of boiling water ; while cool- 
ing add the sulphate of zinc; when cold, strain well and bottle. Use as an eye wash 
three times a day. In severe cases a poultice is useful, made from pulverized slippery 
elm and warm milk and water. In most cases an active purgative is needed, such as 
a 5-grain blue pill at evening for two or three days, followed each morning by about 
half a bottle of citrate of magnesia or a seidlitz powder. In place of this the anti- 
bilious pills (see article on Bilious Fever) may be used. 

All eye-washes must be used with caution, especially those contain- 
ing belladonna or caustic solutions, or more harm than good may result. 

Sore Mouth. — Boric acid; chlorate of potash; peroxide of hydrogen. 

A disorder very common in infancy and childhood and sometimes 
affecting adults. 

Treatment. — 1. To correct the acidity of the stomach, which causes 
the disorder, give small doses of a few grains of prepared chalk or cal- 
cined magnesia dissolved in sweetened water. Wash the mouth fre- 
quently with the following excellent gargle : 

Sumach berries 2 tablespoonfuls 

Sage leaves 2 tablespoonfuls 

Hyssop leaves 1 tablespoonful 

Borax, pulverized 1 teaspoonful 

2. Make a very strong tea, with a pint of boiling water, of the first 
three ingredients; sweeten with syrup or honey, and add the borax; stir 
well together and use frequently. 

3. To cure canker in infants who are still nursing, the mother should 
chew small pieces of rhubarb. root (two or three pieces the size of a pea) 
every day. This will benefit the child through the mother's milk. For 
grown children and adults the following laxative will probably cause the 
canker sores to disappear: 

Flowers of sulphur 1 tablespoonful 

Cream tartar 2 teaspoonfuls 

Mix in one-half cupful of syrup and take one teaspoonful three or four times 
a day. 

4. In some cases these little sores are very hard to get rid of, and 
assume a very angry appearance. For this phase of the disorder the fol- 
lowing is highly recommended : 



1294 SIMPLE HOME REMEDIES. 

Tincture perchloride of iron % drachm 

Glycerine %. drachm 

Mix. Dip a camel's-hair brush into the mixture and lightly touch the ulcers with 
the point of the brush ; after holding it there a moment, rinse out the mouth with tepid 
water. This is a little painful, but usually produces a radical cure. Or touch each 
sore with lunar caustic or trichlor acetic acid. 

Sore Throat — Hardly any remedy for sore throat proves more effi- 
cacious than the old-fashioned plan of tying around the throat a slice of 
fat bacon on which is sprinkled black pepper. Gargle with peroxide of 
hydrogen. 

Sour Stomach — Heartburn. — Symptoms. — This common and distress- 
ing complaint results simply from undue acidity of the stomach caused 
by errors in diet or by dyspepsia. It produces a burning sensation in the 
stomach and under the breast-bone, often accompanied by nausea. 

Treatment. — Take the following mixture, after meals, when the 
trouble occurs: 

Baking soda V2 teaspoonful 

Water % cupful 

and avoid pickles, preserves, candies, sweet cakes and all sweetmeats. 

Spleen, Enlargement of. — See Enlarged Spleen. 

Sprains — Hot water locally ; laudanum and water ; later camphorated 
soap liniment. 

St. Vitus' Dance. — Make infusion of black cohosh, one ounce to pint 
of boiling water ; strain and cool and give teaspoonful four times a day, 
or two drops of Fowler's Solution three times a day. 

Stings of Insects — Apply hartshorn or water of ammonia to part, 
which neutralizes the formic acid, the active principle of the poison. 

Sun Stroke. — Apply alternately hot and cold applications to fore- 
head and base of the brain or back of neck ; place the feet in warm mus- 
tard water, and apply mustard to stomach and calves of legs. Keep per- 
fectly quiet. 

Sunburn — Anoint the affected surface two or three times daily with 
plain vaseline or cosmoline or benzoated zinc ointment. 

Tonsilitis. — Chlorate of potash, a teaspoonful in a teacupful of water, 
and gargle throat frequently. Borax, put quarter teaspoonful in teacup of 
water and gargle throat frequently. 

Toothache — Apply oil of cloves on small piece of cotton and place 
in cavity of tooth, or rub gum lightly with oil of sassafras. Or, a drop 



WAUTS TO REMOVE. 1295 

of laudanum on a pledget of cotton, inserted loosely into cavity, if one 
exists. Hot water bag applied to face sometimes affords relief. 

Tympanites. — Make mixture of one tablespoonful of turpentine to 
half pint of water, and apply as fomentations, hot as can be borne. 

Ulcer.— Make poultice of fresh scraped carrot, and apply to ulcer 
or sore two or three times a day, keeping parts well cleansed. 

Treatment. — 1. Foul and indolent ulcers, old sores, and so forth, 
require cleansing and healing applications. Among the best washes is the 
following : 

Carbolic acid, crystals 20 to 40 drops 

Pure water 1 pint 



2. Wash thoroughly with peroxide of hydrogen. 

3. An excellent ointment for old sores and ulcers, is made as follows : 

Burnt alum 1 ounce 

Red precipitate 4 drachms 

White vitriol 2 drachms 

Sugar of lead 4 drachms 

Pulverize finely together and make into an ointment with one-half pound of cos- 

moline or plain vaseline. Heat the vaseline and stir into the mixed powder, allowing 

it to cool slowly while stirring. 

Urine. — Boil three tablespoonfuls of watermelon seeds in one pint 
of water, strain and cool, and give tablespoonful every half hour until 
relieved. Put patient in hot bath. Give five to ten grains of Dover's 
Powder. 

Varicose Veins. — Apply witch hazel night and morning, and wear 
bandage during day. 

Vomiting. — A distressing and harrassing affection, induced by various 
causes. But, no matter what the cause, mustard applied as follows is the 
sovereign remedy: A mustard plaster, made with two or three teaspoon- 
fuls of common mustard, with the white of one egg (don't use water or 
vinegar in mixing the mustard), and apply the same to front of throat and 
directly over the pit of stomach, will quickly relieve the most obstinate 
case of vomiting, caused either by biliousness, nervousness or indiges- 
tion; or lime water and cracked ice may be used. 

Vomiting, to Produce. — Emetic of mustard and warm water, or of 
syrup of ipecac. 

Warts — To Remove. — Treatment. — Take a little nitric acid in a 



1296 SIMPLE HOME REMEDIES. 

glass-stoppered bottle and add one-half as much water, making the acid 
two-thirds normal strength. Apply by means of a little piece of wood, 
such as a match-stick, taking care to have the stick merely wet, and not 
with a drop adhering. Hold it on the top of wart until there is a slight 
burning sensation. Do not apply enough acid to cause active burning. 
Repeat this process daily, and patiently. In the course of a week or more 
the wart will be gone. Be careful not to let the acid touch any healthy sur- 
face, and do not try to do the work all at once. Avoid making a sore, 
even if it takes two or three weeks to destroy the wart; or the tri-chlor 
acetic acid may be used instead of nitric acid. 

Water Brash. — Give about quarter teaspoonful of common baking 
soda in wineglassful of water after each meal. 

Wen. — A mixture of ten grains sulphate of copper to two tablespoon- 
fuls of water, and apply three or four times a day. 

Whooping Cough. — Treatment. — 1. Keep the bowels open with cas- 
tor oil, or the following mixture : 

Castor oil 2 ounces 

Molasses 4 ounces 

Mix well and give a tablespoonful once or twice a day. 

2. To relieve the paroxysms of coughing have the following pre- 
pared by an apothecary: 

Extract belladonna 2 grains 

Powdered alum I drachm 

Alcohol 4 drachms 

Simple syrup 4 ounces 

Give one teaspoonful of the mixture every four or five hours, or every three 
hours if the fits of coughing are very severe. 

3. Or take : 

Antipyrine 32 grains 

Tincture belladonna i drachm 

Syrup tolu 2 ounces 

Syrup wild cherry 2 ounces 

Teaspoonful every three or four hours. 

Womb, Falling of the. — 1. A mild infusion of white oak bark, or 
of alum, or of tannin, used in quantities of a pint as a douche, will 
often give immediate relief. Peach leaves, mullein leaves and hops made 
into a tea and used twice a day as an injection often cures when other 
remedies fail. 



worms. 1297 

Womb, Ulceration of the. — 1. The symptoms of pain, soreness and 
smarting at the neck of the womb yield to an injection of alum water, 
twice a day. The solution should consist of a third of a teaspoonful of 
powdered alum in a pint of water. 

2. Fluid extract of white pond-lily, in doses of ten to fifteen drops, 
three times a day, has been recommended as an excellent cure. The same 
effect follows injections of an infusion of the plant, two or three times 
daily, at the same time drinking teacupful doses of the infusion three 
times daily. 

3. An infusion of golden seal, used two or three times daily as an 
injection, proves efficacious. 

4. An infusion of oak bark, used as an injection twice a day, is found 
very curative. If tannic acid be applied directly to the affected part, a 
like result is reached. A strong solution of tannic acid in collodion is 
very effective, or sulphate of zinc with warm water as a wash. 

Worms. — Make decoction of pink-root tea, one ounce of pink-root to 
pint of water, and boil to half pint. Give teaspoonful three times a day 
for two days, followed by purge of castor oil or cream of tartar, or santon- 
in, one quarter grain three or four times a day. Take a wineglassful 
of vermuth and mix it with twenty-five seeds of the pumpkin, add water 
and boil, as in making tea. Drink a teacupful of the tea three times a day 
for two to three weeks. This is the celebrated Kneipp cure for worms as 
practiced at his sanitoriums in Germany, and is generally effectual. An- 
other valuable remedy is pink-root and senna, one ounce of the former and 
four drachms of the latter, steeped in a quart of water. Doses, two table- 
spoonfuls twice a day. 

• Tape Worm. — Among the many remedies used by the profession, the 
following have been found useful and harmless to the patient : 
1.— 

Asafcetida 2 ounces 

Garden rue i ounce 

Garlic . i ounce 

Rye whiskey I quart 

Bottle and let it stand for about ten days. Dose: One-half wineglassful three 
times daily, before meals. 

2.— 

Spirits of turpentine % tablespoonful 

Castor oil I teaspoonful 

Milk i cupful 

82 



1298 SIMPLE HOME REMEDIES. 

Take this dose once a day. For a child under ten years, one-fourth the above, 
with or without the castor oil. This is also a good remedy for round or stomach 
worms. 



3. A remedy found to possess much value is : 



Fresh pumpkin seeds 24 ounces 

Macerate and grind to powder; divide into twelve portions, and take one por- 
tion three times a day. The bowels should be kept open with castor oil or some 
similar purgative, and the system stimulated by iron and quinine tonics; food 
should be kept from patient as much as possible w r hile using this remedy. 

Round Worms. — An excellent remedy for round or stomach worms is 
the following: 

American wormseed 1 ounce 

Cassia senna 1 ounce 

Manna 1 ounce 

Carolina pinkroot 1 ounce 

Boiling water 1 quart 

Macerate the first four ingredients thoroughly together and add the boiling 
water ; let it steep in a closed vessel for an hour or more ; sugar and milk may be 
added. Dose for a child : One gill four times daily, on an empty stomach. Good also 
for pin worms. 

Pin Worms. — These may often be destroyed by using the following 

injection: 

Powdered aloes 5 grains 

Hot water Vi pint 

Mix and divide into two injections and use at about bloodheat. 

The following has also been used with success : 

Quassia chips 1 ounce 

Water 1 pint 

Boil, strain and inject into the bowel. 

Wounds, Healing of. — Wounds may heal by what is known as first 
intention or primary union — that is, when asepsis or freedom from germs 
has been obtained and preserved, resulting in that the wound quickly 
heals and leaves but little scar. But if a wound does not heal by first 
intention, then it comes under the slow process of second intention — that 
is, with formation of granulations — and finally leaves a large scar. Sec- 
ond intention is in evidence when the skin has been destroyed over such 
area that the edges cannot be brought together, when the wound is dis- 
turbed, when blood collects in it, forcing it apart, or when the wound is 
dirty — that is, when asepsis has not been preserved. Contused and la- 
cerated wounds generally heal by second intention. 



BOOK XI 

Is a thorough treatise on the arrangement, struc- 
ture, eruption and diseases of the teeth, cause and 
prevention of decay and the effects of diet upon the 
teeth. 



Abscesses 1319 

Accumulation of Tartar 1326 

Aching Gums 1326 

Aching Tooth 1323 

Arrangement of Teeth 1308 

Artificial Teeth, Soreness from 1328 

Biscuspid Teeth 1306 

Breath, Foul 1327 

Canine Teeth 1306 

Care of the Teeth 1301 

Caries 1319 

Causes of Decay 1310 

Cavity Caused by Decay 1323 

Cavity of Mouth 1303 

Cementum . .' 1308 

Cleaning, Results of 1326 

Cleansing Teeth 1313 

Cleft Palate 1303, 1319 

Colds, Effects of 1326 

Cuspid Teeth 1306 

Dead Pulp Beneath Filling 1326 

Dead Pulp in Cavity 1323 

Decay, Causes of 1310 

Decay, Prevention of 1312 

Dentine 1308 

Diet, Effects of on Teeth 1315 

Beans 131 7 

Buttermilk 1316 

Cereals 1316 

Cheese 1316 

Eggs 1316 

Fish 1317 

Meats 1316 

Milk 1316 

Peas 1317 

Potatoes 1317 

Vegetables 1317 



Digestive Organs 1301 

Diseases of the Teeth 1318 

Dislocated Jaw 1328 

Ear as Affected by Abscess of 

Teeth 1320 

Effects of Colds 1326 

Effects of Diet on Teeth 1315 

Enamel 1308 

Eruption of the Teeth 1308 

Eye as Affected by Abscess of 

Teeth 1320 

Filled Teeth that Ache 1325 

Foul Breath 1327 

Fractured Jaw 1321 

Functions of Teeth 1309 

Gumboils 1319 

Gums, The 1303 

Hemorrhage 1326 

Home Remedies 1323 

How to Eat 1317 

Incisors 1305 

Keeping Teeth Clean 1313 

Live Pulp Beneath Filling 1325 

Live Pulp in Cavity 1323 

Locked Jaw 1321 

Molar Teeth 1306 

Mouth, The 1302 

Mouth Washes 1314 

Necrosis 1321 

Neuralgia 1322, 1327 

Nose as Affected by Abscess of 

Teeth 1320 

Palate, The 1303 

Cleft 1303, 1319 

Pastes 1314 

Permanent Teeth 1305 

Appearance of 1309 



1290 



1300 



INDEX TO BOOK XI. 



Premolars .1306 

Prevention of Decay 1312 

Pulp 1308 

Pyorrhoea Alveolaris 1322 

Result of Lacerated Gum from Ex- 
traction 1326 

Rigg's Disease 1322 

Soreness from Artificial Teeth .... 1328 

Structure of Teeth 1308 

Syphilitic Cleft 1320 

Tartar 1312 

Tartar, Accumulation of 1326 

Teeth, The 1304 

Arrangement of 1307 

Care of 1301 

Cleansing of 13 13 

Diseases of 1318 



Eruption of 1308 

Functions of 1309 

Permanent 1305 

Roots 1304 

Structure of 1308 

Temporary 1305 

Temporary Teeth 1305 

Appearance of 1308 

Erroneous Ideas Concerning. . 1310 

Toothache 1322 

Toothbrush, Choice of 1313 

Use of 1313 

Tooth Powders 1314 

Ulceration 1323 

Uvula 1303 

Vestibule, The 1302 



ILLUSTRATIONS 



Decay in Front Teeth Caused by 

Collection of Food 1318 

Dental Caries 13 18 

Diseases of the Teeth 1320 

Front and Side Views of Teeth and 

Jaws 1307 

Natural Crevices on Teeth 1318 

Nerves Leading to Roots of Teeth. 1324 

Permanent Teeth, Right Side 1306 

Pyorrhoea 1322 



Rigg's Disease 1322 

Teeth of Child between Six and 

Seven 1308 

The Digestive System 1302 

Temporary Teeth in Child about 

Four Years 1311 

Temporary Teeth of Left Side 1305 

Temporary Teeth of Right Side... 1305 

Ulcerative Stomatitis 1322 

Vincent's Angina 1322 



Diseases of OieTeeth 




FOR DESCRIPTION SEE BOTTOM OF PAGE 1300 



Book XI 



THE CARE OF THE TEETH 



INCLUDING A CONSIDERATION OF THE GUMS, THE 

MOUTH, ETC. 



It has been well said that a healthy stomach indicates a healthy body, 
and many people give much attention directly to this organ, yet do not 
consider the requirements of its accessories without which the stomach can- 
not perform its functions. Prominent among the accessories are the teeth. 

It is the purpose of this chapter to outline the close relationship be- 
tween the stomach and the teeth and to show that none can be healthy who 
neglect the care of the teeth. In order to understand the relationship in 
all its bearings it will be necessary to consider for a moment the nature of 
the digestive organs generally. 

THE DIGESTIVE ORGANS. 

Nature's contrivance for the digestion of food consists of the ali- 
mentary canal and of certain accessory organs. The alimentary canal 
(see Fig. 1) is a muscular-membranous tube about thirty-five feet in 
length, extending from the mouth to the anus, and lined throughout the 
entire extent with mucous membrane. This canal is given different names 
in the various parts of its course, the entrance being called the mouth, 
where provision is made for the separation of the food into properly-sized 
particles by mastication and for its admixture with a fluid secreted by the 
salivary glands; beyond this are the pharynx and the a?sophagus, the 
organs which convey the food into that part of the alimentary canal — the 
stomach — in which important chemical changes occur and in which the 
reduction and solution of the food takes place preparatory to digestion. 
The only substance which enters the circulation through the wall of the 
stomach is water, which is taken up by the process of osmoses or molecular 
attraction. The next part of the alimentary canal is the small intestine 

1301 



1302 



THE CARE OF THE TEETH. 



MOUTH 



salivary 

"glands 



PHARYNX 



where digestion of the food after admixture with the bile and pancreatic 
and intestinal fluids commences. The nutrient elements of the food are 
partially absorbed in the small intestine, complete absorption taking place 
in the large intestine, where the waste material is collected and expelled 
from the system through the rectum and anal canal. Each part of the 

alimentary canal must properly per- 
form its functions in rotation, and 
if there be failure on the part of any 
one portion, undue work is thrown 
upon the succeeding portions, and 
these, being thus overtaxed, are liable 
to become diseased. The pharynx, 
aesophagus, stomach and intestines 
each perform their functions auto- 
matically, but the mouth only re- 
ceives what the individual chooses to 
put into it, and it performs its func- 
ttions as directed by the will, and 
therefore if there be no deformity 
it is a matter of individual control 
whether this organ shall or shall not 
properly perform its functions. 
The mouth cannot be made to per- 
form its functions properly, however, 
if it or any of its accessories be dis- 
eased, and the teeth are the most im- 
portant of these accessories. The 
mouth also is the medium of speech, 
and has other duties to perform, in 
all of which the teeth play an im- 
portant part. 




SMALL 
INTESTINE 



The Digestive System. 



THE MOUTH. 

The mouth consists of two parts — an outer, smaller portion, called the 
vestibule, and an inner, larger part known as the cavity proper of the 
mouth. 

The Vestibule. — The vestibule is bounded in front and laterally by 
the lips and cheeks, and behind and internally by the gums and teeth. It 
contains various glands and ducts and is lined with mucous membrane. 



THE GUMS. 1303 

The Cavity of the Mouth Proper — This is bounded laterally and in 
front by the alveolar or tooth-socket arches with their contained teeth ; be- 
hind it communicates with the pharynx by a constricted aperature termed 
the isthmus faucium. It is roofed in by the hard and soft palate. The 
greater part of the floor is formed by the tongue, the remainder being 
completed by the reflection of the muscles from the sides and under sur- 
face of the tongue and the sublingual muscles which are attached to the 
mandible (lower jaw bone). The whole cavity is lined with mucous 
membrane. Upon lifting the tongue from its natural position the true 
floor of the mouth with its ducts and muscular arrangements may be 
examined. 

The Palate. — The palate forms the roof of the mouth and consists of 
two portions, the hard palate about two-thirds in front and the soft 
palate about one-third behind. 

The hard palate is bounded in front and at the sides by the upper 
alveolar arches and gums and at the back it is continuous with the soft 
palate. It consists of horizontal processes from the upper maxillary bones 
arching over the mouth and dividing it from the nose. The bone is cov- 
ered on both sides by a dense structure of fibrous tissue which contains 
many mucous glands. 

The soft palate is a movable slanting fold suspended from the pos- 
terior border of the hard palate. It consists of a fold of mucous membrane 
enclosing muscle fibres, nerves, lymphoid tissue, glands, etc. When oc- 
cupying its usual position it is relaxed and pendant. Its anterior or 
upper border is attached to the posterior margin of the hard palate and its 
sides are blended. Its posterior or lower border is free. 

Uvula. — Hanging from the middle of the soft palate is a small, cone- 
shaped pendulous process, called the uvula. It varies greatly in length in 
different individuals. It is composed of glands, connective tissue and 
muscle and is covered with mucous membrane. 

Cleft Palate. — This is a frequent oral deformity, and may be either 
congenital or acquired. It may also be partial or complete. Most of the 
cleft is in the middle line. It may be a mere cleft of the uvula, it may be 
limited to the soft palate or it may involve the hard palate as well, and 
may or may not pass through the gums. Complete cleft is usually accom- 
panied by harelip. 

The Gums. — These are composed of a dense fibrous tissue distributed 
over the portions of the maxillae holding the teeth. They also surround 
the necks of the teeth. They are covered by a smooth and vascular mucous 



1304 THE CARE OF THE TEETH. 

membrane, remarkable for its limited sensibility. Around the necks of 
the teeth the fibro-elastic portion presents numerous fine papilla?, is ex- 
ceedingly dense and is in the form of a free fold of tissue known as the 
Dental Ligament or gum margin, and from here is reflected into each 
alveolus or tooth socket, where it is continuous with the periosteal tissue 
lining that cavity. 

THE TEETH. 

The human being N is provided with two sets of teeth, which make their 
appearance at different periods of life. Those of the first set appear in 
infancy and are called the temporary, deciduous, or milk teeth. Those 
of the second set are called permanent or succedaneous teeth. 

Temporary Teeth. — These are twenty in number; four incisors, two 
canines and four molars in each jaw (Figs. 2 and 3). 

Permanent Teeth — These are thirty-two in number; four incisors, 
two canines, four biscuspids and six molars in each jaw (Figs. 4 and 5). 

The dental f ormulse may be represented as follows : 

Temporary Teeth. 
Permanent Teeth. 

General Characteristics. — Each tooth consists of three portions: the 
crown or body, projecting above the gums, the root, entirely concealed 
within the alveolus or tooth-socket, and the neck (the constricted portion 
between the root and the crown), covered by the gum margin. 

Roots. — The roots of the teeth are firmly implanted within the 
sockets or alveoli of the jaws. These sockets are lined with periosteum, 
or fibrous tissue, which has strong fibres running from bone to root and 
fixed in each. This entire fibrous structure is the peridental membrane, 
better called the pericementum. 

Surfaces. — Owing to the arch of the mouth such terms as anterior, 
posterior, internal and external are not applicable to the teeth and special 
terms are therefore applied. That which faces the lips and cheeks is 
called the labial and buccal surface, respectively ; that toward the tongue, 
the lingual surface ; that toward the middle line of the mouth (supposing 
the teeth were arranged in a straight line outward from the central in- 
cisor) is called the mesal surface; while that directed away from the 
in if I rile surface is called the distal or distant surface. As both are in con- 
tact with adjacent teeth, both are called approximal surfaces. The sur- 
face which comes in contact with the teeth of the opposite jaw when at rest 



THE PERMANENT TEETH. 



1305 



is called "occlusal surface/' when gliding over one another, the "articu- 
lating surface." 

DESCRIPTION OF THE TEMPORARY TEETH. 

The temporary, deciduous or milk teeth (Figs. 2 and 3) are smaller 
than the permanent set, but resemble the latter in form. The neck is more 





Fig. 2. 
Temporary Teeth of left side, 
outside of mouth. 



View from 



Fig. 3. 
Temporary teeth of right side. 
View from inside of mouth. 



marked owing to the greater degree of convexity of the labial and lingual 
surfaces of the crown. The last of the two temporary molars is the largest 
of all the deciduous teeth. The first upper molar has only three cusps — 
two labial and one lingual. The second upper molar has four cusps. The 
first lower molar has four cusps. The second lower molar has five cusps. 
The roots of the temporary molar teeth are smaller and more diverging 
than those of the permanent set, but in other respects bear a strong re- 
semblance to them. 



DESCRIPTION OF THE PERMANENT TEETH. 

Incisors. — The incisors or cutting teeth are so called because of their 
sharp edges adapted for incising, cutting or tearing of food. They are 
eight in number and comprise the four front teeth in each jaw. The 
crown is directed vertically and is chisel-shaped. The labial surface is 
convex, smooth and highly polished. The lingual surface is concave and 
is marked by two marginal ridges extending from an encircling ridge 
at the neck to the angles of the cutting edge of the tooth. The neck of the 
tooth is constricted. The root is long, conical, transversely flattened, 
thicker before than behind, and slightly grooved on either side in the 



1306 



THE CARE OF THE TEETH. 



longitudinal direction. The root is sometimes curved. The incisors of the 
upper jaw are larger and stronger than those of the lower, the central 
incisors being larger and flatter than the lateral. The direction is 
obliquely downward and forward. 

Cuspid (Canine) Teeth. — These are four in number, two in the upper 
and two in the lower jaw. They are larger and stronger than the incisors, 
especially the roots, which are deeply implanted. The crown is large, 
spearhead in form, and its convex labial surface marked by three longi- 
tudinal ridges, the concave lingual surface being also marked by three 
ridges, which unite at a basal ridge. The point or cusp is longer than the 
other teeth. The root is single, is oval or elliptical in form, and is longer 
and more prominent than the incisor roots. The upper cuspids are larger 




Fig. 4. 
Permanent Teeth. Right side. 



and longer than the lower. The lower cuspids have the general form of 
the uppers, but their approximal surfaces are much more flattened, as are 
also their roots. 

Bicuspid Teeth or Premolars. — These are eight in number, four in 
each jaw, two upon each side of each jaw. The crown has two cusps which 
are separated by a groove. The necks of the teeth are oval. The roots are 
single and laterally compressed, those of the upper bicuspids being more 
so than the lower, and less rounded. 

Molar Teeth.— These arc twelve in number, six in each jaw, three 
being placed back of each second bicuspid. They are the largest and 



ARRANGEMENT OF THE TEETH. 



1307 



strongest teeth of the permanent set and are adapted for the crushing 
and grinding of food. The crowns are convex and flattened. The necks 
of the teeth are large. The first upper molar has three roots, one large 
and two smaller, and the second upper molar has two roots of about the 
same size. There are only two roots in the lower molars, each of which is 
much flattened. The first molars are the largest of all the teeth, the 
second molars not only being smaller, but having their crowns more com- 
pressed. The third molars are commonly called wisdom teeth from their 
late eruption. These "wisdom teeth" have three cusps upon the upper 
and live upon the lower. The roots of the upper are frequently fused 
together, forming a grooved cone, which is usually curved backward. The 
roots of the lower (two in number) are compressed together and curve 
backward. Unlike the other molar teeth, the third molars have no definite 
number of roots. They may have from one to as many as Hve roots. 

ARRANGEMENT OF THE TEETH. 

The human teeth are arranged in two rows or arches, the upper row 
or arch being larger, its teeth overlapping the lower row or arch. Owing 




Fig. 5. 
Front and side views of the teeth and jaws. 



to the smaller sizes of the lower incisors, the teeth of the mandible, or 
lower jaw are each one-half a tooth toward the mesal of. the upper cor- 
responding tooth, so that each tooth of the whole series of upper and 
lower teeth has two antagonists, with the exception of the lower central 
incisors and upper third molars (see Fig. 5). 



1308 THE CARE OF THE TEETH. 

The order of placement of the teeth in both the upper and lower 
jaws is as follows: Four incisors in front; immediately behind these on 
each side are the cuspid teeth; next come the bicuspids, two on each 
side ; behind these on each side are the three molar teeth. 

The movement of the lower jaw in mastication is rotary. In the 
lateral movements but one side is in effective action at one time. 

STRUCTURE OF THE TEETH. 

The teeth are composed of four principal parts : Enamel, Dentine, 
Cementum and Pulp. 

Enamel. — This is the outer covering or occluding surface of the tooth. 
It is the hardest tissue in the human body. Because of its great density 
it is admirably adapted to the purposes of mastication of hard substances. 
The enamel may be easily distinguished from the dentine by its clear, lus- 
trous and somewhat translucent appearance. 

Dentine. — This is the principal constituent of the teeth. It lies under 
the enamel and is permeated by a great number of minute canals which 
connect with the pulp chambers. It is a hard, elastic substance with a 
yellowish tinge and is slightly translucent. 

Cementum. — This is a thin structure covering the root of the tooth, 
and extends from the neck to the apex. 

Pulp. — This is contained in what is called the pulp chamber of the 
tooth, which is an elongated canal, wide at the crown and narrow at the 
root portion. It is a soft tissue containing the nerves and blood vessels 
of the tooth. It is the vital part and sends forth minute fibers of living 
matter through the microscopic canals of the dentine, thus affording 
nourishment to it and endowing the teeth with sensation. These fibres 
when exposed to irritants like salt, sweet or acid substances, cold or heat, 
or when touched furnish a sensory response which should be taken as a 
warning of decay. 

ERUPTION OF THE TEETH. 

"Eruption" is the word generally used to indicate the appearance of 
the teeth, whether temporary or permanent. Eruption varies somewhat 
in different individuals, but approximately may be relied upon as follows : 
Temporary Teeth. — 

Central incisors 5th to 6th month. 

Lateral incisors 7th to 8th month. 

First molars 12th to 16th month. 




Cross-section of head. 




Teeth of child between six and seven years old. Bone removed to show 
second set forming in the jaws. 



E. T. S. 



FUNCTIONS OF THE TEETH. 1309 

Canines 14th to 20th month. 

Second molars 21st to 36th month. 

Note. — The eruption of the lower teeth usually takes place before that 
of the upper. 

Permanent Teeth. — 

First molars 5th to 6th year. 

Central incisors, lower jaAv 6th to 7th year. 

Central incisors, upper jaw 7th to 8th year. 

Lateral incisors 7th to 9th year. 

First bicuspids 9th to 10th year. 

Second bicuspids 10th to 11th year. 

Cuspids 11th to 13th year. 

Second molars 12th to 13th year. 

Third molars (wisdom teeth) 17th to 23rd year. 

It is to be noted that the permanent first molar does not replace 
any tooth of the temporary set, yet is the first permanent tooth to appear. 
As a rule, it comes painlessly. It comes back of the temporary second 
molars and frequently being mistaken for a "first" tooth, it is neglected 
and decay ensues. 

FUNCTIONS OF THE TEETH. 

The teeth are a potent factor in speech and are of utility in other 
ways, but the most important of all their functions is that of mastication. 
Each and every tooth has its own specific work to do in the preparation 
of food for the stomach, and if even one tooth be lost or impaired there 
must follow a deterioration in the masticating powers, and hence the dan- 
ger of sending food to the stomach in an improperly prepared state. It is 
not merely the grinding and disintegrating of the food, but the very 
process of mastication brings about a flow of saliva, the mixing of which 
with the food is essential to digestion. If this work of masticating the 
food be thoroughly performed before it passes to the stomach, the food 
is rendered easily susceptible to the action of what is known as the 
gastric juice, which is found in the stomach, and which by reducing the 
food to a liquid state prepares it for absorption into the system. When, 
however, the food is swallowed without proper mastication, the action of 
the gastric juice is retarded, becomes largely ineffective, and fails to yield 
all the nourishing essence which it contains. The result is indigestion, 
and if long continued, dyspepsia. All this applies both to the temporary 
and the permanent teeth, and it will therefore be apparent how important 



1310 THE CARE OF THE TEETH. 

it is that from very earliest childhood until old age the greatest of care 
should be taken to preserve all the teeth in such a manner that they may 
completely and efficiently perform their functions. 

ERRONEOUS IDEAS CONCERNING TEMPORARY TEETH. 

It is a common but grave mistake to consider preservation of the tem- 
porary teeth as of minor importance because they are so soon to be re- 
placed by the permanent teeth. It is due to this impression that decay 
and filth are frequently allowed to accumulate and as soon as the teeth be- 
come troublesome they are extracted. School children lose sleep, suffer 
pain, have indigestion, lose time from school through sickness, are dulled 
mentally by all these processes and fall behind their normal rate of ad- 
vance. Thus it is not theory but proven by tests of special classes in 
various mental attributes before and after dental treatment. The total 
average gains were from 32 to over 100 per cent., representing the average 
for all kinds of mental effort. 

The idea that these deciduous teeth should be taken out as soon as 
they ache is not only erroneous, but may result in permanent injury to the 
mouth by preventing normal expansion of the arches for the accomoda- 
tion of the permanent teeth, prejudicially affect the permanent teeth 
which are forced to appear before their allotted time, and cause life-harm 
to the digestive system, since the power of mastication is impaired 
through loss of the teeth. Nature indicates the time for the removal of 
the temporary teeth by absorbing their roots and loosening their crowns 
preparatory to the appearance of the permanent teeth, and when the 
proper time arrives the permanent teeth practically oust the temporary 
ones from their places without pain or inconvenience of any kind. 

There is also danger in premature extraction of the deciduous teeth, 
because the jaw at this time is not fully developed, is frail and not only is 
liable to malformation, but to possible fracture if the socket of the early 
tooth be left vacant. 

CAUSES OF DECAY. 

There are many possible causes of decay of the teeth, but chief among 
them is the fermentation of particles of food lodged between the teeth or 
in the pits or depressions during mastication, and which through carless- 
nese or indifference are not removed. Under the influence of warmth, 
moisture and microbes, fermentation or chemical change takes place, and 



CAUSES OF DECAY. 



1311 



an acid is generated which dissolves the enamel and dentine, leaving a 
cavity which grows larger and deeper. The dentine is of a tnbular struc- 
ture and into these tubules microbes, which constantly exist in the mouth, 
penetrate as soon as there is opening through the enamel, and unless 
proper measures be taken to eradicate them and make the tooth impervious 
to them, they continue their work until the tooth is completely destroyed. 




„ Fig. 6. 

Temporary teeth in child aged about 4 years. The permanent teeth are seen in process 
of formation in their alveoli or sockets. 



The process of fermentation itself is the result of the growth and multipli- 
cation of these minute organisms, which are so small that they are only 
visible under microscopes of the highest power. 

Among secondary causes producing decay may be mentioned pro- 
tracted illness, the lack of outdoor exercise, excessive study, worry, or 
anything tending to lower the general tone of the system. When the 
body is ill all organs are more likely to become diseased than at other 
times, and this holds good as respects the teeth. 

Again, the teeth may be crowded or depressed, or there may be fis- 



1312 THE CARE OF THE TEETH* 

sures which offer a ready means for lodgment of food. The structure of 
the enamel may be imperfect and full of microscopic spaces, thus affording 
less resistence to the action of acids and bacteria. 

Like the bones and other parts of the body, the teeth need constant 
nourishment, especially in childhood, and not infrequently it happens that 
the food partaken of does not contain the elements of nourishment requisite 
for the proper development of the teeth. Sometimes, too, there is hered- 
itary tendency to decay. 

When one tooth is decayed and permitted to remain in a decaying 
state it is certain sooner or later to affect and cause the decay of teeth in 
close proximity, for wherever there is decay of a tooth there are acids and 
microbes which will find their way to the surrounding teeth. 

PREVENTION OP DECAY. 

An adage handed down from the immemorial says: "An ounce of 
prevention is worth a pound of cure." ]^ever was this saying more ap- 
plicable than it is in respect of the preservation of the teeth, and the 
sine qua non, or indispensable condition, is cleanliness. 

The vital importance of keeping the teeth and the mouth free from 
remnants of food and masses of tartar cannot be too strongly urged. Com- 
petent members of the dental profession affirm that ninety-five per cent. 
of all diseases of the teeth are the outcome of uncleanliness at some time 
in the life of the individual concerned. Whether it be during childhood 
or in adult years, the accumulation of particles of food upon and between 
the teeth invariably sets up fermentation, which continued must result in 
decay of the teeth. And not only are the teeth affected, but putrefaction 
may ensue and the mouth itself become the very center of disease and in- 
fection. Were the mouth to be kept perfectly clean and pure, from 
earliest infancy onward, teeth would never decay. But, as this is prac- 
tically impossible, the only safeguard is to thoroughly clean the teeth 
and the mouth after each meal, that the remnants of food may be each 
time removed before deleterious action sets in. 

Tartar. — This is a deposit of animal and mineral matter combined, 
precipitated from the fluids of the mouth upon the teeth, imparting to 
them a greenish, yellowish, darkish and occasionally a whitish color, and 
sometimes accumulating in such quantities as to completely incrust the 
teeth. Seme of the effects of tartar upon the mouth, teeth and gums may 
be thus enumerated: 



THE TOOTHBRUSH. 1313 

1. Spongy and sloughy gums, subject to bleeding upon the slightest 
irritation. 

2. Suppuration of the gums, pus frequently accumulating in such 
quantities as to make the mouth most unwholesome. 

3. By working its way between the gums and the teeth, such absorp- 
tion of the bony socket ensues as to cause the teeth to either fall out of 
themselves, or permit of their removal with the least display of force. 

4. Vitiation of the saliva occurs, and as this fluid is essential to di- 
gestion, the digestive organs are deranged and the entire system conse- 
quently disturbed. 

5. Disagreeable odors are imparted to the breath, making the suf- 
ferer obnoxious to everyone. 

It is then a first principle of prevention of decay that the teeth be 
kept free from accumulations of tartar. This cannot be accomplished by 
the mere polishing of exposed surfaces. There must be daily, diligent work 
in cleaning crevices and the brushing away of tartar before it reaches a 
hardened stage. 

When a tooth is allowed to become incrusted with tartar, it is im- 
possible for anyone to remove it himself or herself, because the accumula- 
tions cannot be seen by oneself, while further there is the necessary use 
of professional instruments. It is to be advised, therefore, that from 
early childhood the teeth should be examined at least twice a year by a 
competent dentist, and all tartar and other impurities properly removed. 

Keeping the Teeth Clean. — After the teeth have been cleaned by a 
dentist, effort should be made to keep them clean by washing them several 
times daily with lukewarm water, polishing with a powder or other dental 
preparation and by using an antiseptic mouth-wash. Lukewarm water 
is recommended not only because it is more cleansing than either hot or 
cold water, but also because either hot or cold water, especially if one fol- 
lows the other, will have a prejudicial effect, for as the laws of expansion 
and contraction will cause a glass to break when plunged from cold into 
hot water and vice versa, so in the case of the teeth a sudden change from 
one extreme to the other may cause the enamel to crack. 

Choice and Use of Toothbrush. — A soft rather than a hard toothbrush 
is recommended, as the latter irritates and abrades the gums. Brushing 
should be from the gums towards the summits of the teeth — that is to say, 
longitudinally and transversely. By brushing across the teeth, particles 
of food may be forced between the teeth, and so become centers of decay. 

83 



1314 THE CARE OF THE TEETH. 

After being used, the brush should be thoroughly washed, that all decom- 
posed matter caught by the bristles may be removed. 

A silk floss is of advantage in cleaning the teeth, by forcing it be- 
tween the teeth, and thus removing matter which may have become 
lodged, and the daily use of floss silk with tooth powder in the same man- 
ner is recommended as an adjunct to the toothbrush. 

Tooth Powders, Pastes and Mouth Washes Great care should be 

exercised in selection of these. There are undoubtedly many excellent 
preparations on the market, but on the other hand there are many of them 
which should be condemned. Some of them, for instance, clean the teeth 
very quickly and so seem to have much merit, yet they contain acids which 
work upon the mineral salts of the teeth, causing corrosion and dissolu- 
tion, thus eating into the enamel and destroying the teeth. Another fatal 
error committed by many manufacturers is in the endeavor to make their 
pastes and washes palatable by sweetening, for which purpose a consider- 
able percentage of sugar or like ingredient is used. Sugar in the mouth 
undergoes a chemical change, and is converted into an acid which is dele- 
terious to the teeth. Then again because of economy the average tooth 
powder is made of cheap, gritty and coarse materials which by abrading 
the enamel frequently become a cause of decay. It is of vital importance 
then that special care should be taken in selecting pastes, powders and 
washes, and it will usually prove poor economy to use a preparation simply 
because it is cheap and quickly cleanses. It is not here intended to decry 
all patent tooth preparations, but simply to caution our readers as to 
selection. For those who wish to make a powder themselves, the follow- 
ing will be found safe, useful and agreeable : 



Precipitated chalk 12 drachms 

Rose pink 2 drachms 

Carbonate of magnesia 1 drachm 

Oil of rose 5 drops 

Mix well together. 



Or, 

Precipitated chalk 1 ounce 

Pulverized orris root 1 ounce 

Pulverized castile soap 1 ounce 

Flavor to suit with oil of rose, sassafras, wintergreen, etc. 

A good mouth wash may be made up with the following ingredients : 



EFFECTS OF DIET ON THE TEETH. 1315 

Boric acid 10 grains 

Resorcin 4 grains 

Salol 2 grains 

Thymol V 2 . grain 

Pure glycerine %. drachm 

Pure water , . 1 ounce 

To neutralize the acidity of the stomach use lime water, taken in- 
ternally in moderate doses. It is very efficient in hardening the teeth. 
Lime water is of little value as a mouth wash. It has no action on bacteria, 
is not an antiseptic and the antacid effect is so momentary that it is of 
little value. Nevertheless, it is very valuable as an antacid, the idea 
being that an acid stomach is contributary to deranged nutrition and lime 
water in the stomach is an offset. A better antacid, however, is to be found 
in milk of magnesia. A mouthful "soused" about the teeth will upon 
expectoration of the excess leave a coating on the teeth and in the inter- 
proxinal spaces. 

A solution of bicarbonate of soda makes another excellent mouth 
wash. Use a teaspoonful in a glass of water after each meal. Like lime 
water it has a neutralizing effect when there is acidity of the mouth. 

The teeth should be thoroughly cleaned and the mouth well rinsed 
every morning and every night and also after each meal. Lime water 
should occasionally be used to overcome extreme acidity of the mouth, as it 
is an alkali and neutralizes the affects of acids. Acids are not only con- 
tained in food, but are frequently found in the saliva itself, especially 
when one is in a state of debility. Lime water is also a bone builder, and 
taken internally will be found beneficial, especially with infants and with 
mothers during pregnancy. 

EFFECTS OF DIET. 

While lack of cleanliness is the main cause in the decay of teeth, 
there can be no question as to improper or deficient diet being also an 
important contributing factor. 

The food which is proper for one person may not agree with another, 
and the question of diet must therefore be solved differently for different 
people. Temperament, age and occupation must all be considered. Yet 
there are certain foods which generally speaking are safe for all and which 
are nutritive to the teeth. 

The bones, muscles, flesh, etc., of the human body are formed by 



1316 THE CARE OF THE TEETH. 

various combinations of some seventeen different elements, chief among 
which are hydrogen, nitrogen, carbon, and the salts of lime, and each part 
of the body nourishes and sustains itself by extracting from the blood a 
sufficient quantity of the elements which enter into its composition, so that 
if food be deficient in any one element necessary to any part of the body, 
such part is destined to suffer. With the exception of milk and eggs no 
one food contains all the elements which enter into the structure of the 
body, and so to properly nourish all parts of the body, recourse must be 
had to a diversified diet, in order that deficiency of certain elements in 
one food may be supplied by abundance in another. 

Teeth are of the nature of bone in their composition, and are com- 
posed of animal and mineral elements. The mineral matter is the more 
abundant of the two, and chiefly consists of lime salts, such as phosphate 
of lime, carbonate of lime, fluoride of lime, and phosphate of magnesia. 
The teeth gain their strength and hardness from these elements, and if 
they be absent in any marked degree the teeth are weak, frail and soft. 
Scientific study has proven that these elements are found in greatest 
abundance in the following foods: 

1. Milk. — This contains all the elements entering into the human 
structure, but as it is especially subject to microbes, it should be sterilized 
before using, and this is imperative in the case of infants. 

2. Buttermilk. — Ths is a most valuable food and aids in development 
of tooth structure. 

3. Cheese. — This also has high value as a food in aiding teeth struc- 
ture, but is difficult of digestion if taken in large quantities. 

4. The Cereals. — Wheat, maize, rye, oats and rice, when ground with- 
out separation of their parts, contain elements of value to the teeth, but the 
white flours should be sparingly used, because in their preparation the lime 
salts and phosphates are extracted. As an instance it has been estimated 
that five hundred pounds of graham flour contain seventy-five pounds of 
muscle and eighty-five pounds bone material, while an equal quantity of 
white flour contains only sixty-five pounds of muscle and but fifty pounds 
of bone material. 

5. Eggs — The necessary elements for the teeth are contained in eggs 
and they are nourishing to the whole system. They are better "soft- 
boiled" than "hard-boiled," and are more wholesome if taken with bread. 

6. Meats. — Beef and mutton are the most wholesome of the meats 
and contain a goodly percentage of the elements requisite to the teeth. 
Veal and poultry are also recommended. 



EFFECTS OF DIET ON THE TEETH. 1317 

7. Fish — When fresh and well cooked, fish will aid in supply of 
nourishment to the teeth. 

8. Beans. — The nutritive value of beans is very high and they are 
recommended for teeth nourishment. 

9. Peas. — Peas have much the same qualities as beans, but not in as 
high degree as respects teeth nourishment. 

10. Potatoes. — There is good nourishment in potatoes, which should 
always be eaten before becoming cold, as when cold they are hard to digest. 
They are most nourishing when baked or boiled with the skin on. Pota- 
toes contain valuable potash salts, which are lost in boiling without the 
skins, but are retained in baking and roasting. 

11. Vegetables. — Cabbage, parsnips, carrots, onions, tomatoes and 
beets are good foods and more or less aid directly and indirectly in nour- 
ishment of the teeth, but if taken in large quantities are difficult of 
digestion. 

Innumerable other foods have great nourishing powers, but the fore- 
going have been especially mentioned because they abound in elements 
requisite for the teeth. Pastries and dainty viands which in their prepara- 
tion have been deprived of the phosphates and lime salts (the elements 
that build up bone and teeth) should only be occasionally indulged in. 

Lactophosphate of lime may be used in those cases in which the 
food is deficient in lime salts. It aids in retention of food in the stomach, 
strengthens the teeth, and in the case of childbearing contributes to the 
better development of the bones and teeth of the child. It should be taken 
in teaspoonful doses three or four times daily. 

How to Eat. — This is second only in importance to the nature of the 
food itself. The following rules should be carefully observed : 

1. It is important above everything that the food should be well mas- 
ticated. 

2. Food should not be taken in excess, for not only is the overloaded 
stomach retarded in the performance of its functions by overwork, but 
there is lack of saliva and gastric juice for the extra load, the stomach 
becomes disordered and the saliva acidified, and this acid saliva destroys 
the teeth. 

3. Food should neither be very hot nor very cold. Food digests most 
readily at normal body heat, or 98 degrees F., and if taken either hot or 
cold the temperature of the stomach is raised or lowered accordingly, and 
the work of digestion thus retarded. 

4. The stomach should be allowed full freedom of movement — that 



1318 THE CARE OF THE TEETH. 

is to say, its movements should not be restricted by tight corsets or the 
like, for these impede movement and retard digestion. 

CHILDREN'S TEETH. 

In a chapter entitled "The Mother and the Child" (see Index) will be 
found a full discussion of "Teething" and other matters concerning the 
teeth of children. 

DISEASES OF THE TEETH AND RELATED PARTS. 

Excepting in congenital cases, diseases of the teeth are primarily due 
to decay, technically termed "caries." There are many variations in the 
forms of decay, and among dentists classifications are made technically, 
distinguishing the different forms and their resultant diseases, but for the 
purposes of the present article it is sufficient to cover the whole series in 
general terms. The following then is an epitome : 

Diseased teeth may be divided into three classes, namely: 

1. Those in which the affection extends only to the dentine. The 
exposed part is sensitive to the touch and to heat and cold, but the pain 
is not acute and ceases when the immediate cause of irritation is removed. 
If attended to at this time the operation of filling is comparatively pain- 
less and the tooth becomes thoroughly sound, for the vital portions have not 
been affected. 

2. Those in which the pulp is exposed, but only recently. The pain is 
acute and may become agonizing. The pulp can be cured by the applica- 
tion of soothing mediums which will sufficiently remove irritation and in- 
flammation to permit of filling. 

3. Those in which the pulp has been long exposed and is either dead 
or dying. This class is subdivided into: 

(a) Those in which the pulp is not yet dead or has only recently died. 
These can be cured by a competent dental surgeon with comparative ease. 

(b) Those in which there is more or less inflammation and infection. 
These are quickly amenable to competent treatment, but require more 
skilful work than class (a). 

(c) Those with a fistulous opening and a more or less constant dis- 
charge of pus. These require long treatment and the exercise of unques- 
tionable skill on the part of the dentist. The canals are often crooked, 
and as every particle of infected matter must be removed, the task is some- 
times performed with great difficulty. It is sometimes necessary to put 




Natural crevices on healthy back 
teeth in which food' collects and so 
leads to decay and formation nf cav- 
ities. 



\JL$^jL^Jlj^ 



Upper Jaw. — Showing front 
teeth and places between the 
teeth where food has collected 
and led to decay. 



VgftTifcAL SEC T ION THBOUSH TEETH 
AND BONE. LOWER JAW 



Biood V easels and Serves destroyed 

and decomposed 
Abscena forming at the end of one fang 




E. J. S. 



Dental Caries. 



CLEFT PALATE. 1319 

in a temporary filling and leave it there for weeks before attempting 
permanent filling, watching all the time for untoward symptoms which 
may indicate that there is still some infected part uncleaned. 

The following are some of the specific troubles which occur in connec- 
tion with diseased teeth: 

Abscesses or Gumboils. — These are collections of pus or putrid mat- 
ter, due to infection and inflammation of the tissues surrounding the roots 
of diseased teeth, and unless given proper attention may result in serious 
and even dangerous ailments, such as neuralgia, locked jaw, necrosis, eye, 
ear and nose troubles, etc., which see under their respective side-headings 
in this chapter. The pain during the formation is almost insupportable 
and continues until the pus finds vent. It is a common practice to apply 
hot poultices to the outside of the face to relieve the pain. This is a 
grave mistake for it draws the pus toward the cheek and may cause the 
abscess to break through on the face. The proper method is to make a 
small poultice of equal parts of mustard and flour and mix into a paste 
with glycerine. Put this in a small, sterilized bag and apply over the dis- 
eased part within the mouth, and on the outside administer cold applica- 
tions to the cheek. This tends to force a breaking of the abscess within 
the mouth, which is to be desired. If this fails the abscess should be 
lanced inside the mouth, its contents removed, the sore antiseptically 
cleansed and the tooth treated and filled or extracted, according as the 
circumstances may require. 

Caries (decay). — In all cases where possible the tooth should be 
treated and filled, but a tooth is sometimes neglected so long and the 
decay becomes so great that the only remedy is the extraction of the tooth. 

Cleft Palate. — This is sometimes a congenital defect, but frequently 
it is what is termed accidental or acquired, being due in some instances 
to syphilis. Both the hard and soft palates are divided into two parts, 
which are united in the median line of the mouth. The union usually 
takes place during the third week of embryonic life, but occasionally the 
union does not take place and the child is born with a cleft palate. Both 
in congenital and accidental cleft the affection may extend to both hard 
and soft palate or may be confined to one or the other. When it extends 
to both palates the interior of the nose and the bones of the skull are 
exposed. In congenital cases only little inconvenience is caused in eating 
for the instincts of self-preservation teach the child from the time of its 
birth to protect the cleft with the tongue, the food being taken under that 
organ and dexterously shifted from side to side until forced into the 



1320 THE CAKE OF THE TEETH. 

pharynx. The process is curious and complicated and practically im- 
possible of imitation by anyone who has been born with a normal palate, 
and so when the affliction comes from disease in adult life the sufferer 
is utterly unable to close the opening with the tongue, and consequently 
in eating a portion of the food is invariably forced into the nose, causing 
inconvenience, suffering and humiliation. But this is not all. Whether 
the cleft be congenital or accidental the sufferer is unable to speak 
clearly or distinctly and in some cases speech is utterly impossible. (For- 
merly the only treatment for cleft was a surgical operation called stra- 
phylorraphy which signifies suturing or sewing together of the parts. 
This operation was seldom entirely successful and there was usually an 
after breaking-away of the parts. Modern dentistry, however, has come 
to the rescue of such sufferers and artificial palates are now made which 
are held in place by attachment to the teeth and which are so true in 
their copy of nature that the sufferer is enabled to eat and speak as per- 
fectly as one with normal palates.) 

Syphilitic cleft is not as readily open to surgical treatment as is 
congenital cleft, and the use of the vellum or artificial cleft is, as a rule, 
the only remedy. On the other hand, congenital cleft is in its very nature 
clearly amenable to surgical treatment, and in most cases surgical treat- 
ment is to be recommended. It is advised that the operation should be 
performed in early infancy when ossification of bone tissue has only begun 
and the bones are very little more than masses of cartilage. Operation 
should be performed when the infant is from six to nine months of 
age. The flap of periosteum is laid over the cleft and sewn to the flap on 
the other side. The periosteum through the action of what are known as 
the giant cells, is the medium through which new bone tissue is formed, 
thus closing the cleft. If successfully performed, the results of this 
operation are more hygienic and in every way to be preferred to artificial 
vellum. Formerly the operation was usually unsuccessful, but latter-day 
surgery has accomplished marvelous results when the case has been taken 
in sufficiently early infancy. 

Eye, Ear and Nose, as Affected by Abscess of the Teeth. — Diseased 
teeth frequently cause trouble with the eye, ear and nose. That portion 
of the upper jaw bone which holds the roots of the molars forms the floor 
of a cavity, one side of which is the wall of the nose. Through this wall 
there is an opening into the nostrils. It sometimes happens that the roots 
of a molar penetrate into this cavity. The walls of the cavity are thin 
and lined with a very sensitive membrane. If a penetrating molar be- 



NECROSIS. 1321 

comes diseased, inflammation and suppuration (the exuding of pus) may 
extend into this cavity, and if the pus accumulates in large quantities it 
will ooze out through the opening into the nostrils. Thus a constant dis- 
charge of pus from the nose may indicate a diseased tooth. If the accu- 
mulation of pus be very large it may press against the lower wall of the 
eye socket in such a manner as to displace the eye or cause partial or 
complete blindness, or it may break through the bone and discharge upon 
the face. Cases are on record where such abscesses have developed into 
tumors of such size and pressure as to plug the nose and finally, breaking 
down the wall of the cavity have dislodged the eye, forced themselves into 
the ear and even penetrated the brain. The only treatment in former 
times was extraction, but the dental surgeons of to-day resort to what is 
known as drainage of the antrum, either through the root of the tooth or 
by means of a drain introduced through an opening made between the 
second bicuspid and first molar or through the nasal orifice of the antrum. 
What is here advised is that the sufferer should immediately consult a 
competent dental surgeon. Every day of delay but aggravates the con- 
dition. 

Fractured Jaw. — This subject is fully discussed in the chapter on sur- 
gical diseases (see index), but is here mentioned because the treatment 
of fractures of the jaw is now considered as within the province of the 
dental surgeon. 

Locked Jaw. — This is a dental term and does not refer to tetanus, 
which is commonly termed "lock-jaw." Locked jaw is the result of a 
severe abscess caused by diseased molars of the lower jaw. Through con- 
stant irritation the nerves become paralyzed, the muscles remain in a 
contracted state and the sufferer is unable to open his mouth. A com- 
petent dental surgeon should be at once consulted who will treat the 
tooth and abscess. 

Necrosis — Death or necrosis of the jaw-bone frequently results from 
an abscess caused by diseased teeth. When pus is permitted to accumulate 
in large quantities it may burrow between the bone and the enveloping 
membrane which gives it nutrition and vitality, and this membrane being 
thus severed from the bone the latter dies from lack of nutrition and the 
severe inflammation caused by the abscess. The treatment should be pre- 
ventive by placing oneself in the hands of a competent dental surgeon at 
the beginning of the trouble. Where necrosis has actually set in the 
tooth and abscess must be first treated and then the bone treated as pre- 
scribed in the article on Diseases of the Bones (see Index). 



1322 THE CARE OF THE TEETH. 

Neuralgia. — The nerves of the eye, ear, face and teeth are intimately 
associated and an ulcerated tooth may cause severe neuralgia in any or all 
of these parts. This is thoroughly recognized by the oculist and aurist 
who frequently advise attention to the teeth as first treatment in seeming 
ailments of the eye and ear. 

Pyorrhoea Alveolaris. — See Rigg's Disease. 

Rigg's Disease — This disease occurs with considerable frequency, and 
is especially serious because of the large quantities of pus involuntarily 
swallowed by the sufferer. It first makes its appearance at the margin of 
the gum, which normally adheres closely to the necks of the teeth, but 
which with this disease becomes detached from them and thickened. Even 
in its early stage small quantities of pus or blood-stained fluid may be 
squeezed out of the intervening space if firm pressure be made with the 
finger, and as the disease progresses this becomes more and more marked. 
Gradually the space becomes greater and deeper until an instrument can 
be passed down between the tooth and its socket, finally extending the 
whole length of the root and resulting in complete detachment and loss 
of the tooth. The disease usually starts with one tooth, but is apt to 
spread to adjoining teeth and may involve all. The pus is full of or- 
ganisms. The cause of the disease is not definitely known. It was at 
one time attributed to irritation set up by accumulations of tartar, but 
this idea is now discredited. A dental surgeon should be consulted with- 
out delay, and where this is not possible the affected gum should be fre- 
quently and carefully washed with strong antiseptics and the mouth im- 
mediately after rinsed with a good antiseptic mouth wash. 

The accumulation of tartar deposits on and around the necks of the 
teeth constitutes a foreign substance, and if allowed to remain will con- 
tinuously increase. Deposits act as an irritant to the gum tissue, which 
becomes inflamed. The numerous micro-organisms which are always 
present in the mouth and ever ready to act, find excellent soil for pro- 
pagation in the inflamed area aided by the heat and moisture of the mouth, 
forming pus and destroying tissue. As a result of the disturbances the 
blood which is exuded is disintegrated and the lime salts in solution are 
deposited into the pus socket, thus increasing irritation. 

The treatment is simple and positive and lies in a thorough cleansing 
of the parts affected and in proper and frequent massage of the gums, 
the idea being to destroy germs and produce normal circulation of the 
blood. 

Toothache — This is due to the exposure of the nerves of a tooth 




Pyorrhea Alveolaris or Rig-g-'s Disease. 




Ulcerative Stomatitis. 




Vincent's Angini 



E. T. S. 



HOME REMEDIES. 1323 

caused by decay. It is a natural accompaniment, too, of abscesses and all 
other diseases of the teeth. Its treatment should be by filling of cavities. 
See Home Kemedies in this chapter. 

Tumors. — See Abscesses. 

Ulceration.— An ulcerated tooth is one in which decay has reached 
the roots causing an inflammation and the gathering of pus. This may 
occur in a tooth which has been filled, but where the pulp canal has not 
been thoroughly cleaned and some particle of infected matter has re- 
mained. See Abscesses. 

HOME REMEDIES. 

Toothache invariably indicates a more or less diseased tooth, and 
where there is disease it should be at once treated by a competent dentist. 
It is false economy to delay and later may result in serious trouble. 
Nevertheless there are occasions when it is practically impossible to visit 
a dentist and in such cases the following instructions will be found of 
great value and will in many instances afford temporary relief. 

ACHING TOOTH WITH A CAVITY CAUSED BY DECAY. 

1. When the Pulp in the Cavity is Living. — Whether the pulp be liv- 
ing or dead may be determined by holding very warm or very cold water 
in the mouth and bringing it in contact with the pulp. If the pulp is 
living the pain will be increased. Or, if on pressing a toothpick into the 
cavity the pain is intensified, the pulp is still alive. Treatment. — The 
cavity must first be washed out with lukewarm water. This may be done 
with a syringe or by adequately rinsing the mouth. Then saturate a little 
pellet of antiseptic gauze or absorbent cotton with spirits of camphor, oil 
of cloves or laudanum. On top of this insert a piece of dry cotton, so 
completely filling the cavity as to thoroughly protect it from changes of 
temperature and prevent the entrance of any foreign substance. 

2. When the Pulp in the Cavity is Dead. — These cases may be divided 
into two classes. In the first the suffering is from mere inflammation of 
the lining membrane between the root and the socket. In the second the 
inflammation has become more severe and an abscess or gumboil has de- 
veloped. If the first stage be promptly and efficiently treated the second 
stage will usually be avoided. Excepting that in the second stage there is 
swelling of the gum around the tooth the symptoms in the two stages 
are the same and consist in an elongation of the diseased tooth above the 
level of those surrounding it, so that on closing the teeth together the dis- 



1324 



THE CARE OE THE TEETH. 



eased tooth is struck first and a painful shock occurs; the tooth is some- 
what discolored, being darker, and there is frequently a bad odor. In the 
first stage relief may be temporarily secured in several ways : 

(a) By applying a dental plaster to the gums. These may be ob- 
tained at almost any drug store. 

(b) By rubbing a mixture of iodine and aconite (equal parts) about 
the gums with a camel's-hair brush or a sterilized rag, first cleaning the 
gum thoroughly with lukewarm water and antiseptic mouth wash. The 
application of the mixture facilitates the removal of waste material by 
causing a more healthy flow of the blood. The remedy must not be swal- 
lowed ; it is poisonous when taken internally. 




Fig. 7. 
Showing nerves leading to the roots of the teeth. 

(c) By using a cathartic. The effect of this is to reduce the quan- 
tity of water in the blood and so give relief by decreasing the blood 
pressure. 

(d) By pressing with the fingers on large nerve, at points indicated 
by Figures 1, 2, 3. See Fig. 7. 

In the Second Stage ; that is, when an abscess is present, temporary 



FILLED TEETH THAT ACHE. 1325 

relief may be obtained by the application of poultices to the affected part, 
within the mouth — never on the outside. The following poultices are 
recommended : 

(a) Capsicum Poultice. — Three parts flour, 1 part red pepper or 
capsicum ; mix ; put in small cotton bag ; thoroughly warm ; apply upon 
head of abscess in the mouth. Change every three hours. 

(b) Flaxseed Poultice. — Put flaxseed in small linen bags and thor- 
oughly heat; apply around the affected gum, replacing with hot poultice 
as fast as one becomes cool. This aids in bringing the abscess to a head 
and will prepare it for lancing. The lancing should always be done by 
a doctor or dental surgeon who will have proper instruments and anti-, 
septic methods. Otherwise there is danger of blood poisoning. 

(c) Raisin Poultice. — The seeds should be taken out and the raisins 
cut in two. Apply in the same manner as with flaxseed poultice, chang- 
ing the poultices as fast as they become cool, and continuing the applica- 
tions for several hours. 

The breath is usually feverish and foul when an abscess is present, 
and to relieve this condition an antiseptic mouth wash should be fre- 
quently used. Either of the following are good: (1) 1 teaspoonful of bi- 
carbonate of soda in a glass of lukewarm water; (2) 2 drachms carbolic 
acid, 4 drachms glycerine, 10 ounces rose water. When the abscess is so 
large as to cause swelling of the face cold applications to the face at the 
same time that hot poultices are being applied within the mouth are 
recommended. Heat must never be applied externally, as it may cause 
the abscess to burst through the cheek. 

FILLED TEETH THAT ACHE. 

When a tooth has been prematurely filled by a dentist ; that is, filled 
before a living nerve is thoroughly quieted, or a dead one completely 
eradicated, after trouble is almost certain to ensue. It also sometimes 
happens in spite of the most skilful and cautious work that after the 
cavity has been filled the pulp dies beneath the filling. Thus there are 
two classes of disease with filled teeth — those with living pulps and those 
with dead pulps. When the pulp is alive there is usually intermittent or 
"jumping" toothache. When it is dead the pain is more constant. 

1. When the Pulp Beneath the Filling is Living — In the first place 
take a hot foot bath, putting a little mustard in the water. This tends to 
relieve the blood pressure and so lessens the pain. Then take, a saline 



1326 THE CAKE OF THE TEETH. 

cathartic, such as citrate of magnesia or epsom salts, which by reducing 
the water in the blood relieves blood pressure on the pulp. 

2. When the Pulp Beneath the Filling is Dead. — Adopt the same 
method of treatment as that recommended for unfilled, aching teeth when 
the pulp is dead; that is, apply within the mouth, in the manner de- 
scribed, hot poultices of capsicum, flaxseed or raisins, and use cold 
applications to the outside. 

ACHING GUMS. 

Aching gums may result from several causes : 

1. Accumulation of Tartar. — When this is the cause the gums will 
have receded from the teeth, the teeth will be more or less loose, the 
breath foul and usually there will be an oozing of pus from the gums. 
Treatment. — Mix one or two teaspoonfuls of bicarbonate of soda in a 
glass of lukewarm water and thoroughly dissolve. Rinse the mouth with 
this solution every hour. Paint gums with solution of aconite and 
iodine and see dentist. 

2. Effects of Colds — There is slight inflammation. Treatment. — 
The gums may be painted with a mixture of equal parts of calendula and 
water or rinsed with a solution of one teaspoonful of borax to a pint of 
water. One teaspoonful of chlorate of potash may be used instead of 
borax. 

3. Result of Recent Cleaning. — After the teeth have been cleaned by a 
dentist the gums are apt to be sore for a day or two. This may be re- 
lieved by rinsing the mouth every half hour with salt and water — a tea- 
spoonful of salt in a glass of tepid water and thoroughly dissolved. Or, 
a mild solution of bicarbonate of soda used as a mouth wash at short in- 
tervals will be found effective. Or still better, use a solution of aconite 
and iodine. A mouthful of whiskey or brandy used as a rinse and not 
swallowed is most effectual. 

4. Result of lacerated Gums from Extraction. — Use frequently a 
mouth wash of tincture of calendula diluted with an equal quantity of 
water. This hardens the gums, soothes the pain and sweetens the breath. 

HEMORRHAGE. 

Upon extraction of a tooth there is always a certain amount of 
hemorrhage or flowing of blood. This is normal and usually stops in 
a comparatively short time without treatment. But occasionally there is 
what is called secondary hemorrhage, which occurs perhaps several hours 



FOUL BREATH. 132? 

afterward and which is due to a lack of coagulation or thickening quality 
in the blood, or there may be hereditary tendency to hemorrhage. Treat- 
ment. — The patient should be placed in a reclining position with the head 
raised. Apply hot water bags to the feet to draw the blood from the 
head. Thoroughly wash the mouth and cavity with lukewarm water and 
then force into the cavity a firm plug of absorbent cotton ; take a piece of 
cork of suitable size, cut a notch in it and place astride the gum over 
the cotton plug, close the mouth firmly upon it and then bandage the mouth 
to keep it tightly shut. During active bleeding it is well to hold in the 
mouth a portion of a solution of two drachms of borax to a glass of warm 
water. Leather scrapings, alum, cobwebs or pieces of sponge saturated in 
nut-gall also sometimes prove effective as plugs in emergency. While one 
or other of these remedies is being employed the physician or dentist should 
be sent for, as hemorrhage sometimes proves to be of very serious char- 
acter, requiring the best professional skill. 

NEURALGIA. 

Neuralgia frequently occurs when the teeth are perfectly sound. 
Such cases are dealt with elsewhere (see Index) ; but it is of common 
occurrence to find neuralgia directly due to diseases of the teeth, owing to 
the fact that the nerves of the face and the teeth are closely related. In 
such cases the remedy lies in finding out what tooth or teeth are affected 
and then removing the cause by having the tooth or teeth properly treated. 
There is sometimes considerable difficulty in locating the trouble when the 
tooth at fault is one that has been filled and therefore is apparently sound, 
but when neuralgia exists without apparent other good reason the ques- 
tion of the teeth should be carefully considered and endeavor made by the 
dentist to discover the cause. 

FOUL BREATH. 

Foul breath is one of the most disgusting of ailments, making the 
sufferer repulsive to all associates, yet in many cases the sufferer is quite 
ignorant of the ailment as it is not noticeable to himself and associates are 
usually loth to make mention of the ill. It may arise from disordered 
stomach or from certain diseases such as catarrhal affections, but prob- 
ably more frequently than from any other cause it is due to decayed or 
filthy teeth. If this be the case the sufferer should at once see a dentist, 
have the teeth thoroughly cleaned and afterward guard against recurrence 
by daily use of proper powders or tooth pastes and of an antiseptic mouth 



1328 THE CARE OE THE TEETH. 

wash. In cases where a dentist cannot be seen at once the mouth should 
be thoroughly washed and rinsed a number of times each day with tepid 
water in which two grains of permanganate of potash have been dissolved. 

SORENESS FROM ARTIFICIAL TEETH. 

For a time after artificial teeth are first used there is liability to 
soreness of the palate. It may be due to the fact that the plate is not 
accurately fitted, in which case the defect should be immediately remedied 
by the dentist, or it may be due to the gums not having thoroughly healed 
after extraction of the teeth; but most frequently it is simply because 
the mouth has not become accustomed to the artificial contrivance. 

Treatment. — The teeth should be removed for several days to per- 
mit of the mouth resuming normal conditions. Yet this is not advised 
unless there be real suffering, as where the discomfort is merely due to 
lack of custom the retention of the teeth in the mouth is the best means of 
overcoming the difficulty. Where there is much soreness relief is fre- 
quently obtained by use of an alum mouth wash, which is made by putting 
a piece of alum about the size of a plum in half a glass of water and 
leaving it there for five minutes. Another treatment is to paint the sore 
places with the following solution: One ounce of glycerine is placed in a 
jar and set in warm water, and into the glycerine stir slowly two ounces 
of tannic acid. Paint on sore spots with a camel's-hair brush. 

DISLOCATED JAW. 

See Accidents and Emergencies. 



BOOK XII 

Treats of the Occupational Diseases. The indus- 
trial poisons are arranged alphabetically in the form 
of a table, together with the industries in which they 
are used, the means by which the poison enters the 
body, the conditions produced and special measures 
of relief therefrom. 



Acetaldehyde 1334 

Acetate of Amyl 1335 

Acid, Carbolic 1364 

Fluoric 1355 

Hydrochloric 1354, 1355 

Nitric 1359 

Oxalic 1363 

Picric 1367 

Sulphuric 1370 

Sulphurous 1369 

Acridine 1334 

Acrolun 1334- 

Air, Compressed 1349 

Alcohol, Amyl 1335 

Wood 1358 

Ammonia 1334 

Amyl Acetate 1335 

Alcohol 1335 

Aniline 1336 

Dyestuffs 1337 

Antimony Compounds 1338 

Arsenic Compounds 1338 

Arseniureted Hydrogen . 1339 

Asphalt 1340 

Benzine 1340 

Benzol 1341 

Binitrobenzol 1352 

Bone 1354 

Brass 1342 

Bromin 1342 

Bronze 13 j 2 

Broom 1 368 

Carbolic Acid 1364 



Carbon Bisulphide 1343 

Dioxide 1343 

Disulphide 1344 

Monoxide 1345 

Oxychloride 1365 

Carburetted Hydrogen 1346 

Cement 1347 

Chinin 1347 

Chinone 1347 

Chloride of Lime 1347 

of Platinum 1367 

of Sulphur ....1369 

Chlorine 1347 

Chlorodinitrobenzol 1348 

Chloronitrobenzol 1348 

Chromium Compounds 1349 

Compounds, Antimony 1338 

Arsenic 1338 

Chromium 1349 

Cyanogen . ., 1350 

Rhodanic 13 50 

Sulphocyanic 1350 

Compressed Air 1349 

Copper 1350 

Cotton 1 350 

Cyanogen Compounds 1350 

Cyanide, Natrium 1350 

Diazomethane 1351 

Dimethyl Sulphate 1351 

Dinitrobenzol 1352 

Dioxide of Manganese 1357 

of Sulphur 1369 

Dust, Street 1368 



84 



1329 



1330 



INDEX TO BOOK XII. 



Dyestuffs, Aniline 1337 

Earths 1368 

Emery 1352 

Ether 1352 

Methylated 1352 

Ethylaldehyde 1334 

Ethyl Nitrite 1352 

Feathers 1353 

Felt 1353 

Filings 1358 

Flax 1353 

Flour ..1354 

Fluoric Acid 1355 

Formaldehyde 1352 

Fumes, Solder 1351 

Fur 1353 

Gasoline 1353 

Glass and Emery Dust 1353 

Glycerin Trinitrate 1361 

Gold 1354 

Grain 1354 

Hair 1354 

Hemp 1353 

Horn 1354 

Horsehair 1354 

Hydric Sulphide 1369 

Hydrochloric Acid 1354, 1355 

Hydrogen, Arseniureted 1339 

Carburetted 1346 

Phosphureted 1367 

Sulphureted 1369 

Iodine 1355 

Iron 1355 

Jute 1355 

Lead 1355 

Lime, Chloride of 1347 

Lydol 1357 

Manganese Dioxide 1357 

Meerschaum 1357 

Mercury 1357 

Metal Filings 1358 

Methyl Alcohol 1358 

Methyl Bromide 1359 

Methylated Ether 1352 

Metol 1359 

Mirbane Oil 1360 

Natrium Cyanide 1350 

Nitraniline 1359 



Nitrate of Silver 1368 

Nitric Acid 1359 

Nitrobenzol 1360 

Nitroglycerin 1361 

Nitronaphthalene 1362 

Nitrous Gases 1362 

Occupational Diseases 133 1 

Oxalic Acid 1363 

Paper 1368 

Paraffine 1363 

Petroleum 1364 

Phenol 1364 

Phenyl Hydrazine 1364 

Phosgene 1365 

Phosphorus 1365 

Phosphorus Sesquisulphide 1366 

Phosphureted Hydrogen 1367 

Picric Acid 1367 

Platinum, Chloride of 1367 

Putty Powder 1353 

Pyridine 1367 

Rags 1368 

Rhodanic Compounds 13 50 

Shell 1354 

Silver, Nitrate of 1368 

Solder Fumes 1351 

Steel 1355 

Stones 1368 

Straw 1368 

Street Dust 1368 

Sugar 1368 

Sulphocyanic Compounds 1350 

Sulphur Chloride 1369 

Sulphur Dioxide 1369 

Sulphurous Acid 1369 

Sulphureted Hydrogen 1369 

Sulphuric Acid 1370 

Tar 1371 

Tobacco 1371 

Triton 1371 

Turpentine 1371 

Vanadium 1372 

Volatile Oils 1372 

Wood 1372 

Wood Spirit 1358 

Wool 1372 

Zinc 1372 



Book XII 



OCCUPATIONAL DISEASES 



When diseases are spoken of as occupational, it is not meant that 
they are peculiar diseases to be found only in those employed in certain 
occupations, but simply that people of certain occupations are more liable 
to become affected with this or that disease than those employed in certain 
other industries. There can be no question that occupation has a vital 
effect upon health. Some occupations are conducive to health, others 
are not. To follow any special trade does not mean that one must become 
diseased in some particular form, but that there is greater or less liability 
to this or that disease. One may handle dynamite without being blown 
up, yet there is always the risk, and so one may handle white lead with- 
out acquiring disease, yet there is always the possibility of lead poisoning. 
It is essential, therefore, to everyone to understand the hazards of dif- 
ferent occupations. Some occupational diseases are very serious, yet are 
seldom encountered, while others are very frequently met with yet are 
not serious in their nature. There is a proneness with some people to 
exaggerate the hazards of certain occupations. Exaggeration should be 
avoided, yet on the other hand the risks taken should not be underesti- 
mated. If the risks be clearly and properly understood they may in 
many cases be avoided. As a matter of fact the serious occupational dis- 
eases may be almost entirely eliminated by proper safeguards, and these 
safeguards should be provided by employers, as is more and more being 
appreciated by those in authority and in respect of many risks there are 
now laws on the statute books which make due provision. There are also 
many precautions which the employee may take if there be proper knowl- 
edge of the risks involved. 

Occupational diseases are complex in their nature. One substance 
may produce some particular ailment, others may cause a variety of ills, 
according to the special attending conditions. Steel dust is apt to cause 
"Knife-grinder's Consumption" (pneumonoconiosk) ; lead poisoning may 
cause hardening of the arteries (arteriosclerosis), heart troubles, chronic 
nephritis, chronic anaemia, neuritis, etc. ; mercury may cause bone necro- 

1331 



1332 OCCUPATIONAL DISEASES. 

sis, anaemia and a series of grave nervous and mental disorders. The 
number of substances and the variety of diseases they may cause are many. 
Dr. W. Gilman Thompson, of Cornell University and a high authority 
on occupational diseases, has well pointed out that it is not so much a 
question of how much of a poisonous substance enters the body, as how 
much of it is actually absorbed. A knowledge is necessary of the poi- 
sonous substances encountered in different occupations, the parts of the 
body affected by them, the manner of avoiding their ills, and the treat- 
ment necessary when the ill has come. 

In regard to poisonous substances, they may be broadly classified as 
follows: (a) metallic poisons; (b) poisonous gases, vapor and fumes; (c) 
poisonous fluids, such as acids, alkalies, dyes, petroleum products, etc. ; 

(d) irritant dusts and fibers, which may be soluble, insoluble or organic; 

(e) organic germs, such as those of anthrax, sometimes encountered by 
butchers, workers in horsehair products, etc. ; (f ) miscellaneous irritants. 

Harmful environment is also a dominant factor and may be sum- 
marized thus: (a) air compression and rarefaction; (b) excessive hu- 
midity; (c) extreme heat and cold; (d) excessive light, such as X-ray, etc. 

Certain tissues and organs of the body are more likely to become 
injured in one occupation than in another, and such injuries may be thus 
named: (a) injuries to the blood; (b) injuries to nerves, muscles and 
bones; (c) injuries to eyes; (d) injuries to ears; (e) injuries to mouth, 
nose, throat and lungs ; (f ) injuries to the skin. 

The effects of different poisons encountered in industrial work may 
be divided into acute and chronic. Certain vapors and fumes such as 
methyl alcohol and sulphur vapors practically always act acutely, seldom 
if ever acting chronically, while nitrate of silver and some other sub- 
stances almost invariably act insidiously or chronically, and still others 
such as carbon monoxide may not only cause acute symptoms but also 
have serious chronic effect. Cases of chronic poisoning are much more 
frequent than those of acute poisoning, and as the poison works insidiously 
serious condition may arise before the victim becomes aware of the nature 
of the the ill. 

When these facts are taken into consideration along with the knowl- 
edge that the physique, constitution and temperament of different in- 
dividuals make them respectively especially liable to certain ills, one may 
judge whether or not it is advisable to engage in certain occupations — as 
that which may be perfectly safe for one individual may not be for an- 
other. For instance, weavers, hatters and furriers are especially liable to 



OCCUPATIONAL DISEASES. 1333 

become afflicted with lung troubles, and therefore when the lungs are 
naturally weak these occupations should be avoided and some occupation 
selected which is not conducive to such disease. 

As an instance of the effect of occupation upon health, mention may 
be made of the employees in cotton mills. There are dangers which are 
direct and obvious in their effects upon the health of workers. The work 
involves more or less constant confinement in a dusty atmosphere, in ad- 
dition to which there is usually excessive heat, nauseating odors, irritat- 
ing gases and generally lack of proper centilation, resulting in artificial 
moisture which cannot but have a deleterious effect. Dust in cotton 
workrooms is only a prominent feature in the first few processes. The 
danger lies chiefly in the opening, picking and carding processes. 

This danger from dust in cotton mills may be largely avoided by 
mechanical contrivances, and so it^is with all trades in respect of which 
dust is a disease factor. The vital thing is to realize the actual danger in 
connection with each separate employment, and then, whether the danger 
be found in dust, in noxious gases, in contact with acids, other substances 
or conditions detrimental to the health, to find the proper means of safe- 
guarding oneself. 

In the following table, alphabetically arranged, will be found a list 
of the various poisonous substances which are to be found in connection 
with various industrial work, with particulars as to the different indus- 
tries, where respectively danger exists, an explanation as to the mode of 
entrance into the body, the general symptoms of poisoning, and special 
measures of relief in case of emergency. This table has been especially 
prepared by the Bureau of Labor, Washington, D. C, which Department 
has authorized their use in this work. 



OCCUPATIONAL DISEASES. 



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For the itching, 10 
grains of menthol to the 
ounce of petrolatum, or 10 
to 15 grains carbolic acid 
to the ounce. 

For a permanent relief, 
change of occupation. 


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yellow discoloration of the cuticle 
and eyelids; sneezing and nasal 
catarrh; inflammation of the 
mucous membrane of the mouth; 
bitter taste; disturbances of diges- 
tion; irritation of. the central 
nervous system and of the kid- 
neys. Industrial poisoning by pic- 
ric acid is extremely rare. 

Blood poisoning. The morbid 
symptoms resemble those in poi- 
soning by amido compounds; ail- 
ments of the central nervous 
system in great variety; paralysis. 

Intense irritation of the skin, 
caused, it is asserted, partly by 
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skin. 

Intense irritation of the skin, 
caused, it is asserted, partly by 
using excessive quantities of 
chloride of lime in cleansing the 
skin. 

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eyeball. 




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Action on the skin; in 
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digestive organs. 

Action on the skin; in 
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digestive organs. 

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the skin. 

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the skin. 

As dust or fine particles 
in the eyes. 


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dye houses; also manufac- 
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Aniline Dyestuffs — 

The majority of the very 
numerous aniline dyes are 
non-poisonous. Generally 
the basic dyes are more 
dangerous than the acid 
dyes. 

Regarded as suspicious 
or injurious to the health 
are: 

(a) The various phenol 
nitrates, dinitrophenol, di- 
nitrocresol (saffron yellow, 
aniline orange), picric acid 
(trinitrophenol). 

(b) The many naphthol 
nitrates, dinitronaphthol, 
Manchester yellow, dinitro 
and naphthol calcium; 
tetranitronaphthol. 

(c) The nitroso dyes. 

(d) The aurantia — hexa- 
nitrodiphenylamine; impe- 
rial yellow, its sodium salt. 

(e) Ethyl and methyl 
violet. 



1338 



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1341 



I 

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Prompt removal of the 
patient into the fresh air; 
inhalation of oxygen; ex- 
clusion of female workers 
from every employment in 
which benzol is used. 




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Benzol, its like compounds and 
the rest of the hydrocarbons of 
coal tar have a specific affinity 
for the cemtral nervous system 
and a general action on the proto- 
plasm of the organic cells (fatty 
degeneration). Female workers, 
particularly in their develop- 
mental years, especially at the 
time of menstruation, are more 
susceptible than men to the 
poisoning, and in an extraordinary 
degree to the subacute and 
chronic forms of it. 

Acute Poisoning. — (a) In mild 
cases: Cerebral disturbances, 
humming in the ears, giddiness, 
sleepiness, a condition resembling 
inebriation, vomiting and irritant 
cough, slight flushing of the face. 

(b) In severe cases: Symptoms 
on the part of the central nervous 
system, muscular tremor, like 
chilliness from exposure to cold; 
trembling of the whole extremi- 
ties; finally, tonic and clonic 
spasms; pale, livid skin; lips re- 
markably scarlet hued; blood 
bright red, thin. Dlscolorations 
of the skin like those In aniline 
and nitro-benzol poisoning are 
wanting in benzol poisoning. 

(c) In the most violent cases: 
Hallucinations, delirium, pro- 
tracted unconsciousness and death 
in tonic convulsions. 

Subacute and Chronic Poison- 
ing. — Numerous spots of extrava- 
sated blood in the skin, together 
with severe ana?mia; hemorrhage 








In the form of vapor, 
through the respiratory or- 
gans; reabsorption through 
the skin. 




Is 

11 
c° 

— «c 

Si 

12 




Manufacture of benzol, 
its like compounds and 
numerous derivatives; 
technical use of these prod- 
ucts in the manufacture 
of colors, in carburizing 
illuminating and water 
gas, in refining and dis- 
solving of caoutchouc, res- 
ins, fats, alkaloids, iodine, 
phosphorus, and sulphur; 
in the removal of grease 
from materials; dye works, 
laundries; lacquer and var- 
nish factories; the rubber 
industry. 




§1 

a s 

■ 




14 

A very unstable, color- 
less fluid, burning with a 
bright, very sooty flame; 
extremely volatile; its like 
compounds, e. g., toluol, 
xylol and cumol. 

1 





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. r gas, a mixture of 
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Producer gas contains 34 
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camphorated oil); to con- 
trol the irritating cough, 
hypodermics of morphine 
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steam. 

For the prevention of 
chlorine acne: 

Substitution of anodes 
made of molten metallic, 
oxides for the carbon 
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tense difficulty in breathing; bron- 
chial catarrh with hemorrhage; 
sometimes lobular pneumonia. 
The concentrated vapor causes 
uncontrollable cough, spasm of 
the glottis, cold sweats, cyanosis 
and small pulse; death occurs 
within a few minutes (sudden 
collapse). 

In its Chronic Effect. — Distress 
In the gastric region; chronic ca- 
tarrh of the stomach; heartburn; 
pallid countenance; catarrh of 
the respiratory tract; lobular 
pneumonia; headache, vertigo, in- 
somnia; gradual emacation and 
premature senescense. 

Chlorine Acne. — (Occasioned in 
the electrolytic production of 
chlorine by chlorinated carbu- 
reted hydrogen.) Inflammatory 
processes in the dermal glands; 
the occurrence of unusually dif- 
fuse, confluent comedones with 
indurated, dark-green heads; solid 
infiltration of the sebaceous fol- 
licles, their inflammation and sup- 
puration causing pustules and 
boils. 




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Chloronitrobenzol — 

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Chronic Poisoning (very doubt- 
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of appetite, disturbances of the 
gastric and intestinal functions; 
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effects like those of dimethyl sul- 
phate. 


Strongly corrosive effect on the 
skin and mucous membranes; 
burns; pains in the nape of the 
neck and in the thoracic cavity; 
hoarseness; destruction of the 
mucous membrane and aspiration 
of the broken-down products into 
the lungs; watering of the eyes; 
conjunctivitis; formation of ero- 
sion-eschars and oedema, photo- 
phobia and parenchymatous 
clouding of the cornea; even 
coma, convulsions, paralysis and 
a fatal outcome. 


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Immediate removal from 
the workroom; inhalation 
of oxygen; artificial res- 
piration; eventually blood- 
letting; stimulants, non- 
alcoholic; prohibition of 
the use of alcoholic drinks 
during working hours; 
avoidance of the same, 
also, outside of employ- 
ment. 


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Poisoning by all of the homo- 
logues of nitrobenzol is very 
nearly the same. However, the 
larger proportion they contain of 
the nitro groups the more viru- 
lent they are likely to be. The 
nitro-chloro compounds are very 
much n.ore dangerous than the 
simple nitro compounds. 

The first toxic symptoms may 
appear within a few hours (8 to 
24) after absorption of the poison. 

Acute Poisoning. — (a) In mild 
cases: Uneasiness, headache, gid- 
diness, nausea, loss of appetite, 
costiveness, burning sensation of 
the skin and mucous membrane. 

(b) In severe cases: A feeling 
of anxiety, disturbances of sen- 
sation, like formication on the 
legs and furriness of the soles of 
the feet, ringing in the ears; dis- 
turbances of co-ordination (reel- 
ing gait, stammering speech), in- 
creased excitability of the re- 
flexes, convulsions and a state of 
general spasm; later, with decline 
-of sensibility, symptoms of par- 
alysis; vomiting; odor of the 
vomitus and of the exhaled 
breath like that of bitter-almond 
oil; jaundice of the skin; at first 
increased, afterwards diminished, 
activity of the heart, with low- 
ered tension of the pulse; visual 
derangements (amblyopia, optic 
neuritis) ; blood viscid, bro,wn to 
deep dun color; diminution of the 
red blood corpuscles and altera- 
tions in their form; formation of 
crystals. Death may occur with 



2 £ 

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(1) Absorption takes 
place, first of all, through 
the skin, both the unin- 
jured and especially the 
pathologically altered skin, 
particularly in the case of 
profuse perspiration; (2) 
through the respiratory 
organs; (3) through the 
digestive organs. 


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Coal-tar color industry 
and those establishments 
in which its intermediate 
products are manufactured, 
as in explosive works; per- 
fumery and soap factories, 
' pharmaceutical laborato- 
ries, etc. 


IS 

I 




69 

Nitrobenzol (mirbane oil, 
imitation bitter-almond 
oil) — 

A colorless, highly re- 
fractive fluid, having an 
odor like that of bitter al- 
monds; and all nitro com- 
pounds of benzol and its 
homologues. The most of 
the nitro and chloro com- 
pounds are the more poi- 
sonous. 



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£^ 

"oo o 

O 00 



c -o 



^r5is 



>?j3 



~ V 



0) 



x a; d 
W-5 



£ 03 

gbo 

-cW p 
o3 S 



it 

flP5 



^4 



o3 co S t-i 



-m boo c 

^ 3 2 p 

O Lh N jj. 



3 C4«! C 
eS.2 w rt 

5 8hS 



<W <H CO *-> I 

O O 3 o3 O 

o c .t: „ c 

« " c a 



0) 0> 



ft *" 
■d (« c ft 



C 0) = O) <t> 

• 5 © o 3 






as 



to 3 o3 

ft CP >> 
*?,* 

i ° 

<M ^ 

O 3 <D 
03 

CO <D 



s5 



p >>•" 

CO.. 
S o " 

03 J? H 

.2 5 s 



o « 

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'5 



S §o 

cv co o 

it u% 

g - p-5 

" S I cd.ti 

g cs >>d 

5 ^S 



'86 



13(52 



OCCUPATIONAL DISEASES. 



g 

n 

I 






Immediate removal from 
the noxious atmosphere; 
inhalation of oxygen; 
finally, bloodletting and in- 
fusion of normal salt so- 
lution. 


u 

a 

•a 

9 
an 

"3 
Ph 

e 

X 

g 

e 
■** 

A 

s 


cyanosis, motor paralysis and loss 
of consciousness; intermittent, 
stertorous respiration, coldness of 
the skin, small pulse; after recov- 
ery of consciousness, debility, 
nausea, vomiting, headache, inter- 
mittent pulse, and finally death. 

Chronic Poisoning. — Disturb- 
ances of digestion, trembling, 
neuralgia. 




Susceptibility to the effects of 
nitrous gases fluctuates consider- 
ably. Persons who suffer from 
diseases of the respiratory organs 
are especially susceptible; not in- 
frequently the continual inhala- 
tion of small quantities, for many 
consecutive years even, occasions 
no serious disturbances of the 
health. A pale, sallow complex- 
ion and chronic bronchial catarrh 
may be deemed, nevertheless, the 
usual consequences of occupa- 
tional inhalation of very moder- 
ate quantities of nitrous gases. 
Often, however, larger quantities 
of the poisonous gases are borne 
for hours together (6 to 8 hours) 
without discomfort; when sud- 
denly, after a long interval with- 
out disturbance, ominous symp- 
toms appear. 

Symptoms of irritation in the 
air passages are manifest, as a 




H 

I 1 

I 1 






In gaseous form, through 
the respiratory organs. 


T 09 

- u 

X O 

3 x 

J! 






Nitrous gases are pro- 
duced by the action of 
nitric acid on deoxidating 
substances of various kinds, 
principally on metals 
(iron, lead, zinc, etc.), on 
organic substances (coal 
dust, wood, straw, paper, 
textile fabrics, woolen ref- 
use, etc.), as well as many 
other substances (pyriates, 
sulphurous acid and its 
salts, soda sediment, hydro- 
chloric acid, iron chlorides, 
sulphate of iron, etc.); in 
the preparation of nitric 
acid, its combinations and 
salts, among which the 
nitrous salts also are to 
be included; metal etching 
and metal refining; stamp 
mills and mints; galvano- 
technics; nitrification in 
chemical works and manu- 


*1 

|| 

— X 

- £ 

I 




71 

Nitronaphthalene — 

A yellow, friable, crystal- 
line mass of strongly aro- 
matic odor. (See Nitro- 
benzol.) 


72 

Nitrous Cases (low degrees 
or oxidation of nitro- 
gen, which appear si- 
multaneously ) — 

Nitrogen protoxide; ni- 
trogen deutoxide; nitrogen 
trioxide; anhydrous nitrous 
acid. Nitrogen protoxide is 
a colorless gas which, un- 
der the influence of atmos- 
pheric oxygen, is readily 
transformed into brown ni- 
trogen dioxide. Below 20 
degrees Centigrade nitro- 
gen trioxide is a blue fluid; 
at the ordinary tempera- 
ture it separates into ni- 
trogen protoxide and ni- 
trogen deutoxide. 



OCCUPATIONAL DISEASES. 



1363 



I 

•a 




■0 
6 

03 2 
Si 

o3 ® 

6.. 

at 




1 

•s 
h 

"g 

1 

ft 

s 


feeling of constriction of the lar- 
ynx, spasmodic cough, oppression 
in the chest, labored respiration, 
anxiety, cold perspiration on the 
face, protrusion of the eyes, gasp- 
ing speech, paroxysms of cough- 
ing, bluish discoloration of the 
countenance, coldness of the 
hands and feet. 

Consciousness is at first unim- 
paired, but with increased diffi- 
culty of breathing it becomes 
dimmed; injury to the teeth. 
The urine is scanty, brown in 
color, containing crystals and al- 
bumen. Death results from dropsy 
of the lungs. In very severe 
cases corpuscle crystallization is 
observed, and then a general sys- 
temic poisoning may result. 


Opalescent or bluish discolora- 
tions (with brittleness) of the 
nails; blood stasis in the hands; 
corrosive action on the mucous 
membrane of the aesophagus, of 
the stomach and bowel; weakness 
of the heart; convulsions and 
spasms. 

However, industrial poisoningr 
by oxalic acid are extremely rare 


Diarrhoea, dizziness, headache, 
gastric disturbances, difficulty in 
breathing, sweating, eczema and 
sometimes cancer of the skin. 


If 




*r >> 

«(( 

u 

O W 

U 

6 

H 

5* . 

bo m 

3 C 

C O 03 
M U bjo 

si u 

+-> o 


Into circulatory and di- 
gestive system as a vapor 
when melted; locally, by ir- 
ritation of the skin. 


Is 

x e 

a » 


factories of explosives; cel- 
luloid manufacture; sul- 
phuric acid manufacture; 
production of picric acid, 
aniline colors, nitro-cellu- 
lose (gun cotton, collodion 
cotton), xyloidine, nitro- 
starch, nitro-jute, dyna- 
mite, abelite, nitro-man- 
nite, nitro-saccharose, vis- 
cosine, etc. ; nitric acid 
manufacture and storage; 
preparations of thorium 
and cerium; bleaching ma- 
terials (oils, etc.); hat- 
making (maceration of the 
hair; etching and en- 
graving on copper (etch- 
ing of the plate) ; dyeing 
and printing (fixer and 
mordant). 


Manufacture of oxalic 
acid; polishing of metals, 
especially of copper and 
brass utensils; used in dye 
works, chemical cleansing 
plants (rust and ink 
stains) ; straw hat manu- 
facture and straw braid- 
ing. 


it 
a > 
*3 

ti y 

X <o 
u 
© n 

*%* 

03 ™ L, 

ego 

ft .5 


s 

s 




2 

9 

a 
a 

bO 

S | * 
2 « 

o 


I 
i 



1364 



OCCUPATIONAL DISEASES. 



1 

■ 

fl 


Removal into the fresh 
air; in collapse, a tepid 
bath with cold afCusions; 
subcutaneous injections of 
camphorated oil. 


u • 
°3 

*£ 

*£ 

o^ 

M 

. >> 

AS 

b, * 

c3 g . 

© Z « 


Remove at once from 
exposure to chemical; spe- 
cial treatment for symp- 
toms required. 


si 

e 

1 

CB 
"3 

VI 

© 

1 

© 

£ 

>> 


The vapors of petroleum cause 
a profound acute poisoning with 
a condition of inebriation; shout- 
ing, reeling and prolonged sleep 
without any recollection of what 
has happened; in severe cases, 
loss of consciousness, lividity of 
the countenance, staring look and 
contracted pupils, almost imper- 
ceptible pulse, asphyxia. The 
chronic effect of petroleum vapor 
causes numbness and irritation of 
the Schneiderian membrane. 

In general, the symptoms of 
the action of petroleum resemble 
those resulting from the action 
of benzine. By reason of the high 
boiling point of petroleum there 
are produced in the extraction of 
paraffin butter, in the handling 
of crude paraffin, in the emptying 
of retorts, and in the filling of 
casks with petroleum, obstinate 
inflammations of the hand in the 
form of acne (nodules, pustules 
and boils). 


Erosion of the skin, which by 
great extension may lead to se- 
vere internal injuries; symptoms 
of degeneration in the blood and 
in the internal organs (nephritis) ; 
gangrene, icterus, collapse. 


Obstinate vesicular eruption on 
the -skin, with itching and burn- 
ing; diarrhoea, loss of appetite; 
granular degeneration of the 
blood corpuscles; formation of 
crystals in the blood; a sense of 
faintness. 


9 
V . 

-I 
S = 

■• 

II 

a* 


In the form of vapor, 
through the respiratory 
organs. As a fluid it has 
a direct action on the skin. 


h 

2 * 

as 

© 

© 
© > 

© 
C bo 

°^ 

5 © 
•2 5 

© 


a 
3 

© 

*" a 

,a tn 

- ® 

J- 

ftfl 
u O 

K S 

.Q O 
c3 


is 

- be 

si 

12 


Production of oil; refin- 
ing of the crude oil; fur- 
niture polishing by use of 
so-called polishing oil. 


Anthracite coal tar dis- 
tillation; production of 
picric acid and of many 
organic aromatic com- 
pounds; used in dyeing, 
calico printing; manufac- 
ture of lamp-black, in pho- 
togen factories; impreg- 
nating wood with tar and 
oil of tar; surgical dress- 
ing industry. 


A by-product in the 
manufacture of antipyrine 
from aniline; manufacture 
of organic compounds. 


s 

11 

a z 

09 jB 

btx 

1 


75 
Petroleum — 

A mixture of various hy- 
drocarbons of the methane, 
•thyl, and aromatic series. 


76 

Phenol (carbolic acid) — 

A white crystalline mass 
and its homologues, e. g., 
cresol, lysol and their de- 
rivatives. 


77 

Phenyl Hydrazine — 

A yellowish, oily fluid, 
shading into brown, of 
pungent odor. 



OCCUPATIONAL DISEASES. 



1365 



s . 
1* 

©•a 

•a 2 



a £ w 

or- C 

£*2 

g fi 3 

o C * . 

oj c3 >, 0> 



- o £ O d 
,Q O -u 

I c « fl 5 

ft £ fc, m m 
*,£ O 3 J 
w j3 a) O cd 

6 ^"3 " 

•5 © 2 

5 0) ° w 
a) -m ft™ 



O > rj O 

c v, 

o go 

y « 2 ? 

I- 0> C 

*J to 



O C 

£»£ 
. o. >. 

O CO O 



4) O e3 S 
£- 2" «* 



. . y 

e c 

.2 bo c fi 



*£ 

? y 



«-> of . 
" C 





3 £ 05 Z ed 



« C m 

hi 



** C h 

b5 
y o y 
00 ft.3 

ft o 



O m (< 1 

Pi. U H o « 



XI O, 



pq 



DO Bj 



O 3T 



g « M 

y y 



e-°"E.-£ 

fc.fi O CO « 

C ° 3 -— • 
co 2 O C co 3 
m 5 >- O bo ra 

C * >. y 5 u 
3 u.fi'O- 



bO - 
3 <M 

5 -a 

* j o> 

ft so 

ai Op 

d >> 0) 

(;(.£ 

ft C o 
O to 

1 bo £'~ 

1.532 

'^s a S 
*-> o 

I u C 3 



iiS 



5 - ° 8- 

ai — y - 
•3 cd to ft 

c o 

• 8|»- 

*-> -fie 



y a^5 m S 



o .£' 
to C oj -f 
S R fc. (D 



o — . « 
to c o 
og ■ 






4) w- 

U 



SSSto 



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a -> ft 



0) S3 

3 
O 

C 3 S 5^ 
S 



•° cr^ -^ 



*£ ^ 



** si 

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c.S 

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*^ " to 



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3-8=3 



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y rfi 

o ft 



fti2 — to 
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c o 

00 O F A y 






; « ? 
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ci) 



IU j> ~ . 



ro l r" 

1 «j <d y 

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r 1 ZZ '*-' "- 1 , 
C gS O - 

o — cs c -^> 

— ei c v. c k 

c u e toe e.5 
y -i q, c . x 3 

* * £ 4> O 

bo 3 r 2 vi ■* d 

cd ~ - - : - - 



it 


O CD 


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O rj 


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3 e 




Cod 



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32 



si 



£ o bo 

D w £j 

y 

^«o 

3 -1 
c C 
d ti o 

SB3 



2 * - 

i L. Z 

a o~ bo 

M ss.s 



u >» 0) 



vi 03 "d 
O cp 



O-C O 
*^ +J <-J 

c 



a> 

k3 



5^ 



1-3 d .. 

1 3 ti w 

e c u 

, - o ci) 

1 y y to 



to -rt 1 ' 

t. 5 ^ C 
o rt ^S 



a u £1 -^ 
u. O y g 

ft O i. 

.9 2 bo 



♦J o 

X 3 4) 

O C 

u o 



T3 4> 
C.fi 



^ & ^ft^ 

£ ^g£ 

O y O U 2 



a » 



y 03 



. Odo 

i: 3 o. & bo g 

5|v,5|S 

cfl C C ft C w 



» 6 



3 •" -^ ai « N 

81 » g 62 mv 



■ - ./ a) 0) ' 
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"'£ ft ft 



h-- >>0 



c y y o 



Eog25«4§3 

SoeUfflnAn 



>>£ 



3 y 

w y 



5 H •« « CO 

a J= CP 3 

o o 



•c 3^v,cc£yy w fi-r-5-S°o 
i« B3ic«rt.fift r a-tiaJ^cijaxco 



1366 



OCCUPATIONAL DISEASES. 






o ^ « _■ 

2 s " « 5: 

° >»a 

b ° ^ p s 

«-2§i o 






CO B 



> S3 ft ni o> T3 



D i © 0) 4> 



I 0> i <D 03 

! 3 E 3 T* , 
'HiJO 

•5 2 £ 



■"-> \1 *J ™ ?■ ' 



1 5 1 £ ^ 

O ? BJ-M s 

3 ■-; ra 

m OT c 5 

c e 2 5 
.« r to *-> . 

{- ? » 'o 9J 

2 «J 3 S* 
a ts © d o 



* c 
§1 

a rf 



s « 

Sg°§ 

»3 ri Eh 



CD <D >m 



P. <D V bfl 



2 »ea'o 

ER C W , 



CD o *""' 
Oftg5 

» 222 

^* 

ra .E -w 

CO) ,Q 

fife* . 

■-15 



«3 C 



■^ to 

0) 

3 u 
•2 bo ©' 

CO C ^ 

b © « 
«-2.e 






3 a eo *j o, 



e 3.5 c 



xt~ „ 

22 y 
o 

3^* 
O gin 



.2 * 
" > 

4) 



1^ 

>>.5 =o 

« J3 



I - 

S 2 

3 s 

<n a. 

3 w (rt 

■*"' CO 
_, <n to 

Ms 

3 d cp 



•Sss| 

a> oj cd ° 
§ of w *° -2 

o £ v J3 °2 

B >0 to O . 

IIIII 

2 ft o a> • 

2 5 a* B 
■° § to? 



o ft oS s 



S> to 
S3'" 
»^° 

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2 ai 3 t3 
2 B§ 

° to © to 

C ,QrtH E 

2 m to U 

5^5 



Sft-' 

>. to , 

■ aj" 

t- "2 ° 

s3 M ® 

£ o 

5 B fi 



B SO 
2 & 

o . 

o bo 

ft to B 

SSb 

83°, 



.S-b 

§ bo 

to • O 
O OJ T3 

ft bo >> 

bo^ U 
B * B" 

o3 0) >B 
-O u ft 



B iA 

II 



^3 
ft 



%'i%h&$*& 



of* 



bo 

b£ 

O n3 
'2 >, 
rt.E 

XI 

BT3. 



uu w d n * H u 

— i S ™ O B S 0) '2 

C ^ 3 ..» 603 

£ <u B 2 ° 'B 



° « bO«w - 0,w *" o 



B o X 2>.. 

.5 '"bo ego 

"O fi "O to£s *j ft 5 






12 



■3 to 



c 5 
25 

= - 
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lil 



a a. 



to 



^< at 



OCCUPATIONAL DISEASES. 



1367 



I, 

03 <m 

•g© 
« 

GO 


Fresh air and stimulants. 


Wearing of "rubber 
gloves; instant removal of 
the patient from the poi- 
sonous atmosphere. 


o 

01 
N 

al 

So 

0Q 

<D . 

a c 


Wearing of rubber 
gloves; instant removal of 
the patient from the poi- 
sonous atmosphere. 


a 

•a 

o 
m 

© 
On 

«H 

e 

OB 

s 



a 
S 
>> 


An oppression in the chest, 
changing to a burning, lancinat- 
ing pain; affections of the head, 
vertigo, tinnitus aurium; genera! 
debility; loss of - appetite; greai 
thirst. Death occurs without con- 
vulsions, through the effect of 
the poison on the blood. 


Poisonings with picric acid are 
rare; when they occur there are 
itching, inflammation of the skin, 
vesicular eruption, yellow pig- 
mentation of the epidermis and 
of the conjunctiva, inflammation 
of the buccal mucous membrane, 
bitter taste, disturbances of di- 
gestion, epigastric pain, nausea, 
vertigo, diarrhoea and jaundice; 
picric acid decomposes the con- 
stituents of the blood. 

By the penetration of dust into 
the nostrils, sneezing and nasal 
catarrh are occasioned. 


O bo m 

c 2 
£'3-2 
«S £ o 
2 c ffl 

*3 m £2 

"J 

CO .— . 
W V 3 

.c o 


Catarrh of the mucous mem- 
branes; hoarseness, irritation and 
choking sensation in the throat; 
headache, vertigo, flaccidity and 
trembling of the extremities; dif- 
ficulty of breathing and clonic 
convu'sions; eczema of the hands. 


© 
© . 

11 

spa 

© « 

©.5 


50 f^ 

u 

in 

© 

O 0) 

*! 

60 CO 

3 C 

cots 

HfclO 

5 6 


In the form of dust, 
through the respiratory 
passages; direct action on 
the skin. 


1 (1) 
co 
o 

+J <*> ni 

fit O 

cd co C 

~ s 

(1) 
^ ctf 

CO CO 

3 
>» O 

^ ri 3 
O S 


In the form of vapor, 
through the respiratory 
organs. In a fluid state it 
acts on the skin of the 
hands and arms. 


*§ 
£■§ 

2 s 

S ce 

M H 


In the extraction of 
phosphorus; in the prepa- 
ration of red phosphorus 
and the sesquisulphide of 
phosphorus; in the reduc- 
tion of iron silicate con- 
taining phosphorus by the 
action of moisture; in the 
production of acetylene 
with calcium carbide that 
contains an admixture of 
calcium phosphate. 


Chemical works, dye 
houses; manufacture of 
explosives and powder 
(lyddite, melinite); pro- 
jectile factories, filling 
shops. 


bo 

o 

o 

.3 
ft 

C 

bo 

C 
ft 


"3 

<D . 

& 


In its manufacture out 
of coal tar and bone tar; 
in the use of denaturing 
spirits (shops for wood- 
working, gilding and hat 
manufacture). 


© 

.2-2 

"-W CD 

os.fi 

C 9 
OCX 

1 


SI 

Phosphureted Hydrogen — 

A colorless gas of nau- 
seating odor. 


82 

Picric Acid— 

Trinitrophenol in a pure 
state forms pale yellow, 
bitter tasting foliate, met- 
allic crystals. 


J, 
© 

1 
« 5 

» JB 

i 

1 

1 

Oh 


84 

Pyridine— 

A colorless fluid of pun- 
gent and characteristic 
odor. Its homologues, py- 
ridine ba.sis. 



1368 



OCCUPATIONAL DISEASES. 






©.A 



c > . 
3 g « 

d <d d 



~£ 



O J 

"" C 
o 



PQ a> 



d -r® 

53— d 
^d 

~ = £ 

§*2 

u d o 
X! g d 

d « £ " 
U ® ffl 

l! 

75 SI 



d o 



IS 






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u 3 I 

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c 


d 




U 


d 




bn 


> 




C 




ID 


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- 


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w 


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C 


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M £ 






DO 

| s 



2 cJ d d 



C B 

IIS 



Oti = 



ffl ho 

> c 

1c 



d 

~ r X Oy 
? * ft o3 



a — 

2-3 



£§ a£ 
o 

1 1 

"tj fl Opt] 

e c d- § 



s § * g j 

^c§»s 

PQ <1> d t- as G 
- u £ >, d 
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to 5 
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as as _ a. _c •, y 

3 <« mA m C 

" a oj cd y w y 

*» £ * - , 

| U |oaf-S 
5)2 cq as +^ O as 



OCCUPATIONAL DISEASES. 



1369 



T. uJ 

■a I 



g £ 53 

u 9 A 



dcS 



3 5 w 

C ft 3 

£ o 

M <c c 

A o 



X BO d o c o o 

111 = §■« 

5 - 3llv3 



u A .5 33 « • 
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— Ooj-^J.m'd 
* 3 i< §-3 • 3 O 

d ""^ d O O 






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ftj- O 

g-xj 



C bo ■ >> a 

U — 3 © *- 

- >> C 3 
*-i roe 
ft >, <n ~ 

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* 2-2-© 1 

"d £ ® s 3 



s> 3 

ftg 



>> d »c 4- 

2-S.3 S I 

to a o a) a 

3 3XX1 c 

O 0Q OC CJ L- 



I irj © , m 

3 © £ O 4) 

p. 

• S ■« 5 

.3 3 ° •* ® 



2 o 3-. 



r; ,-; d d D 
C 3 > O > 



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3 s-o x! 



5 >> 

w Jo 
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1 ft c5 +J 

i _ « 3 

1 o 3 — 

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£ 2 tod 
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2 3 



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Sulphuric Acid — 

A colorless, odorless, 
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PART I OF BOOK XIII 

Treats of the inorganic or mineral materials used 
in medicine, together with the definition, property 
and use of each. 



Acidum Arsenosum ..1376 

Acidum Boricum 1377 

Acidum Hydrochloricum 1378 

Acidum Nitricum 1380 

Acidum Sulphuricum 1382 

Alum 1376 

Alumen 1376 

Ammonium 1376 

Argentum 1381 

Arsenic 1376 

Aurum 1378 

Eismuth 1376 

Bismuth Subnitras 1376 

Boric Acid 1377 

Calcium 1377 

Chlorine 1377 

Chlorum 1377 

Copper 1378 

Cuprum 1378 

Drugs, Importance of 1375 



Ferrum 1379 

Gold 1378 

Hydrargyrum 1380 

Hydrochloric Acid 1378 

Importance of Drugs 1375 

Inorganic Materials . . . . „ 1375 

Iron 1379 

Magnesia 1379 

Manganese 1379 

Manganum 1379 

Mercury 1380 

Mineral Materials 1375 

Nitric Acid 1380 

Oxygen 1380 

Phosphorus 1381 

Silver 1381 

Sodium 1381 

Sulphur 1382 

Sulphuric Acid 1382 



1373 



Book XIII 



MEDICAL MATERIALS; THEIR 
PROPERTIES AND USES 



PAET I. 
INORGANIC (MINERAL) MATERIALS. 

Importance of Drugs — Drugs have to-day a very wide and important 
claim to our attention from the fact of their wide application. Those in 
more common use should be understood by the laity, while a knowledge 
of the rarer drugs should be close at hand, should we wish to learn of 
them. Drugs are our friends, but, like friends, must be properly and 
carefully used; in cases where not so used they prove a detriment rather 
than a benefit. 

All Nature Assists. — For purposes of healing nature gives her vital 
forces in the form of plants and animals. Those forms of nature without 
life lend their aid, and thus some very important remedies come from the 
mineral kingdom. 

Divisions of the Subject. — Our subject is therefore divided into parts, 
depending upon the source. Part I deals with drugs from the inorganic 
kingdom; Part II treats of drugs derived from the organic kingdom, 
and Part III shall be devoted to animal juices and extracts. These latter 
are among the newer remedies and, though strictly speaking, they are of 
organic origin, they are especially prepared in or from the animal body. 
The application of the drugs shall be given. Formulae are not given, but 
such as are in common use will bo found carefully and fully written under 
"Medicinal Prescriptions," "Home Administration of Medicines," and 
elsewhere. 

(1375) 



1376 TTSTORGANIC MATERIALS. 

The first in alphabetical order of the Inorganic Materials is : 

ALUM (Alumen). 

Definition. — A double sulphate of potassium and aluminium. 

Property — It may cause vomiting. Locally it checks bleeding. 

Use. — It acts as a styptic, astringent and emetic. 

Manner of Using. — As an emetic a teaspoonful is the dose for a child 
and a tablespoonful for an adult, and it should be given in syrup. A 
lotion of alum and whiskey is very useful in the prevention of bed-sores. 

AMMONIUM (Ammonium). 

Definition — The salts are derived from the gas, ammonia. 

Property — It stimulates the heart. Weak solutions excite the flow 
of gastric juice. It is an antagonist to acids. 

Use. — It may be used in cases of fainting or in cases of heart failure. 
Weak solutions are used as a sub-acid. 

Manner of Using. — The aromatic spirits may be used in water, a 
teaspoonful as a dose. It should be remembered that this affords but 
temporary relief. Locally the liniment is useful. 

AKSENIC ( Acidum Arsenosnm) . 

Definition. — Occurs as a white powder or in dense masses of crystals. 

Property. — It serves as a stimulant to the nervous system, and in 
small doses improves the appetite and digestion. 

Use — Its properties indicate its use. Its stimulant effect upon the 
nervous system is made use of in the treatment of St. Vitus' dance. 
Preparations are used locally. 

Manner of Using. — The common form used internally is called Fow- 
ler's solution, which is used in doses as high as ten drops. For local use 
a concentrated preparation is employed. In all cases arsenic is to be used 
with extreme caution, as it is very apt to produce symptoms of poisoning. 

BISMUTH (Bismuthi Subnitras). 

Definition. — A heavy white powder. 

Property. — It has a soothing influence on the gastro-intestinal or 
digestive tract. Locally applied it is sedative and exsiccant; that is to 
say, it dries up excretions. 



INORGANIC MATERIALS. 1377 

Use. — In cases of diarrhoea large doses are employed for the astringent 
effect. Locally it is employed in the treatment of burns and in skin 
diseases, where there is secretion to dry up. 

Manner of Using. — It may be taken as a powder or in mucilage of 
acacia. 

BORIC ACID (Acidum Boricum). 

Definition. — It appears as colorless, transparent six-sided plates. 

Property. — The influence of boric acid is sedative and destructive to 
low forms of organized life. 

Use. — As a sedative and antiseptic. 

Manner of Using — Internally it is given in the form of a powder. 
For external application a lotion is prepared by dissolving the acid in 
water. 

CALCIUM (Calcium). 

Definition. — A metallic substance, the oxide of which constitutes lime. 
Chalk is scientifically called the carbonate of calcium. 

Property. — Some preparations are sedative, others are sedative and 
astringent. Lime water and chalk are astringent and alkaline. 

Use. — Either freshly slacked lime or, better, chlorinated lime may 
be used as a disinfectant. Carron oil consists of linseed oil and lime water, 
and is useful in the treatment of burns. Prepared chalk on account of its 
soothing and astringent effects makes a very useful tooth powder. 

Manner of Using. — For internal use lime may be given in the form 
of a syrup where its assimilation is desired. Lime water may be used as 
a spray, or may be taken internally. Added to milk it prevents curdling. 

CHLORINE (Chlornm). 

Definition — A gaseous element of a greenish color and strong suffo- 
cating odor. 

Property. — Chlorine has the property of destroying the various forms 
of bacteria. 

Use. — Chlorine is generated in the sick room and used in its free 
state as a disinfectant. For commodes, for bed-pans, or for internal ad- 
ministration a solution of chlorinated soda is employed. 

Manner of Using. — Chlorine is to-day but little used internally, its 
principal use being external, and depending upon its power to kill germs, 
87 



1378 INORGANIC MATERIALS. 



COPPER (Cuprum) 



Definition. — A metallic substance used to a slight extent in medicine, 
more widely in the arts. 

Property. — Copper is astringent and caustic. 

Use. — Its use is dependent upon its properties, it being an astrin- 
gent and caustic. Copper is sometimes added to pickles to make them of 
a bright green color. This fraud can be detected by placing a piece of 
steel or the blade of a knife in the liquor ; if it contains copper there will 
be a deposit of metallic copper upon the steel in a few minutes. The 
amount of copper present would not be sufficient to cause symptoms of 
poisoning. A far more dangerous source is the pigment found in wall- 
paper made of copper arsenite, which is very poisonous. This imparts 
to the wallpaper its green color. 

Manner of Using. — Copper should always be used with caution, and 
never without the advice or direction of a physician. When used inter- 
nally a salt known as the sulphate is used. Externally its caustic action is 
effected. 

GOLD (Aurum). 

Definition. — A well-known precious metal. On account of its high 
place among the metals gold was supposed to have some special value in 
medicine. As a matter of fact it is but little employed. 

Property — Its chief property is to stimulate the glands of the stomach 
and liver. It acts also upon the kidneys, increasing the flow of urine. 

Use. — It is used for its general stimulary effect on the system and for 
its stimulant effect on the liver and stomach in particular. 

Manner of Using. — The preparation used is an orange-colored powder 
made of equal parts of sodium chloride or common table salt and gold 
chloride. The dose for internal administration is minute. 

HYDROCHLORIC ACID (Acidum Hydrochloricum) . 

Definition. — A metallic acid sometimes called muriatic acid or spirit 
bf salt. 

Property. — Dilute hydrochloric acid excites or stimulates the flow of 
secretions of the digestive tract and thus promotes appetite and digestion. 

Use. — In dyspepsia due to insufficient amount of hydrochloric acid, 
the dilute acid is of value. 



INORGANIC MATERIALS. 1379 

Manner of Using. — The dilute acid is used in drop doses freely diluted 
with water. 

IRON (Ferram). 

Definition. — The most useful, widely distributed and abundant of all 
the metals. 

Property. — Being a normal or natural element of the blood, iron and 
its preparations have the property of building up the blood and tissue 
wornout by disease. Iron has also a tonic effect on the nerves. 

Use. — In cases of anemia or lack of blood the various preparations of 
iron are employed to replace the loss. In convalescence from disease iron 
is of distinct value when given in small doses over a long period. 

Manner of Using — Locally the tincture of the chloride is astringent. 
Care must be taken whenever iron or its preparations are used locally 
about the throat or taken internally in liquid form that they do not come 
in contact with the teeth. Internally iron may be given in pill form or as 
a solution. 

MAGNESIA. 

Definition. — A metallic substance, four preparations of which are 
used generally in medicine. 

Property^ — Magnesia being an alkaline substance is antagonistic to 
acids. It is also laxative. 

Use. — The laxative property is marked in the oxide of magnesia and 
in the sulphate of magnesia or epsom salt. The citrate is laxative. The 
oxide is a useful antacid. 

Manner of Using The sulphate or epsom salt is readily soluble in 

water. A teaspoonful is sufficient for most people as a purgative, though a 
tablespoonful would do no harm. Magnesia can be used in doses as high 
as a teaspoonful to two teaspoonfuls for an adult. For young children the 
dose is ten to twenty grains. The citrate of magnesium is a pleasant 
purgative in liquor form. 

MANGANESE (Manganum). 

Definition A metallic substance, two preparations of which, the 

dioxide and the sulphate, are used in medicine. 

Use. — Manganese is used in the same cases as iron. 



1380 INORGANIC MATERIALS. 

MERCURY (Hydrargyrum). 

Definition. — A heavy fluid, with a silvery lustre and free from odor 
or taste. 

Property. — Mercury in small quantities acts as a tonic, improving the 
condition of the blood. It is sometimes called an alterative from the fact 
that it alters or changes the state of the system. 

TJse. — Its use is that of a tonic, but should always be used advisedly. 
The preparation called corrosive sublimate, which is the bichloride of mer- 
cury, has no equal as an antiseptic. Calomel and blue mass are valuable 
as laxatives. 

Under the name quicksilver we recognize the mercury used in the 
arts, as to manufacture thermometers and mirrors. 

Manner of Using. — Corrosive sublimate should be used only externally 
without a physician and with great caution, as it is very poisonous. Blue 
mass pill may be given as high as five grains. Calomel is best taken in 
small amounts, but this, too, should be used with caution. 

NITRIC ACID (Acidum Nitricum). 

Definition. — One of the metallic acids occurring as a colorless, fum- 
ing liquid. 

Property. — Locally the application of nitric acid is followed by de- 
struction of tissue. Taken internally it is an astringent. 

Use. — The local effects are made use of in the employment of the 
acid as an escharotic. Internally it is used where astringent results are 
desired, as in diarrhoea. 

Manner of Using. — The strong acid is used locally, but for internal 
use only small quantities are used and very well diluted. 

OXYGEN (Oxygen). 

Definition. — A gaseous element forming one-fifth of the atmosphere. 

Use. — Being a vital part of the air we breathe it is used in diseases 
of the heart and lungs associated with great difficulty in breathing. 

Manner of Using. — It is usually kept in tight cylinders ready for use. 
It is used by inhalation. 



INORGANIC MATERIALS. 1381 

PHOSPHOEUS (Phosphorus). 

Definition. — A yellow wax-like substance obtained from bones. It 
has the odor of garlic. 

Property — Phosphorus acts upon the nervous system and upon the 
bones. 

Use — In disease of the bones, dependent upon defective nutrition, 
phosphorus is of great value. In those nervous diseases dependent upon 
nerve exhaustion, rather than organic disease, phosphorus is employed 
with benefit. 

Manner of Using, — Phosphorus is given in the form of pills or as a 
liquid preparation. Poisonous effects quickly follow an over-dose. 

SILVER (Argentum). 

Definition. — Another of the precious metals. It is much more ex- 
tensively used than the metal with which it is so often associated. 

Property. — The preparation of silver that is most often used and the 
only one to be considered in this work is the nitrate of silver, or, as it is 
called, lunar caustic. 

Locally and internally lunar caustic is astringent in its properties. 
The mark made externally is white, but this subsequently becomes black 
on exposure to light. Solutions of this substance behave in the same 
manner. 

Use. — Locally the astringent or even caustic property of the drug are 
made use of in the destruction of exuberant granulations forming what is 
commonly called proud flesh. A solution of thirty grains to a pint of water 
painted on the finger will absorb a felon. Internally also the drug is used 
for its astringent action on the gastro-intestinal tract. 

Manner of Using. — Internally minute doses are used. For external 
applications solutions are employed and are made of varying strength, 
depending upon the particular need. 

SODIUM (Sodium). 

Definition. — This element is not used by itself in medicine, but certain 
of its salts are well known and widely employed. 

Property. — Sodium hydrate or caustic soda, as its name implies, is a 
caustic. Bicarbonate of soda is a sedative when used externally. In- 
ternally it is antagonistic to acids, hence is said to be antacid. Borax or 



1382 INORGANIC MATERIALS. 

sodium-borate is used internally, but is liable to disturb the stomach. It 
is sedative in its action. Sodium chloride or table salt is an important 
part of our food. Sodium phosphate is mildly purgative in its action. 
Sodium sulphate or Glauber's salt is a powerful purgative. 

Use. — Bicarbonate of soda is much used in dyspepsia. When given a 
few hours before meals it stimulates the flow of gastric juice. When 
given an hour or so after meals it serves to neutralize fatty acids which 
are products of faulty digestion. Sodium chloride in solution is much 
used to-day injected in the bowel or under the skin. 

Manner of Using. — All the salts are soluble and should be taken in- 
ternally in solution, in doses to meet the requirements of each case. 

SULPHUR (Sulphur). 

Definition. — A lemon yellow-colored substance, brittle, tasteless and 
without odor. It is found native in Sicily and Iceland in the neighbor- 
hood of extinct volcanoes. 

Property. — Locally applied, sulphur is a stimulant to the skin and a 
parasiticide. Internally its acts favorably, so changing the nutrition of the 
person that it is called an alterative. This drug has long been famed as a 
medicine needed by the young in the spring time. 

Use. — The preparation known as compound licorice powder is a mild 
laxative. In cases of disordered nutrition sulphur oftentimes acts most 
favorably. The fact that sulphur is absorbed into the blood from the 
small intestine is shown by the effect upon silver coins or jewelry work by 
persons taking it. The effect or results is a beneficial one upon the blood, 
hence in cases where the blood is deranged or below par, sulphur is useful. 

Manner of Using Internally sulphur is taken in solution. It may 

be taken in syrup or molasses. Externally it is best applied in ointment. 

SULPHURIC ACID (Acidum Sulphuricum) . 

Definition. — A heavy oily liquid without odor, but with a strongly 
acid taste. It is sometimes called oil of vitriol. 

Property. — Sulphuric acid is astringent and antiseptic when taken 
internally. Locally its acts as an escharotic. 

Use. — Tts properties indicate its use. It is an escharotic, internal 
antiseptic, astringent and tonic. 

Manner of Using. — Sulphuric acid should be used well diluted and 
always advisedly taken. 



PART II OF BOOK XIII 

Treats of the Inorganic (Vegetable) Materials used 
in medicine. Superb colored illustrations of eighty- 
four plants, fruits and vegetables are also to be found 
in this chapter. 



Acetanilid 1385 

Acetic Acid 1385 

Aconite 1385 

Ague Root 1386, 1404 

Alcohol 1386 

Allspice 1387 

Almond 1387 

Aloes 1388 

Amygdala 1387 

Anise , . . .1388 

Apple 1345 

Arbutus 1410, 1470 

Arnica 1388 

Artichoke, Garden 1477 

Asafetida 1388 

Asparagus 1398, 1414 

Balsam Apple 1388 

Barberries 1432 

Bean 1389 

Beet 1389, 1399 

Belladonna 1428, 1445 

Benzine 1389 

Benzoin 1389 

Bilberry 1438 

Bitter Ash 1389 

Bitter-sweet Nightshade 1434 

Blackberry 1426 

Black Briony 1436 

Black Mustard 1390 

Black Snakeroot 1390 

Boneset 1390 

Bramble 1426 

Buchu 1390 

Burdock 1390 

Caffeine 1391 

Calabar Bean 1391 

Calamint 1412 

Calamus 1391 

Camphor Tree 1391 

Capsicum Annum 1392 

Caraway Seed 1434 

Carbolic Acid 1392 

Cardamon 1392 

Carrot 1425 

Cassweed 1440 

Castor Oil 1392 

Cathartic Ramno 1408 

Cayenne Pepper 1392 

Celery 1392, 1402 

Chamomile 1434. 1442 



Chittim Bark 1404, 1442 

Chloral 1442 

Chloroform 1443 

Cimicifuga 1300 

Citric Acid 1443 

Coca 1443 

Cochineal 1443 

Cod-Liver Oil 1444 

Coffee 1444 

Colt's Foot 1418, 1444 

Common Rush 1444 

Compresses, How to Make 1475 

Copaiba 1445 

Ci anberry 1445 

Cranesbill 1445 

Creosote 1445 

Crow-foot 1430 

Currants 1418 

Dandelion 1426 

Dandelion Wine 1445 

Deadly Nightshade 1445 

Decoctions 1475 

Digitalis , 1430 

Dill 1436 

Elder 1432 

Ergot of Rye 1446 

Ether 1446 

Eucalyptus Oil 1446 

Fennel 1408 

Flaxseed 1425, 1446 

Fomentations, How to Make 1475 

Foxglove 1430, 1446 

Gallic Acid 1447 

Garlic 1416, 1447 

Geranium 1434 

Ginger 1447 

Glycerine 1448 

Golden Thistle 1410 

Gi ape Fruit 1 395 

Grapevine *397, 1448 

Great Mullein 1428 

Hedge Mustard 1406 

Hedge Nettle 1406 

Hedgewort 1438 

Hellebore 1420 

Hemlock 1432, 1448 

Henbane 1412 

Herbs, How to Prepare 1473 

Hoarhound, White 1418 

Honey 1448 



1383 



1384 



INDEX TO PART II OF BOOK XIII. 



Hops 1414, 1448 

Horse Chestnut 1425 

Horse-radish 1416 

Hound's Tongue 1448 

Indian Hemp 1449 

Indigo, Wild 1472 

Ipecac 1449 

Iris 1426 

Juniper 1418 

Kerosene 1449 

Lactic Acid 1450 

Ladies' Slipper 1450 

Lard 1451 

Laurel 1436 

Lemon 1394, 1451 

Leopard's Bane 1388 

Licorice 1426 

Lily of the Valley 1422 

Lime-Tree 1406, 141 1 

Linseed 1446 

Liverwort 1440, 1454 

Lousewort 1410 

Male Fern 1454 

Malt : 1454 

Marshmallow 1414, 1455 

Masterwort 1455 

May Apple 1455 

Meadow Saffron 1416, 1455 

Mezereon 1436 

Monkshood 1385 

Mountain Balm 1412 

Musk-root 1455 

Mustard 1412 

Hedge 1406 

Myrrh 1456 

Navy Bean 1456 

Nettle 1428 

Nightshade 1445 

Nutgall 1456 

Nutmeg 1456 

Nux Vomica 1460 

Oak-tree 1432 

Oats 1456 

Olive Oil 1456 

Onion 1400, 1458 

Opium Graveoleus 1392 

Orange 1458 

Oregon Wild Grape 1396, 1458 

Organic Materials 1385 

Parsley 1430 

Peach Leaves 1459 

Pennyroyal 1420 

Peony 1422 

Pepper 1459 

Peppermint 1436, 1459 

Pepsin 1459 

Periwinkle 1438 

Peruvian Bark 1460 

Physostigma 1391 

Pineapple 1460 

Pink Root 1460 

Plantain 1420 

Poison Nut 1460 



Poppy 1420 

Potato for Aches and Pains 1460 

Pumpkin 1400, 1462 

Purple Willow Herb 1462 

Red-berried Trailing Arbutus 1410 

Red Pepper 1403, 1462 

Red Root I4 63 

Rhubarb ^63 

Rosemary I42 8 

Rush, Common t 1444 

Saffron 1406, 1416, 1455 

Sage i 4I2 

St. John's Wort 1422 

Salt in Medicine 1463 

Salt Remedy for Sunstroke 1466 

Salvia i 4I2 

Santal Wood !4 4 

Sarsaparilla . . 1466 

Scurvy Grass 14^ 

Senna I4 66 

Shepherd's Purse 1440 

Skullcap I4 67 

Soapwort i 440 , 1467 

Spanish Flies 1467 

Spirit of Wine 1386 

Starch I4 6; 

Stavesacre ' J4 I0 

Stone Root 1404, 1468 

Strawberry, Wild 1438 

Straw Lily I42 6 

Sugar ; ; ; ; ; I4 68 

Sweet Fern I4 68 

Sweet Flag I3QI 

Tannic Acid 1468 

Tansy \[\\ I40 g 

Tartaric Acid ^69 

Tea I4 6q 

Thistle, Golden 1410 

Thorn-Apple .' I4 i 4 

Tinctures, How to Make 1474 

Tobacco I4 6 9 

Tomato 1401, 1469 

Turpentine Tree 1470 

Unicorn Root i^y 

^ aler „ ia Ki ••;;••••••, 1430,' 1470 

Vegetable Materials 1385 

Wahoo I4 7o 

Wall Pellitory ..WW'.".'! 1470 

Walnut Tree 1440 

Water Hemlock 147! 

w ax I47I 

White Hoarhound 1418 

White Oak Bark i\ ?l 

White Pond Lily i^yi 

Wintergreen Tea Berry 1472 

Wood Sorrel 1408 

Wolf's Bane 1422 

Wormseed 1472 

Wormwood 1424 

Yam, Wild ^72 

Yellow Goat's Beard 1406 

Yellow Root 1472 

Yerba Reuma 1473 



MEDICAL MATERIALS 

PART II. 



ORGANIC (VEGETABLE) MATERIALS 



The materials of this group are far more numerous than those of the 
preceding group. They will be found arranged according to their common 
names, the scientific names in most cases being given. 

ACETANILID ( Acetanilidnm) . 

Definition. — A white, crystalline substance, made from acetic acid. 

Property. — It is sedative to the nervous system ; causes a lowering of 
the temperature associated with free sweating. 

Use. — It is employed in the treatment of spasms, for the relief of 
headache and to reduce temperature in mild cases of fever. 

Manner of Using. — May be used as the powder or in the form of a 
tablet or capsule, irve grains being the usual dose. 

ACETIC ACID (Acidum Aceticum). 

Definition. — A colorless liquid with a vinegar-like odor. 

Property. — It checks hemorrhage locally, also has a soothing local 
effect. Taken internally it produces a cooling sensation. 

Use. — It is useful as an antagonist to scurvy, as a refrigerant in 
mild cases of fever and locally for its soothing properties in sunburn. It 
acts also as a styptic. 

Manner of Using — The dilute acid is the safe preparation and may 
be used in amounts from one to two teaspoonfuls. 

ACONITE, MONKSHOOD (Aconitum). 

Definition. — Aconite is the root of a plant growing in Europe. The 
root is conical in shape, two or three inches long, and closely resembles 

1385 



1386 MEDICAL MATERIALS. 

horseradish. When slowly chewed it produces a sensation of warmth, 
slowly followed by numbness. 

Use. — Aconite is sedative in its effects, and in accordance with this 
property it is employed locally in neuralgia. It is used also in cases of 
vomiting. Its principal action is upon the circulation, its effect being 
to slow the pulse. 

Manner of Using. — The tincture of aconite is the preparation usually 
taken internally. The dose is very small, and even then poisonous symp- 
toms are prone to develop. 

AGUE ROOT (Aletris Farinosa). 

(See Plate I.) 

Height, from a foot to eighteen inches; leaves, pale and smooth; 
bears white flowers; grows mostly in sandy soils. It has proved useful 
in dyspepsia and flatulent colic, and is especially useful for the purpose of 
restoring the activity of the generative organs, giving them vigor and 
healthy action. A valuable agent to prevent tendency to miscarriage and 
falling of the womb. The dose of the tincture is from six to ten drops 
three times a day, or can be used in pill form. 

ALCOHOL, SPIRIT OF WINE. 

Definition. — Alcohol is a transparent, colorless liquid obtained from 
the distillation of fermented saccharine material. For use in medicine, 
whiskey should be at least two years old and wine at least four years 
old. Wine is made by fermentation without distillation. Red wine 
differs from white wine in that in the production of the former the 
skins of the grape are used. Malt liquors — ale, beer, porter, are produced 
by fermentation of malt and hops and contain nutritive material. 

Use. — When taken internally in small amounts and at meal-time the 
effect of alcohol is to stimulate the glands of the stomach to greater secre- 
tion. The presence of alcohol in the stomach, however, retards digestion, 
so that if much be taken it is a detriment rather than an advantage. 

As a result of the long-continued use of alcohol, changes take place 
in the coats of the stomach. The inner lining of the stomach loses 
its delicacy and becomes thickened. It can no longer secrete as formerly, 
and indigestion results. Upon the heart and circulation alcohol is a de- 
cided stimulant. It strengthens the heart, it enlarges or dilates the blood- 
vessels and hence the flushed face of the one addicted to alcohol. Al- 
cohol by its stimulant action enables the system to pass through great 
strains, but if its use is prolonged beyond the period of actual need it 



ORGANIC MATERIALS. 138 Y 

is followed by its harmful effects. These latter manifest tkemselves by 
changes in the stomach, liver and kidneys and blood-vessels, and consist 
essentially of a hardening of these organs, rendering their functions im- 
perfect Alcohol does not increase the heat of the body, as some suppose. 
By actual experiment it is found that by dilatation of the capillaries it 
leads to a loss of heat. It is found, for instance, that those explorers in 
the Arctic region who avoid alcohol can better endure the trials of those 
regions than those who indulge. 

Manner of Using. — A discussion of this portion scarcely seems neces- 
sary. Much depends upon the person. There are many persons who 
cannot take even the malt liquors, which contain but from three to live 
per cent, of alcohol. On the other hand, we have abundant examples of 
men who have indulged in alcohol and yet whose health seems not to be 
greatly impaired by such indulgence. From the physical standpoint alone 
it may be said that people, especially young people, do not need alcohol 
in any form. Their system does not require it. In disease its benefits are 
undoubted, and, it may be added, are greatest to those to whose system it 
is a stranger. 

AUSPICE (Pimenta). 

Definition. — Allspice represents a fruit. 

Use. — It is employed chiefly to promote appetite and digestion. It 
may be used to disguise the taste of unpalatable drugs and is one of the 
ingredients of spice plasters. 

Manner of Using. — Internally, the oil is the preparation used in drop 
doses. 

ALMOND (Amygdala). 

Definition. — There are two varieties of almond — the bitter almond 
and the sweet almond. 

Use. — There are two oils of almond, one, the oil of bitter almond, is 
used in minute doses, the other, known as the expressed oil of almond, 
may be used in large doses, i. e., as high as a tablespoonful. It is quite 
important that these two oils should not be confused. Expressed oil of 
almond and mixture of almond are bland and soothing for local applica- 
tion. 

Manner of Using. — Locally or internally, as already indicated. 



1388 MEDICAL MATERIALS. 

ALOES (Aloe). 

Use. — The dry juice is medicinal and one of the best laxatives for 
promoting and righting the action of the colon or large intestine. It ex- 
cites the circulation of the blood in the organs of the pelvis, and is invalu- 
able in promoting the menstrual flow — in this case it is generally combined 
with iron and myrrh. It is used for chronic costiveness, but those that 
suffer from piles should not take it. By reason of its tendency to increase 
the menstrual flow it ought not to be used during menstruation, especially 
by those having naturally an abundant flow. It should be avoided during 
the period of pregnancy. The dose is from two to five grains, generally 
in pills, combined with other drugs. 

ANISE (Anisum). 

The virtues of this drug depend upon the warming effect when taken 
into the stomach. As it has a pleasant odor and taste, it is much used in 
cases of colic in young children. 

ARNICA, LEOPARD'S BANE (Arnica). 

Definition. — The preparations of arnica are obtained from arnica 
flowers and arnica root. The flowers are orange-yellow, dish-shaped, with 
rays. 

Use. — Arnica is used in domestic practice, but very little by physi- 
cians. The tincture is usually employed in cases of spasms, bruises and 
for rheumatic pains. Taken internally, in small doses, it produces a sen- 
sation of warmth over the body and increases the secretions. 

ASAFETIDA ( Asaf oetida) . 

Use. — The dry juice of this plant is a powerful stimulant in many 
nervous affections, particularly in women. Its most frequent use is in 
the treatment of hysteria. The ordinary dose is from two to five grains. 
From fifteen to twenty drops of the tincture may be given as a dose. 

BALSAM APPLE (Momordica Balsamina). 

Part used — fruit and seeds. 

A liniment formed by infusing the fruit in olive oil is applied to 
burns, old sores, piles, prolapsus ani, and so forth, and the fruit itself is 



ORGANIC MATERIALS. 1389 

mashed and used in the form of poultices. An extract prepared from it 
is useful in dropsy in the dose of from 5 to 15 grains. 

BEAN. 

Those who have tried the white navy bean as a cure for erysipelas 
say it furnishes a sure cure if the disease is taken in time. The beans 
should be boiled soft and applied as a poultice to the affected parts. Ke- 
new frequently. 

BEET (Beta Vulgaris). 

Whenever tried the juice of the common beet has been found a rem- 
edy for gravel. Boil the beets till thoroughly done. Eemove the beets 
and boil the juicy water again till it assumes the form of a syrup. Take 
a cupful three or four times a day. Pursue the treatment till the stones 
pass. This beet syrup is also especially recommended for suppressed or 
tardy menses. 

BENZINE (Benzinum). 

Definition. — Benzine represents a purified distillate from American 
petroleum. It is a clear, colorless, diffusible liquid. Its vapors, when 
mixed with the air, are explosive; hence it should be kept in a cool place 
remote from light or flame. 

Use — Benzine is not used internally in medicine. Externally ben- 
zine is used as a counter-irritant. It may be applied by rubbing, or upon 
a flannel cloth. 

BENZOIN (Benzoinum) 

Definition — Benzoin is a gum resin obtained by incisions made into 
the bark of a tree growing in the East Indies. It occurs in large masses. 

Use — The medicinal preparation of opium known as paregoric con- 
tains some benzoin. The tincture of benzoin is useful as an expectorant. 
The compound tincture is useful for local application as a protectant to 
excoriated surfaces. Benzoin prevents fat from becoming rancid. 

BITTER ASH (Bittera Febrifuga) . 

A tree indigenous to the West Indies. The bark is the part used. 
A decoction is made with one ounce to a pint. Dose: A tablespoonful 
four times a day. Has been found most useful in intermittent fever, 
for which it is claimed to be almost a specific. 



1390 MEDICAL MATERIALS. 

BLACK MUSTARD (Sinapis Nigra). 

{See Plate 7.) 

BLACK SNAKER00T (Cimicifuga). 

Definition — Cimicifuga represents the rootlets of the plant. 

Use. — Upon the nervous system it acts as a sedative. It is claimed 
that it is of value in rheumatic affections of the muscles. 

Manner of Using. — A preparation known as the fluid extract is 
usually employed and taken in small and repeated doses. A tea of the 
root, drunk freely, is used in rheumatic affections. 

BONESET. 

This plant is indigenous of and is found in most parts of North 
America. The tops and leaves are medicinal. They should be made into 
an infusion which is generally known as boneset tea. It is a tonic, dia- 
phoretic, expectorant, and when taken in large doses or warm it acts 
as an emetic and aperient. The extracts of boneset may be purchased at 
drug stores. The fluid dose is from one to two drachms. With the solid 
extract the dose is from one to one and one-half ounces and that of the 
infusion from one to two ounces. 

Two scruples of eupatorin (boneset), one scruple of xanthoxylin and 
one-third grain of strychnia mixed and made into twenty powders, one 
powder being taken three times a day, is recommended for torpor of the 
liver or kidneys and also for rheumatism. 

BUCHU (Buchu). 

Use. — This is one of the best known remedies to soothe the irritation 
of the urinary organs. It has been used for catarrh of the bladder and in 
cases of pain in urinating. Best results are obtained from the infusion 
made from one ounce of the leaves in two pints of boiling water. Two or 
three soup-spoonfuls four or five times a day. There is also an extract, 
which dose is from a half to one teaspoonful. 

BURDOCK (Lappa Minor). 

Root spindle-shaped, about a foot in length. Flowers purple and 
seeds quadrangular. The root is the part employed, and in venereal and 
cutaneous diseases supplants mercury, the iodides and arsenic, eliminating 



ORGANIC MATERIALS. 1391 

very rapidly the specific poison from the blood. Best administered in 
decoction by boiling two ounces of the root in three pints of water to two, 
and given in the dose of a tablespoonful four times a day. 

CAFFEINE (Caffeina). 

Definition. — Caffeine is prepared from the dried leaves of the thea 
sineusis or from the dried seeds of coffea arabica. It occurs also in other 
plants. It exists in the kola nut of Africa. Caffeine is in the form of 
colorless silky crystals. 

Use. — Caffeine stimulates the nervous system. It quickens the intel- 
lect and causes sleeplessness. It causes an increase in the flow of the 
urine. It. is used to stimulate the heart, to increase the flow of urine, and 
combined with other remedies it is of value in relieving headache of 
nervous origin. 

Manner of Using. — The preparation used is known as citrated caffeine. 
It is given in powder form. 

CALABAR BEAN (Physostigma). 

Definition. — Physostigma is the seed of the physostigma venanosum, 
growing in Western Africa, along the River Niger. 

Use — The chief action of the drug is to depress the spinal cord, and 
in accordance with this action it is used to produce quietude in cases of 
convulsion, as from strychnine poison, from tetanus, and so forth. 

CALAMUS, SWEET FLAG (Calamus). 

Calamus is used as a substitute for tobacco by those habitual to the 
weed. It is a constituent of various bitters used to stimulate and promote 
the appetite. 

CAMPHOR TREE. 

The uses of camphor in medicine are numerous. It affords one of the 
safest and surest of household remedies for headache, spasms, neuralgia, 
gout, rheumatism and general debility. It is equally efficacious as an ex- 
ternal remedy for pains, sprains, chilblains, bruises and flesh soreness. In 
such cases the tincture is generally used, and it can be made at home by 
mixing an ounce of the gum with a pint of pirits. It affords a speedy rem- 
edy for colds, in the form of a drink made of one pint of hot water into 
which ten drops of the spirits of camphor has been dropped. It should 
be sipped slowly and as hot as can be taken. 



1392 MEDICAL MATERIALS. 

CARBOLIC ACID ( Acidum Carbolicum) . 

Definition — Carbolic acid is made from coal-tar. It occurs in the 
form of colorless crystals, but exposure quickly converts it into a colorless 
or slightly reddish liquid. 

Property. — A slight fall in temperature follows the use of carbolic 
acid. Its chief action depends upon its property of destroying low forms 
of germ life. 

Use. — By virtue of its properties it is used as an antiseptic and in- 
ternally as an antiferment. 

Manner of Using. — Two or three drops may be taken internally, best 
given with a powder of bismuth. Locally it is used in solutions of various 
strength, the usual being 5 per cent. 

CARDAMON (Cardamon). 

This drug represents a fruit. It is an agreeable vehicle for disguising 
the taste of other drugs, and it also produces a sensation of warmth in the 
stomach. 

CASTOR OIL (Ricini Oleum). 

Definition. — Castor oil is a fixed oil expressed from a seed. It is a 
pale yellow liquid, having a faint odor. 

Use. — Castor oil is a slow purgative, producing copious liquid stools. 
It stimulates the bowels. 

Manner of Using. — The dose for an adult is half to one ounce ; for a 
child, one to two drachms. 

CAYENNE PEPPER (Capsicum Annuum). 

The stem is thick, smooth and branching, about three feet in height. 
The fruit is of a bright scarlet color and contains numerous kidney- 
shaped, whitish seeds. A powerful stimulant. Employed with great 
advantage in la grippe. Two tablespoonfuls of the powder, with a tea- 
spoonful of common salt, infused for an hour in a pint of boiling water 
with half a pint of vinegar. This is strained and a teaspoonf ul given every 
hour. The same is useful as a gargle. In scarlet fever the same infusion 
diluted gives much relief and is of positive advantage. Dose : The same. 

CELERY (Opium Graveoleus). 

Various medicinal preparations of celery are used in the treatment 
of chronic rheumatism. The same result is reached by drinking freely 

(Continued on page 1442.) 



Fruits, Vegetables, Herbs, Roots 

AND 

Plants Valuable in Medicine 



How to Prepare Them 
Their Uses 



ss 




THE LEMON (Citrus Limonum). 
Treatment for twenty-seven diseases. See page 1451. 



GRAPE-FRUIT. 

Mild astringent. Soothing to the stomach in cases of flatulence and 
dyspepsia. 



•1 




©E.J.S. APPLE. 

Gentle laxative. Eaten regularly, apples keep the stomach and howels 
in good condition. 




OEEGOJST WILD GEAPE. 
fsed in leucorrhea and as a Wood purifier. See page 1158. 



E. J. S. 




E. J. S. 

GEAPE. 

Used in dropsy and chronic dysentery. See page l^S. 




ASPAHAGUS. 

I p sed for the kidneys. See page 1414 



E. J. S. 




E. J. S. 

BEET (Beta Vulgaris) 
Used in gravel. See page 1389. 




OXIOX. 
Used in sis diseases. See page 1458. 




PUMPKIN (Cucurbita Pepo). © K - J- s - 

Treatment for worms, retention of urine and inflammation of Mad- 
rid bowels. See page 14G2. 



*-:;-w : : =•.-■. --.^ ■-.:■. - " = ;;-/:> \\:^:'-r ; 




E. J. S. 



TOMATO (Lycopersicum Esculentum), 
Treatment for Cholera Infantum. See page 1469. 






CELERY (Opium Graueolus), 
Used in Chronic Rheumatism. See page 1392. 



:. j. s. 




©E. J. S. 

Used as a gargle in 
page 1462. 



RED PEPPER. 
Scarlet Fever and as a tea in the Grippe. See 



1404 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE I. 

Chittim Bark. — A shrub about seveu or eight feet in height, with 
branches terminating in a sharp spine. The leaves, on short footstalks, 
ovate and veined. The bark is officinal and the part employed. It stands 
without an equal in the treatment of constipation in all its varied forms. 
An infusion of one ounce of the bark to a pint of boiling water; infuse 
for one hour and strain. Dose: One teaspoonful, morning and evening, 
according to symptoms or until the bowels are thoroughly regulated. 

Stone Hoot. — This plant is used in numerous complaints in practice. 
A decoction of the fresh root, one ounce to the pint of water, has been used 
with advantage in hemorrhoids or piles, catarrh of the bladder, gravel 
and dropsy. The dose is one tablespoonful four times a day. The leaves 
are applied in the form of fomentation to wounds, bruises and sores, and 
in cases of internal abdominal pains. 



Santal Wood. — AVhite Sandalwood is a small tree indigenous to India. 
The volatile oil distilled from the wood is the part used. Given internally 
in moderate doses of 5 to 10 drops for gonorrhea. It is sometimes used 
as a stimulant to the respiratory tract in bronchitis and certain forms 
of asthma. 

Ague Root. — Height, from a foot to eighteen inches; leaves, pale 
and smooth; grows mostly in sandy soils. It has proved useful in Dys- 
pepsia and flatulent colic, and is especially useful for the purpose of re- 
storing the activity of the generative organs, giving them vigor and healthy 
action. A valuable agent to prevent tendency to miscarriage and falling 
of the womb. The dose of the tincture is from six to ten drops three 
times a day, and of the powdered root five to eight grains. 




E. J. S. 



Santal Wood. 



Ague Root. 



PLATE I. 



1^0(3 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE II. 

Saffron. — This plant is common in orchards and of a deep orange 
color. It is used as an infusion (tea) ; boiling one ounce of leaves in two 
pints of water. It is a pleasant home remedy in the beginning of scarlet 
fever, measles and chicken-pox. serving to bring out the eruptions. Dose, 
from half to a whole wineglassful, three times a day. It is also good as 
a gargle in sore throat. 

Yellow Goat's Beard. — A tea of the root, bark and leaves of this plant 
is used for diarrhoea in children. Boil one ounce of root in two pints of 
water. Take two or three tablespoonfuls three or four times a day. 

Hedge Mustard. — Used cooked for table purposes as a stimulus to the 
stomach and to relieve coughing. Also used in the form of an infusion 
(tea) to cleanse ulcers and wounds. Boil an ounce of seeds, or a quantity 
of leaves, in a quart of water and wash the sore parts twice a day. 

Common Hedge Nettle. — Made into a tea and drunk freely is excel- 
lent for hemorrhages of lungs and stomach. In doses of half a wineglass- 
ful four times a day it relieves neuralgia. A poultice of the leaves also 
relieves neuralgic pain and aids in the cure of wounds. Used at times 
as a tea, and drunk in wineglass doses twice a day. to promote menstrua- 
tion and kill worms. 




Common Hedge Nettle. 



140 S MEDICAL MATERIALS. 



MEDICINAL PLANTS 

PLATE III. 

Cathartic Ramno. — A tea of the bark, taken in tablespoonful doses, 
three times a day, opens the bowels. But caution is needed, lest it lead 
to purging. 

Fennel. — The seeds and leaves in the form of a strong infusion (tea) 
are excellent for eolie. The seeds in form of a powder are also good 
for cramps. Dose of the tea, a wineglassful, repeated at half-hour inter- 
vals, if necessary. Dose of the powdered seeds, ten to twenty grains. 



Tansy. — Tansy tea, in doses of a teacnpfnl twice a day, promotes 
menstruation. In the form of bitters, it strengthens weakened constitu- 
tions. Cold tansy tea, drunk freely, is good for dyspepsia. 



Wood Sorrel. — A poultice of the leaves was once a popular application 
in cases of cancer. Sorrel tea, drunk freely, also aids in giving relief to 
cancerous affections. 




Wood Sorrel. 



PLATE III. 



1410 MEDICAL MATERIALS. 



MEDICINAL PLANTS 

PLATE IV. 

Stavesacre or Lousewort. — The crushed seeds, made in a paste and 
nibbed on the head, is an effective way to kill lice. 

Golden Thistle. — A tea of one ounce of leaves or stems to two pints 
of water will relieve colic. Dose, a wineglassful, repeated every half- 
hour, if necessary. 



& 



Lime-Tree. — The juice of the lime, mixed with water, is a refreshing 
drink, in frequent sips, for fever sufferers. Lime juice in large quantities 
is carried on board ships as a preventive of scurvy. 

Red-Berried Trailing 1 Arbutus — A strong tea, made of one ounce of 
the leaves to a quart of water, and taken in doses of two tablespoonfuls 
three times a day, is used to relieve bladder trouble. It diminishes the 
irritation caused by the urine, and the inflammation and pain. 




Red-berried Trailing Arbutus. 



E. J. S. 



PLATE IV. 



1412 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE V. 

Henbane. — This plant, like belladonna, is a powerful poison. It is 
used in the forin of an extract to soothe pain. Dose, one-eighth to one 
half a grain once or twice a day. It is frequently used in cases of de- 
lirium, where opiuni cannot be used. Great caution is needed in its ad- 
ministration. 

Mountain Balm or Calamint. — Make a tea of the root, dilute with 
water and sweeten. Give in teaspoonful doses at intervals of half an hour 
to relieve wind colic in children. 

Sage or Salvia. — Sage tea, either alone or mixed with vinegar, honey 
or alum, is an excellent gargle for sore throats. Drunk freely it cures 
night-sweats. Simmered in lard and taken four or five times a day in 
doses of two spoonfuls each cures quinsy. 

Mustard. — Powdered mustard seeds are used on the table and in 
medicine. One or two teaspoonfuls in a glass of hot water is used to 
provoke vomiting. If necessary, repeat the dose till the desired result is 
reached. Mustard in the form of plasters or poultices soothes pain and 
promotes circulation. Mustard seeds, in doses of a teaspoonful three 
times a day, relieves dyspepsia. Mustard plasters, applied to the ex- 
tremities, serve to bring out again the eruption where it has gone in, in 
such cases as measles and scarlet fever. 




Sage or Salvia. 



E. J. S. 



PLATE V. 



1414 MEDICAL MATEKIALS. 



MEDICINAL PLANTS 
PLATE VI. 

Common Thorn-Apple. — This plant belongs to the same family as hen- 
bane and belladonna. Cigarettes made from the dried leaves, and smoked, 
are good to cairn asthma difficulties. 

Asparagus. — Used as a table dish gently stimulates the kidneys. In 
the form of tea, drunk at three or four hour intervals, it promotes a free 
flow of urine. 

Marshmallow. — The powdered root may be used as a poultice in cases 
of gangrene. A fresh infusion ( tea ) . drunk freely, is of service in chil- 
dren's diseases, and especially in Bright's disease. Marshmallow drops 
are useful in sore throat, in scarlatina and diphtheria. The dose is indefi- 
nite. An infusion, drunk freely, is good for acute gonorrhea, and all 
affections of the mucous membrane of lungs and bowels, and inflamma- 
tions of kidneys and bladder. 

Hops. — The root, used as a powder or pill, soothes the irritation of 
the urinary organs and pains of gonorrhea. Infusion of hops, or hop 
tea, is made by taking a tablespoonful of hops to a pint of water and is 
given in doses of two to five ounces, twice to three times a day. In 
delirium tremens hop-tea quiets drink craving and settles the stomach. 
Tn insomnia and restlessness it is useful in producing sleep. A hop poul- 
tice gives relief in local painful affections. Or the hops may be placed in 
flannel and moistened witli hot whiskey and applied to painful cases, as in 
toothache or earache, where the warmth and steam are very soothing. 
The inhalation of the vapor of hops is often attended with good results. 
especially in diseases of the throat and chest, 




E. J. S. 



Marshmallow. 

PLATE VI. 



1416 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE VII. 

Common Scurvy-Grass. — This plant is popularly eaten as a salad and 
is useful in scurvy, chronic rheumatism and chronic malaria. The juice 
has heen used externally for the purpose of stimulating indolent ulcers and, 
diluted with water, as a mouth-wash for spongy gums and ulcers of the 
mouth. ^ 

Meadow Saffron. — Saffron-tea, drunk freely, is used in domestic prac- 
tice to bring out the eruption in measles and scarlet fever and to cause 
sweating. Externally it is used in bruises, rheumatic and neuralgic pains 
and in the form of ointment for bleeding piles. 

Garlic. — Garlic, onion and leek are used in bronchitis and chronic 
cough. Here it can also be applied to the chest in the form of a poultice, 
or the oil can be used externally. A garlic poultice may also be success- 
fully enjoyed in convulsions and intestinal and stomach troubles of 
children. Garlic is also given for worms. It is a domestic remedy in 
whooping-cough. Syrup of garlic is given in doses of five drops to a tea- 
spoonful, two to three times a day, or oftener, if the coughing spells are 
frequent and violent. 3 

Horse-Radish. — Used as a tonic for the digestion, and to promote the 
secretion of the kidneys. Syrup of grated horse-radish and honey or 
sweetened water, taken in teaspoonful doses every hour, will cure hoarse- 
aess. Horse-radish tea, drunk freely, is beneficial in rheumatism and 
neuralgia, 




Garlic 



E. J. S. 



PLATE VII, 



14:18 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE VIII. 

Common Juniper. — By boiling an ounce of the berries (pounded) in 
two pints of water an infusion is obtained which stimulates the action of 
the kidneys. A pint is drunk through the day in Bright's disease with 
its attendant dropsy. The juice of the berries has been successfully used 
in doses of two or three teaspoonfuls daily in children to promote the 
secretion of urine. The oil may be dropped in boiling water and inhaled 
to produce the same effect. 

Currants. — The juice of the berry, boiled and sweetened, and in tea- 
spoonful doses three or four times a day. is binding in infantile diarrhoea. 

Common White Hoarhound. — The herb may be used in infusion (an 
ounce to a pint of water)., taken hot and frequently in recent colds to 
produce sweating. The cold tea, drunk freely, is serviceable in chronic 
lung affections. Cough-drops are used for sore throat and cough. 

Colt's Foot — The infusion of the dry leaves is used to soften the 
phlegm in chronic catarrh. It may be drunk freely. 




Common White Hoarhound 
■)E. J. S. 



Colt's Foot. 

PLATE VIII. 



14:20 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE IX. 

Plantain. — The fresh leaves are pounded in a mortar into a paste and 
applied to wounds to cheek bleeding. In sumach poisoning, burns, scalds, 
bruises, and even erysipelas, it is said to be extremely useful. 

Poppy. — By cutting the unripe seed pod a milky fluid is obtained 
called opium. Powdered opium may be mixed into a paste with water and 
applied to a beginning boil with relief. Opium is used in medicine in 
many forms, as laudanum, morphine, paregoric, and so forth. It is given 
in various forms and quantities to relieve pain and irritation, to relax 
spasms, to produce sleep, to check secretions, and to influence nutrition. 
It should be used with great caution. 

Pennyroyal. — Pennyroyal tea, or a recent infusion of the leaves and 
tops, is used in flatulent colic and recent suppression of the menses. The 
infusion may be drunk in teacupful doses, several times a day. The 
fresh herb is said to be obnoxious to mosquitoes, and may be hung about 
the sleeping room, or the hands and face bathed with a recent infusion or 
a solution of the oil in alcohol (one to ten) in order to keep off these 
midnight marauders. 

Hellebore. — This has been used by some to bring on the menstrual 
flow by purging, but is now very rarely employed. It causes vomiting 
and acts on the heart. It also destroys sensation when used locally. This 
medicine should be carefully used, as it is very poisonous. The dose is 
four to fifteen grains. A dose of the fluid extract of black hellebore, 
three to five drops three times a day, is used in dropsy, especially dropsy 
of the brain. 




Pennyroyal. 



Hellebore. 



E. J. S. 



PLATE TX. 



1422 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE X. 

Peony. — An infusion is made by boiling one ounce of tbe powdered 
root in a pint of water. It is good in spasms, whooping-cough and nervous 
diseases. Dose, half a cup four times a day. Formerly it was considered 
as a tonic for the nerves and was given for epilepsy and St. Vitus' dance. 

Perforated St. John's Wort. — This plant is used as a tea to promote 
menstruation. It may be taken in wineglass doses, three to four times a 
day. 

Wolf's Bane. — This drug, which is beter known under the name of 
aconite, is very powerful and dangerous. It is given in the first periods 
of fevers and inflammations, such as pneumonia, erysipelas and rheuma- 
tism. A few drops of the tincture are mixed in a tumbler of water and 
a teaspoonful of this is given every ten, fifteen or twenty minutes. 
Asthma, especially in children, and preceded by cold in the head, is 
generally benefited by it. In the form of a liniment it is used in neu- 
ralgia. Extreme care must be taken in using wolf's bane. 



& 



Lily of the Valley. — In small doses this drug strengthens the heart; 
in larger quantities it quiets it. It quickly relieves the shortness of breath 
and palpitation in heart disease, and after having been given for two or 
three days may be stopped for a week or more without the symptoms 
returning. It increases the flow of urine and reduces dropsy. An in- 
fusion or tea is made by taking one part of the underground stem and 
rootlets to three parts of water. The dose of the infusion is a table- 
spoonful to a wineglassful two or three times a day. 




Wolf's Bane. 



E. J. S. 



PLATE X 



Lily of the Valley. 



1424: MEDICAL MATERIALS. 

MEDICINAL PLANTS 
PLATE XI. 

Flax. — Ground flaxseed mixed with boiling water forms flaxseed 
poultice, which is spread at least half an inch in thickness upon muslin or 
flannel, and applied as hot as possible in order to relieve pain and con- 
gestion in peritonitis and in pneumonia, pleurisy, and so forth, as jacket 
poultices, renewed every two or three hours. Flaxseed poultices are also 
applied to boils and abscesses to abort them or to hasten their ripening. 

A hot infusion (a tablespoonful to a pint of water) flavored with 
licorice root or lemon peel is used in colds of the chest, to cause sweating 
and to loosen the cough. Flaxseed tea, drunk freely, is used as a soothing 
drink in inflammation of the stomach. Whole flaxseed, in tablespoonful 
doses, once or twice a day. has been ordered as a laxative in habitual con- 
stij)ation. 

The oil of flaxseed, or linseed oil, is an old application to burns. 

Wormwood — An infusion is made with one or two tea spoonfuls of 
the plant to a pint of water, and in wineglassful doses is used as a tonic or 
for worms in children. It is a domestic remedy for flatulent dyspepsia 
and weak digestion. Dose, from one to four tablespoonfuls twice a day. 
Externally it has been used as a stimulating application to indolent ulcers. 
A tincture, flavored with aromatics. forms an intoxicating drink called 
absinthe, used to a large extent in France. 

Carrot. — The seeds are ground into powder and used to relieve colic 
and to increase the flow of urine. The dose is half a teaspoonful to a 
teaspoonful, twice daily. The root is said to be excellent for poultices. 
Carrot, used as a substitute for chewing tobacco, has been said to cure 
kidney complaint. 

Horse Chestnut. — The bark is used, the best preparation being a fluid 
extract with dilute alcohol, although a decoction or tea is also employed. 
The dose of the fluid extract is twenty drops to a teaspoonful. three times 
a day. It is said to be a good substitute for quinine in malarial fevers 
and I- also used in neuralgia. A dose of the tincture, three to five drops, 
three times ii day, is ;i remedy for itching or burning piles. 




PLATE XI. 



1426 MEDICAL MATERIALS. 

MEDICINAL PLANTS 
PLATE XII. 

Licorice. — Licorice root is soothing to the throat, loosens cough, and 
is laxative. Licorice is given for cough as Brown mixture and Wistar's 
cough lozenges. One to two teaspoonfuls of compound licorice powder is 
given daily in constipation, especially during pregnancy. 

Iris (Straw Lily). — The powdered root, when fresh, produces vomit- 
ing and is a powerful cathartic ; less so after drying. In chronic liver 
trouble, especially of malarial origin, the preparations of iris are very 
useful. In dropsy they are also of service in stimulating both the kidneys 
and bowels. They are also given for worms. The dose of the extract 
is a quarter of a grain to a grain, and of the fluid extract, half a tea- 
spoonful to a tea spoonful, two to three times a day. 

Dandelion. — The root should be gathered in the autumn. An in- 
fusion is made by taking two ounces of the fresh leaves or roots to a pint 
of water, the dose being two to four tablespoonfuls, two to three times a 
day. The preparations are bitter and probably stimulate digestion and act 
as a tonic. Dandelion is a laxative and increases the flow of urine. It is 
also prescribed for jaundice and for a sluggish liver. If the extract be 
used, the dose is from five to twenty grains three times a day. 

Blackberry — Common Bramble. — The bark of the root is used. It is 
binding and tonic. It is used in diarrhoea, especially after cleansing the 
bowels with castor oil. The best preparation of the blackberry root is the 
fluid extract, given in doses of half a teaspoonful three or four times 
daily. The syrup and the spiced syrup, in the dose of a teaspoonful to a 
tablespoonful, are also used. Very popular preparations are blackberry 
cordial and blackberry brandy, of which a teaspoonful to a tablespoonful 
is taken three or four times a day. Blackberry tea is valuable as an 
enema in leucorrhea, aleet and falling of the womb. 




Elackberry. 



PLATE XTT. 



1428 MEDICAL MATERIALS. 

MEDICINAL PLANTS 
PLATE XIII. 

Great Mullein. — This plant grows by the roadside and in neglected 
fields. It is given for catarrh, coughs, dysentery and piles in the form 
of an infusion made with milk, four ounces of the fresh, or a correspond- 
ing quantity of the dry leaves, being boiled for ten minutes in a pint of 
fresh milk. This quantity is to be drunk thrice daily, while still warm. 
It has long enjoyed a popular repute in Ireland as a remedy in diseases of 
the lungs. It has likewise been used in diarrhoea and inflammation of the 
bladder. 

The flowers are said to remove warts. They are applied, while 
fresh, by pressing and rubbing upon the growth. 

Rosemary. — From one and one-half to three teaspoonfuls of the plant, 
dried and powdered, taken as an infusion (tea), are said to produce de- 
cided sweating. The oil of rosemary is used in hair lotions and in an 
ointment used in neuralgia, chronic rheumatism and lumbago. 

Nettle. — The juice of the nettle, in teaspoonful doses every hour, is 
of great value in cases of hemorrhage of the nose, lungs, intestines and 
urinary organs. The decoction may be made either with the seeds or with 
the leaves, and, drunk freely, is excellent for diarrhoea and dysentery. 

Belladonna. — The fleshy, creeping root is especially useful, but must 
be taken from plants at least three years old. The leaves of belladonna or 
deadly night-shade are also used, the smaller leaves gathered when the 
plant is in flower being best. 

Locally, belladonna is used as an ointment or liniment in neuralgia, 
chronic rheumatism ; also to check sweating and relieve local pain. In- 
ternally, it is used chiefly to relieve pain, relax spasm and check over- 
secretion or bad discharge. 

Tts power of widening the pupil is used in treating the eye. In 
giving this dangerous drug the eye should bo carefully watched. The 
dose of the tincture is five to twenty drops, once or twice a day, in cases 
of neuralgia, spasms and other nervous affections. Great caution is re- 
quired, as the medicine is a poison. 




Belladonna. 



PLATE XIII 



1430 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE XIV. 

Parsley. — A hot infusion is made by taking an ounce of the fresh 
root to a pint of water. One to four teaspoonfuls, given three times daily, 
in cases of scanty menstruation will relieve pain. It is used to increase 
the secretion of urine in dropsy and gonorrhea, in the form of a decoction, 
drunk freely. 

Valerian. — The underground stem and roots are used. It is given 
in the nervous disorders of women, especially nervous headache and 
hysteria. The various nervous disorders which occur at the changes are 
relieved by it. In convulsion or St. Vitus' dance in children, dua to 
worms, and in whooping-cough it has been used with success. One to two 
teaspoonfnls of the tincture is given, three times daily. 

Digitalis or Foxglove. — The leaves are gathered from plants of the 
second year's growth and must be carefully selected. An infusion is 
made by taking one and one-half parts to one hundred parts of water. 

Locally, digitalis is used in joint inflammation. A poultice contain- 
ing a teaspoonful or two of the leaves is placed over the kidneys in cases 
of difficult or impossible urination. 

Its chief internal use is in heart disease, although it is often given 
for blooding. The dose of the infusion is a teaspoonful to a tablespoonful. 
three or four times a day. 

Crow-Foot. — The buttercup plant is sometimes used externally in 
cases of rheumatism. As it belongs to a very poisonous species, it should 
be used carefully and only on the prescription of a physician. 




©E. J. S. 



PLATE XIV. 



14:32 MEDICAL MATERIALS. 

MEDICINAL PLANTS 
PLATE XV. 

Hemlock. — The full-grown fruit is gathered while yet green. Conium 
jnice is expressed from the fresh leaves, and has half its quantity of 
alcohol added to it to preserve it. This is given in doses of half a tea- 
spoonful to two teaspoonf uls. The seeds are used in making most prepara- 
tions. Internally it is sometimes used in nervous affections, but it is a 
dangerous poison and should be used cautiously. 

Poultices of the leaves of hemlock and flaxseed (two parts of the 
former to six of the latter) with boiling water, have been used as a 
soothing dressing to painful swellings. A hemlock ointment is made by 
bruising the leaves with sufficient water and extracting: and mixing the 
juice with lard, and is an excellent local remedy in painful maladies, 

Barberries. — The bark of the root has been made into an infusion, but 
the fluid extract in ten to thirty drop doses is most used. In this form 
the drug is tonic and stimulates the kidneys. It is valuable in the treat- 
ment of blood diseases, dyspepsia, liver trouble, habitual constipation and 
skin diseases. The tea of the bark may be taken in doses of three to four 
teaspoonfuls, three times a day. 

Elder — One to two teaspoonfuls of an infusion of the flower, drank 
while hot, increases the flow of urine and causes sweating. It may cause 
vomiting, if given in too large a quantity. The flowers are edible, and 
are used in scurvy, rheumatism and syphilis. Elderberry jam is laxative. 

.V decoction is made of the inner bark, which acts on the kidneys and 
intestines. One or two teaspoonfuls, two to three times a day, is the dose. 

Oak-Tree. — A decoction is made of one ounce of the bark to a pint 
of Avater and given in doses of half a teaspoonfnl to a teaspoonfnl three 
times daily, for dysentery and diarrhoea. It is occasionally nsed as an 
injection or wash in leucorrhea ; also as a gargle in sore throat and catarrh. 
The powdered bark is nsed on ulcers. The oak yields tannic acid, in 
which form it is used as an astringent enema in gonorrhea, gleet and 
leucorrhea. 




PLATE XA 



1434 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE XVI. 

Bitter-Sweet Nightshade. — A decoction is made by boiling an ounce of 
the young branches in a pint of water and given in doses of a teaspoonful 
to a wineglassful two or three times daily, for jaundice, rheumatism and 
syphilitic affections. It is believed to be of use in long-standing scaly 
eruptions. The fresh decoction, drunk freely, is used to produce sweat- 
ing in rheumatism or acute bronchitis and colds. It is also beneficial in 
the diarrhoeas of children when caused by exposure to cold or damp. 
The dosage should be small and cautiously given. 

Common Chamomile. — The infusion is made with a tablespoonful of 
the flower heads to a pint of water and is taken freely. In large doses 
the hot infusion causes vomiting, but in one or two ounce doses it relieves 
gas in the stomach, favors perspiration and the action of the kidneys. 
Locally, it may be used as a poultice. It is used principally in domestic 
practice in the treatment of colds, bronchitis and dyspepsia, and is taken 
in the form of an infusion in doses of from two to three tablespoonfuls, 
two or three times daily. 

Caraway Seed. — An oil is made from the fruit and used in doses of 
one to five drops, two or three times a day, for distention of the abdomen 
due to gas. It is combined with other medicines to lend a pleasant flavor 
and to prevent griping. 

Geranium. — A decoction can be made from the underground stem. 
If improves the appetite and digestion and promotes nutrition. It is used 
to stop 1>1 ceding. As an injection it is serviceable in gonorrhea, gleet and 
leucorrhea. In diarrhoea in children the decoction may be given in milk, 
which covera its taste. Dose, one-fourth to one-half teaspoonful, five or 
six times a day. 




PLATE XVI. 



143 6 MEDICAL MATERIALS. 



MEDICINAL PLANTS 
PLATE XVII. 

Common Dill. — Tlie fruit of this plant is warming, stimulating and 
quiets nervousness. A tea of the plant, in teaspoonful doses, is used in 
children's colic to relieve the hiccoughs. Occasional use of the decoction 
by mothers is thought to promote the secretion of milk. 

Peppermint. — Peppermint water is given in doses of teaspoonful to 
a wineglassful ; oil of peppermint, one to five drops, and spirits of pepper- 
mint, ten drops to a teaspoonful. In neuralgia oil of peppermint may he 
painted over the painful spot. It may also he used for rheumatism and 
chronic gout. In the colic of children the spirits of peppermint in hot 
water is a good household remedy. A warm infusion of mint, taken fre- 
quently in teaspoonful doses, is useful for the pains caused by gases in the 
intestines. A cloth, saturated in a teacup of water to which a teaspoonful 
of essence of peppermint has been added, applied to head and temples, 
gives relief from headache. 

Mezereon (Laurel). — An ointment is made from the fluid extract of 
the bark (twenty-five parts), lard (eighty parts) and yellow wax (twelve 
parts). This ointment is used as an irritant to keep up discharges from 
ulcers and blistered surfaces. Mezereon bark has been successfully used 
to relieve toothache. 

Common Black Briony. — The root is dried, and half an ounce of it with 
a pint of boiling water made into an infusion, which is given in doses of 
a wineglassful three or four times a day. It may be given for dropsy and 
inflammation of the joints. It is an active purgative, causing large. 
watery -tools. 




Common Black Briony. 



E. J. S. 



PLATE XML 



1438 MEDICAL MATERIALS 



MEDICINAL PLANTS 
PLATE XVIII. 

Common Hedgewort. — Liquid extract of the root is used inwardly for 
catarrh of the stomach. liver, pancreatic and kidney complaints, hypo- 
chondriasis and hysteria. Physiological effect is solvent, acid-removing 
( alkaline) and blood cleansing. Chemical constituents : Bitter extract, 
resin, sugar, alkaline salts, potash, silicic acid. Taste, very bitter. 

Bilberry. — Infusion of the leaves is given internally for dropsy and 
pleuritic effusions, catarrh, cough, and weakness of the bladder. Phy- 
siological effect : slightly astringent. Chemical constituents : Tannic acid, 
quinic acid, and girm. Taste, herbaceous. 

Wild Strawberry. — An infusion of the leaves is given internally for 
diarrhoea, gout, jaundice, etc. The physiological action is astringent and 
blood cleansing. The chemical constituents are a considerable quantity 
of soda salts and silicic acid. The taste is slightly herbaceous. 

Periwinkle. — The liquid extract of the herb is used internally for 
diarrhoea, mucous discharge from the air passages or intestines, hemor- 
rhage; externally, as a gargle and mouth wash for spongy gums. Physio- 
l«io-iciil action: Strengthening, blood cleansing and aperient. Chemical 
constituents. A very bitter extract and tannin. Taste is bitter and as- 
tringent. 





Bilberry. 




Wild Strawberry. 



Periwinkle. 



E. J. S. 



PLATE XYIII. 



1442 MEDICAL MATERIALSc 

(Continued from page 1392.) 
several times a day of a tea made by boiling celery stalks till they are 
soft. At the same time celery, cooked or raw, should be used regularly 
as a table food. 

CHAMOMILE (Anthemis) . 

Definition. — The flower heads of anthemis nobilis are collected from 
the cultivated plant. The oil is the active principle. 

Use. — The activity of the plant depends upon the presence of the 
oil. The action of the oil is to act as a sedative to the nervous system ; 
hence its use in checking reflex cough. It also favors free perspiration 
and free kidney action. 

Manner of Using. — Make a drink as follows : Pour a pint of boiling 
water over an ounce each of chamomile flowers and the feaves and flower- 
ing tops of boneset ; one-half of this amount is a dose. If the whole 
amount be taken, emesis or vomiting will be produced, and this will at 
times be the action desired. 

CHITTIM BARK (Rhamnus Prushiana). 

This is known medicinally as cascara sagrada. It is much used by 
modern physicians for the cure of constipation, and is an excellent home 
remedy. It is prepared for use by steeping a half-ounce of the bruised 
bark for half an hour in a half pint of warm Avater. When cool, take a 
teaspoonful three times a day. If the fluid extract of the bark is used 
the dose would be from ten to fifteen drops, three times a day. Some- 
times it acts as a physic. In such cases the size of the dose should be 
diminished. 

CHLORAL (Chloral). 

Definition. — Chloral is a colorless liquid formed by the action of 
chlorine on alcohol. With water chloral forms a crystallizable compound. 
Chloral should be kept in well-stoppered bottles as the crystals volatilize 
slowly. 

Use. — Taken internally chloral has a sedative influence on the brain 
and spinal cord. In cases of restlessness and delirium it produces a quiet- 
ing influence on the brain and induces sleep. Tn spasm and convulsion it 
alleviates this condition. It influences the heart adversely, and in cases 
of n weak or diseased heart its use is attended with danger. 



ORGANIC MATERIALS. 1443 

Manner of Using. — It is best given well diluted in some agreeable 
syrup. It should not be taken without the advice of a physician. 

CHLOROFORM (Chloroformum). 

Chloroform is a heavy liquid made by the action of chlorine on 
alcohol. It is used in the same class of cases as ether, but is preferred to 
ether in children and old persons on account of the irritation of the bron- 
chial tubes produced by ether in the very young or very old. 

CITRIC ACID (Acidum Citricum). 

Definition.— Citric acid occurs in the form of colorless crystals. It 
is obtained from lemon or lime juice and has a sour taste. 

Property. — It acts favorably upon the liver in cases of inactivity. 
By stimulating the glandular secretion of the intestinal tract it improves 
digestion and nutrition. 

Use. — The use of citric acid in the treatment of scurvy is well known 
and cannot be superseded by any remedy at present under our command, 
except fresh lemon juice itself. In fevers a drink made of citric acid is 
very soothing. 

Manner of Using. — The best form for administration is the syrup of 
citric acid, which may be given in doses from a teaspoonful to a table- 
spoonful. 

COCA (Erythroxylon). 

Definition. — Coca leaves are taken from a small tree in Peru and 
Bolivia. The principal constituent of the leaves is cocaine. 

Use. — The value of coca lies in cocaine. Cocaine is widely used 
locally for the relief of pain. It may be applied for the performance of an 
operation when for any other reason it is not desirable to give a general 
anesthetic like ether or chloroform. 

COCHINEAL (Coccus). 

Cochineal is derived from the crushed and dried bodies of the females 
of coccus cacti. It yields a very brilliant red coloring matter from which 
carmine is obtained. Cochineal has but little value in medicine in com- 
parison with its use in the arts as a coloring agent. 
91 



1444 MEDICAL MATERIALS. 

COD-LIVER OIL (Morrhuae Oleum). 

Definition. — Cod-liver oil is a thin, yellow, oily liquid, having a fishy 
odor and taste. It is obtained from the fresh livers of the cod. 

Use. — Cod-liver oil is an easily digestible food. In most cases of 
poor nutrition it is of value. 

Manner of Using. — Cod-liver oil should not be taken directly after a 
meal. It should be taken about three hours after a meal, when gastric 
digestion is about complete, from the fact that oil is digested not in the 
stomach, but in the intestine. 

COFFEE (Coffea). 

Definition. — Coffee is the seed or berry of the coffee Arabica. It 
is one of the sources of caffeine. 

Use. — Coffee is a stimulant to the nervous system. It increases the 
capacity for intellectual effort. When taken to excess it is frequently the 
cause of headaches. 

COLTS-FOOT (Tussilago Farfara). 

Parts used — root and leaves. 

Its demulcent properties prove its efficacy in chronic coughs, con- 
sumption and other affections of the lungs. It is used in the form of a 
decoction made with an ounce of the plant to a pint of boiling water, of 
which a teacupful may be given several times a day. 

Description. — A perennial herb with a creeping root. The flower, 
which stands singly, is large and yellow in color. The leaves do not appear 
until after the flowers have blown. The flowers have an agreeable odor. 

COMMON RUSH (Juncus Effusus). 

A common plant, growing in water, or in wet soil, with pithy or hol- 
low, rarely branching stems. A decoction of the root — one ounce of root to 
a pint of water — taken freely three times daily, is good for the kidneys, 
dropsy, gravel and incontinence of urine. Ashes of the rush, in doses of 
five to ten grains twice a day, relieves dyspepsia and sour stomach. A 
tincture of the rush, made by adding a handful of the plant to a pint of 
alcohol, and taken freely three times a day, is also good for incontinence 
of urine. The pith may be used as a demulcent drink in fevers. 



ORGANIC MATERIALS. 1445 

COPAIBA (Copaiba). 

Use — This balsam comes from a tree in South America. Its prin- 
cipal use is relieving the irritation in inflammations of the urinary chan- 
nels, especially in gonorrhea. 

CRANESBILL (Geranium). 
{See Plate XVI.) 

CRANBERRY. 

A cranberry poultice is an excellent application to the affected parts 
in cases of piles. They also serve as a cure when cooked for table use, 
and partaken of freely at each meal. Pounded cranberries, applied as a 
poultice, are excellent for removing the pain and inflammation of ery- 
sipelas. In doses of a tablespoonful daily cranberry extract is said to afford 
relief in hysteria. 

CREOSOTE (Creosotum). 

Definition. — Creosote is obtained from the distillation of wood tar. 
The best preparation is made from beechwood and is known as beechwood 
creosote. Creosote is a yellow, oily liquid having a smoky odor. 

Use. — Creosote is an antiseptic and local anesthetic. Internally also 
it is an antiseptic and is used in diarrhoea and dysentery. In consumption 
its use is often followed by a diminution of all the symptoms and general 
improvement. 

Manner of Using. — It may be given internally in milk, cod-liver oil 
or wine. It may also be given in capsules. 

DANDELION WINE. 

A spring drink for cleansing the blood. In a jar containing two 
quarts of blossoms pour three quarts of hot water. Let stand forty-eight 
hours, strain and add two teaspoonfuls of dry yeast and a teacupful of 
white sugar. Flavor with lemon or wintergreen. A wineglassful three 
or four times a day. 

DEADLY NIGHTSHADE (Belladonna). 
{See Plate XIII.) 



1446 MEDICAL MATERIALS. 

ERGOT OF RYE (Ergota). 

Definition. — Ergot is the compact spawn of a parasitic fungus invest- 
ing the rje. 

Use. — The chief action of ergot is upon the parturient uterus, which 
it contracts. It assists nature. Also used to control hemorrhage. 

Manner of Using. — The fluid extract is the preparation most often 
employed. 

ETHER (-Ether). 

Definition — Ether is a clear, colorless liquid having its own peculiar 
odor and a sweetish taste. It is very inflammable, and its vapor mixed 
with air and ignited explodes. 

Use. — When ether is poured upon the skin it produces a sensation 
of cold from its rapid evaporation. The part may be frozen, and at this 
time a small operation, such as the opening of an abscess, may be per- 
formed. Taken internally ether is a stimulant to the heart. Its well- 
known effects in surgery, producing the state known as anaesthesia^ depend 
upon the action of the drug upon the brain and spinal cord. It was 
first used in surgery by Dr. Warren in 1846 at the Massachusetts General 
Hospital. 

Manner of Using. — To produce loss of consciousness the vapor is in- 
haled, administered with safety only by a physician. For local use the 
vapor is locally applied. 

EUCALYPTUS OIL. 

Eucalyptus is a genus of trees indigenous to Australia and Tasmania 
but now grown in United States and many other parts of the world. The 
medicinal part is the oil distilled from the leaves. Taken internally it 
produces a sense of warmth in the stomach and excites the flow of saliva. 
It is sometimes given for malaria, chronic bronchitis, asthma, gonorrhoea, 
etc. Dose 10 to 20 minims. It is sometimes used locally in ulcers and 
chronic skin affections. 

FLAXSEED (Linum-Linseed). 
(See Plate XL) 

FOXGLOVE (Digitalis). 

(See Plate XIV.) 



ORGANIC MATERIALS. 1447 

GALLIC ACID (Acidum Gallicum). 

Definition. — Gallic acid may be obtained from tannic acid, which is 
found in the galls upon the oak tree. These galls or nodes are lumps 
caused by insects. Gallic acid is in the form of long needles. 

Property. — Gallic acid, like tannic acid, is astringent, but not so 
powerful as tannic acid. 

Manner of Using. — When prompt action is desired it should be used 
in powder. It is given also in other forms, such as pills, and so forth. 

GARDEN ARTICHOKE (Cynara Scolynros). 

A perennial plant, cultivated in our gardens. A tincture prepared 
from the leaves is most efficacious in rheumatic, gouty and neuralgic 
affections. Dose: A teaspoonful three times a day. 

GARLIC (Allium). 
(See Plate VII.) 

Definition. — Garlic is the dried bulb of the allium sativum, a native 
of Asia and Egypt, but now naturalized in Europe and America. It re- 
sembles the onion and leek. 

Use — When added' to a cough mixture garlic aids in the expectora- 
tion of secretion. For this latter purpose it is especially valuable in the 
case of children. Taken internally it is also a remedy against scurvy, 
hence called an antiscorbutic. Applied locally in the form of a poultice 
to the abdomen it relieves infantile intestinal colic. 

Manner of Using. — The odor is quite offensive, and some will prefer 
other measures on this account. The preparation for internal use is 
known as the syrup of garlic, which may be used in a dose from ten 
drops to a teaspoonful. 

GINGER (Zingiber). 

Ginger comes from various sources, but Jamaica ginger is preferred 
for culinary purposes, as it has the best flavor. Ginger increases the 
secretions of the intestinal tract, and acts as a carminative. It is used 
in various preparations to disguise the unpleasant taste. 



1448 MEDICAL MATERIALS. 

GLYCERINE (Glycerinum). 

Definition. — Glycerine is a transparent substance obtained by the de- 
composition of fats or fixed oils. It is a constituent of tke waste in the 
process of the making of soap. It is now prepared in large quantities for 
commercial purposes. 

Use. — Taken internally glycerine is in part absorbed or oxidized and 
so acts partly as a food. If a large amount, as a tablespoonful or two be 
taken, it acts as a laxative. Externally applied it acts as an emollient. In 
the care and treatment of bed sores it is highly useful. The parts should 
be bathed twice daily with warm water and gently rubbed with glycerine. 

GRAPEVINE (Vitis Vinifera). 

The vine is too well known to require description. Most useful in 
dropsy and chronic dysentery. The dried fruit is the part employed, of 
which an infusion is made, placing about two ounces of the fruit in a 
pint of boiling water, straining and cooling. Dose: A tablespoonful, in 
either case, every two or three hours, according to the urgency of the 
symptoms. 

HEMLOCK (Conium). 
(See Plate XV.) 

HONEY (Mel). 

Definition. — Honey is a saccharine secretion deposited in the honey- 
comb by the honey-bee, the apis mellifica. The best honey is known as 
virgin honey. It is obtained by incising recent combs and straining. 
Clarified honey is made by heating honey, removing the frothy scum and 
straining. Other products made by the aid of heat are of a darker color 
and are less pure. 

Use. — Honey is to some slight extent a laxative. It is a pleasant, 
sweet article of food. 

HOPS (Humulus). 
(See Plate VI.) 

HOUNDS' TONGUE (Cynoglossum Officinale). 

A biennial plant, named from the shape of its leaves. The root is 
the part employed. It has been found most useful as a sedative in coughs, 



ORGANIC MATERIALS. 1449 

catarrh, spitting of blood and dysentery. An infusion is made with one 
ounce of the root to a pint of water. Dose : A tablespoonful four times 
a day. 

INDIAN HEMP (Cannabis Indica). 

Definition — Indian hemp is obtained from the flowering tops of the 
female plant of the canabis sativa grown in the East Indies. There is a 
confection known as haschish or gun j ah. 

Use. — This drug is much used in Eastern countries and is a frequent, 
cause of insanity in these countries. It is taken for the pleasant mental 
effect produced, though this is but temporary. The first stage is accom- 
panied by exhilaration during which the imagination is actively engaged. 
The imagination brings up images of its own creation. After a time the 
pleasant effects are followed by unpleasant and disagreeable effects. Ideas 
of time and space are perverted. Erequent indulgence in the drug brings 
about permanent mental change. An impulse to kill has been known to fol- 
low the abuse of the drug. Eor medicinal purposes cannabis is used to 
quiet spasms and produce mental quietude. In accordance with this use 
it is employed in treating coughs and the restlessness and delirium of cer- 
tain diseases. It has been used with benefit in neuralgia. 

Manner of Using. — The tincture is the preparation usually employed, 
though it should never be taken without a physician. 

IPECAC (Ipecacuanha). 

Definition — Ipecac is the dried root of a plant which is native in 
Brazil. 

Use. — Ipecac is used as an emetic and expectorant. It enters as an 
ingredient in cough preparations to soften the expectoration of phlegm. 
It has been used in heavy doses for dysentery. 

KEROSENE OIL. 

Appendicitis. — Since the theory that this disease is curable by absorp- 
tion has gained prominence, the use of kerosene oil in connection with 
the cure has been found useful. 

Bunions and Corns A continuous application to corns and bunions 

for a few days will reduce inflammation and pain, and an entire removal 
of the corn may be brought about. 

Burns — Cloths saturated with kerosene, and applied to burns, ex- 
clude the air and bring desired relief from pain. 



1450 MEDICAL MATERIALS. 

Cleansing the Scalp — A little kerosene introduced into glycerine 
constitutes an ointment that will speedily remove dandruff and contribute 
to a clean and healthy scalp. 

Colds. — Ten to twelve drops of kerosene oil on cut loaf sugar, taken 
every two or three hours, has been found effective in curing colds, also 
rub neck and chest. 

Consumption. — A cloth saturated with kerosene oil, bound around 
the chest at night and frequently repeated, will remove lung soreness, 
and it may be taken inwardly with advantage. Eight to ten drops three 
or four times a day in sarsaparilla. It has been tried as a cure for con- 
sumption. 

Croup — Kerosene has been used in croup with success. It may be 
taken internally and applied externally. 

Diphtheria. — Swabbing of the throat, at intervals of two to three 
hours, with kerosene, has been found effective in destroying the mem- 
brane of diphtheria and reducing inflammation. 

Quinsy. — External and internal use of kerosene has a remedial effect 
in this obstinate disease. 

Rheumatism — Petroleum was a favorite Indian remedy for rheu- 
matism. In the purer form of kerosene it is still regarded as a favorite 
remedy for this painful disease. It may be applied by frequent rubbing. 

Toothache. — Cotton saturated with kerosene and placed in the tooth 
often affords immediate relief. 

Vegetable Poisons. — Kerosene is an excellent lotion for the external 
inflammation resulting from vegetable poisons. It should be applied 
frequently until relief fs had. 

LACTIC ACID (Acidum Lacticum). 

Definition. — Lactic acid is a colorless syrupy liquid having an acid 
taste. It is obtained from sour milk. 

Use. — As this acid is found in the stomach during the first part of 
digestion, changes in the amount present cause forms of dyspepsia. When 
in excess or when it is absent dyspepsia in one form results. Its use in 
cases of deficiency added to that of pepsin, is followed by beneficial re- 
sults. Locally it is a mild caustic, and is applied to warts and ulcers, by 
rubbing it on, with the intent of destroying them. 

LADIES' SLIPPER (Cypripedium Parviflorum) . 

Grows in different portions of our own country, and is marked for its 
beautiful flowers. The root is the part used. Has been used with 



ORGANIC MATERIALS 1451 

marked success in epilepsy and in various other nervous diseases. A 
decoction is made with two ounces of the root in two pints of water, boiled 
to one and a half pints. Dose : A tablespoonf ul four times a day. 

LARD (Adeps). 

Definition. — Lard is prepared from the fat of the abdomen of the 
hog. It is washed with water, melted and strained. 

Use — Care must be taken that the lard used does not become rancid. 
By the addition of benzoin the lard is prevented from undergoing this 
change. As an application for burns lard may be used as follows : Wash 
the lard, beat up with an equal quantity of lime water, and add a few 
drops of oil of bitter almond or carbolic acid. Lard softens and removes 
scabs. 

Manner of Using — For medicinal purposes the form of lard used is 
known as benzoinated lard. 

THE LEMON IN MEDICINE. 

As an Anti-Narcotic. — In poisoning by narcotic substances, as opium, 
lemon-juice may be administered after the poison has been vomited or 
removed from the stomach, to counteract the effects. 

Asthma — The administration of tablespoonf ul doses of lemon- juice 
in a glassful of any of the mineral waters, three times a day, has been 
productive of manifestly good results. 

As an Antidote in Alkaline Poisoning — In cases of poisoning by the 
alkalies the vegetable acids are their antidotes, and the most convenient, 
easily procurable acidulous substances are, in general, vinegar or lemon- 
juice. 

Biliousness. — The use of lemon-juice, in doses of one or two ounces 
diluted with hot or cold water, three or four times a day is an invaluable 
remedy. It is supposed to act as an eliminator of bile. 

Corns. — A slice of lemon held in place by bandage over offending 
hard corn, or placed between the toes for soft corns for several successive 
days, is an old, well-tried, standard remedy. 

Coughs and Colds, Hoarseness. — The following will be found soothing 
and healing in most ordinary coughs and colds : 

Whole flaxseed 2 ounces 

Water (boiling) 1 pint 

Juice of two lemons. 
Sugar. 



1452 MEDICAL MATERIALS. 

Pour the boiling water on the flaxseed in a suitable vessel, let it 
steep three hours, pour off the clear liquid, add the lemon-juice and 
sweeten to taste. Ice it for drinking. Dose, one ounce. 

Diphtheritic Sore Throat and Gangrenous Sore Mouth. — Lemon- juice 
has been used with striking advantage as a local application (gargle and 
mouth wash) in these diseased conditions; also in other varieties of gan- 
grene from constitutional causes. 

Dropsy. — Mild and sustained diaphoreses is entitled to special favor. 
The skin must be brought into a state of moderate excitement by external 
warmth — by hot baths twice a day — at same time administering hot 
lemonade, after which put patient to bed. Free perspiration will follow, 
and an improvement in the quantity and quality of the urine, and a 
material subsidence of the dropsy or edema will ensue. 

Erysipelas. — In this affection rest, saline laxatives, low diet and cool- 
ing drinks are the elements of treatment in mild and simple cases. A 
very refreshing and agreeable way of prescribing a cooling drink and at 
the same time obtaining valuable diaphoretic and diuretic effects is by ad- 
ministering the following: 

Take one drachm (60 grains) of bicarbonate of potassium and water 
four fluid ounces. Make a solution, of which add a teaspoonful to a table- 
spoonful of lemon-juice diluted with a tablespoonful of water and drink 
during effervescence every three or four hours. 

Fevers. — Next to its use as an anti-scorbutic (a cure for scurvy) lemon 
juice is most valuable as a drink (in febrile affections) in which the thirst 
is urgent and the bowels are not disordered. This is usually the case in 
eruptive and periodical fevers. 

Headache — A remedy which may very often be given with advan- 
tage for severe forms of headache is bromide of potassium in five- or ten- 
grain doses twice daily, followed by an ounce or two of effervescing lem- 
onade, as prescribed under La Grippe (which see). If not very severe 
the effervescing draught (alone) will be found efficient and secure prompt 
relief. 

Hemorrhages — It not only assuages thirst, but directly counteracts 
the tendency to loss of blood. Administered as lemonade in one- or two- 
ounce doses as cold as possible. 

Itching of Anus or Scrotum. — Lemon- juice has been used with ad- 
vantage as a local application in itching of the genitalia (privates) and 
anus. 

Jaundice. — Lemon-juice in tablespoonful doses several times a day is 
reputed to be a remedy for jaundice produced by congestion of the liver. 



ORGANIC MATERIALS. 1453 

la Grippe. — As a mild diaphoretic and as acting on the kidneys, and 
to allay restlessness and watchfulness in fever use the following: 

Lemon-juice and water, equal parts, enough to make four ounces; 
bicarbonate of potassium one drachm ; water, three ounces. 

Make and keep in separate solutions. To be mixed in tablespoonful 
doses several times daily and taken while effervescing. 

Rheumatism and Gout. — Lemon-juice has been used with beneficial 
effects in acute and chronic rheumatic affections. According to the state- 
ment of a noted physician, "the sensible operation of the remedy consists 
in reducing the force and frequency of the pulse, a mitigation of severity 
of the attack and in securing an early relief from pain." 

Prescribed in doses of one or two ounces of juice (freely diluted) 
three or four times a day. This is generally well tolerated, yet sometimes 
occasions severe griping or diarrhoea. 

Scarlet Fever, Malarial Diseases (Chills and Fever). — Lemon juice 
furnishes a most agreeable and refreshing beverage and proves an ad- 
mirable refrigerant. 

It may be given with sweetened water in the shape of lemonade. 
This is an old English remedy, formerly called the "King's Cup," made 
as follows : 

Add two lemons, sliced, and two ounces of sugar to two pints of boil- 
ing water, allowing this to digest till cold, when it is ready for use in 
ounce doses ad libitum. Or lemon-juice may be added to the mildly 
nutritive drinks, such as gum water, Irish moss tea, barley water, and so 
forth. 

Scurvy. — One of the most beneficial applications of lemon is the use 
of its juice for the prevention and cure of scurvy. For this purpose ships 
destined for long voyages are always provided with a supply of the con- 
centrated juice or (its equivalent) lime juice; from one to two ounces 
should be given every two to four hours diluted with an equal amount of 
water. 

Syphilis. — In some cases of syphilis a cachetic or scorbutiform con- 
dition of the blood is apt to obtain, and in such fresh lemon-juice several 
times daily has been found a valuable adjunct to the regular treatment 
outlined for this disease. 

The Lemon is the fruit of the citrus limonum, a native tree of India, 
but now naturalized in all warm climates. It is supposed that the Greeks 
and Eomans were unacquainted with the lemon, which only became 
known to Europeans at the time of the Crusades. To-day it is known the 
world over, and its medical uses are numerous. 



1454 MEDICAL MATERIALS. 

To Remove Tan from Face. — Kubbing the half of a cut lemon on face 
at night or bathing the face with lemon- juice, allowing same to dry, and 
washing it off carefully with castile soap and warm water every morning, 
is said to have proved very efficacious. 

Vomiting. — The effervescing draught given under Erysipelas (which 
see) is one of the best remedies for allaying nausea or a tendency to 
sicki 

LICORICE (Glycyrrhiza). 
{See Plate XII.) 

LILY OF THE VALLEY (Convallaria). 

{See Plate X.) 

LIVER-WORT. 

A strong tea of this plant, called also kindey plant, in teacupful doses 
four or live times daily, is recommended as an excellent remedy for kidney 
complaint. 

MALE FERN (Aspidium). 

Definition — Aspidium is the rhizome of plants found in almost every 
part of the world. The rhizome has a slight odor and a bitter taste. 

Use. — Male fern is used in the expulsion of tape worm. It prob- 
ably kills the worms in addition to expelling them. 

Manner of Using'. — When it is suspected or known that a person has 
a tape worm the following treatment should be carried out. The person 
should either take no food at all for a day or two or the diet should con- 
sist of milk only. The drug should then be given in some agreeable form. 
It may be given in milk or mucilage. A purgative should follow the use 
of male fern. 

MALT (Maltum). 

Definition — Malt is the seed of hordeum distichum, caused to enter 
the first stage of germination by artificial means and dried. Extract of 
malt is made with water at a moderate heat and evaporated to the con- 
sistency of thick honey. 

Use. — Extract of malt is valuable as a food. It is easily assimilated. 

Manner of Using. — Extract of malt may be taken alone or it may be 
taken in conjunction with cod-liver oil, mixing it with an equal quantity 
of cod-liver oil. 



ORGANIC MATERIALS. 1455 

MARSHMALLOW (Althea). 

Definition — Marshmallow represents a root. It contains a substance 
called asparagin, upon which its virtues depend. 

Use. — Asparagin renders the drug useful as a means of increasing 
the flow of the urine. Combined with medicinal lard althea makes an 
effective dressing in skin diseases. It has been employed also in cough 
mixtures. 

Manner of Using. — The syrup is taken internally. For making a 
poultice the powdered root may be used. 

MASTERWORT (Imperatoria Obstruthium) . 

Part used — the root. 

It has been used with such beneficial effects as a diuretic, emmena- 
gogue, stomachic and diaphoretic and in such a wide circle of complaints 
with so much success that it has gained the title of divine remedy. The 
dose of the infusion, made with an ounce of the root to a pint of water, is 
a teaspoonf ul every three or four hours. 

MAY APPLE (Podophyllum). 

Podophyllum is a slow cathartic acting upon the liver and the in- 
testinal glands. On account of the smallness of the dose and the slight 
taste podophyllum is much used in the treatment of constipation of chil- 
dren. A grain may be dissolved in the spirit of ginger and a drop or two 
given on sugar. 

MEADOW SAFFRON (Colchicum). 

Definition. — Colchicum represents the corm and seed of a plant. 
Use. — The chief use of colchicum is internally in the treatment of 
rheumatism. 

MUSK-ROOT (Sumbul). 

Part used — the root. 

The virtues appear to be those of a nervous stimulant. It has been 
used with asserted success in diarrhoea, dysentery and malignant cholera ; 
also in gastric spasm, hysteria, painful menstruation, palsy of the limbs, 
epilepsy and other nervous disorders. It may be given in infusion or 
decoction, and may be used very much as we use valerian. 



1456 MEDICAL MATERIALS. 



MYRRH (Myrrha), 



Definition. — Myrrh is a resinous exudation obtained from a tree. It 
appears as brownish-red masses. 

Use. — ^lyrrh is slightly astringent and stimulant locally, hence its use 
as a mouth wash. Combined with other remedies it is sometimes em- 
ployed as a cough medicine. 

NAVY BEAN (Vicia Vulgaris). 

A smooth, green bark. Yellow flowers and pods containing the 
beans are the parts employed. As a remedy for erysipelas it has gained 
quite a reputation on account of successful cures. It is used both exter- 
nally and internally. For internal use about one ounce of the dried bark 
is boiled with one pint of water. Dose : One tablespoonful three times a 
day. It is a most cooling medicine to the system. For external use a 
paste is made with the bruised beans and applied to the erysipelatous 
parts. It rarely fails to relieve all inflammatory symptoms. 

NUTGAIL (Galla). 

(See Gallic Acid.) 

NUTMEG (Myristiea). 

Definition — Nutmeg is the seed of a tree growing in the East Indies, 
but cultivated also in the West Indies and in South America. 

Use — Internally small doses favor digestion by stimulating the secre- 
tion of the gastric juice. It is used to disguise the taste of unpleasant 
mixtures and as a flavor. 

Manner of Using. — The oil or the spirits may be used. 

OATS (Avena). 

Avena is the fruit of the avena sativa and is used as food in the form 
of oatmeal, gruel or porridge. It is a highly nutritious food and should 
be eaten with butter or cream. Skin eruptions, such as eczema, have 
been attributed to the use of oatmeal. Change of diet in these cases pro- 
duces a cure for the eczema. 

OLIVE OIL. 

Olive oil is both a food and a medicine. Its nutritive powers are 
considerable and it acts as a lubricant of the digestive tract. It may also 



ORGANIC MATERIALS. 1457 

be used externally in numerous ways. It is not to be considered as a 
cure-all nor should it be taken in excessive quantities as it imposes extra 
work upon the liver and may cause biliousness, but used in moderate 
quantities it has the effect of generally aiding the digestive organs in their 
work. It is recognized as being an especially effective remedy for gall 
stones. It is also of considerable value to those who are troubled with 
constipation, its lubricating qualities making it a healthful and natural 
regulator. Prospective mothers are almost invariably troubled with 
constipation; ordinary purgatives are irritant and are often dangerous 
at this period. A fairly free use of olive oil internally at this time 
combined with external use in the way of rubbing the abdomen will be 
found not only to give relief in the matter of constipation but Avill give 
an elasticity to the skin which enables it to stretch in such manner that 
scarring of the skin which so often accompanies maternity, is avoided. 

As to the quantity one should take internally this depends upon the 
individual and also the general diet. Two or three tablespoonfuls per 
day will generally prove a satisfactory allowance, but those who are fond 
of it may double this quantity or more. It may be taken before, with or 
after meals or between meals, according to individual preferences. Larger 
quantities may naturally be taken where considerable acid fruit is included 
with the diet than in cases where such fruit is omitted. For those who 
do not like the taste of the oil it may usually be made palatable by adding 
a little lemon or other acid fruit juice, or by adding a pinch of salt. 

Olive oil has been found of much value as a preventive of appendi- 
citis, and for such purposes may be used advantageously both internally 
and externally. A few drops in the nose when suffering from cold will 
soften scabs and have general healing effect. It is also of value in enemas. 
Used externally it affords relief from aching joints and rheumatic condi- 
tions. It is of value for chapped skin and may be used advantageously in 
rubbing the whole body after a warm bath. In its natural form, however, 
it is inclined to darken the skin and to avoid this the coloring pigmeut 
should be removed by bleaching the oil through exposure to sunshine. 

Swimmers find that by thoroughly rubbing the body with olive oil 
before entering the water, they are enabled to endure much greater cold 
and withstand fatigue in swimming long distances. It is said to promote 
the growth of hair, but whether this be so or not, it in any event makes an 
excellent treatment for the scalp, keeping it in healthy condition. 



1458 MEDICAL MATERIALS. 

ONION. 

Hardly any plant furnishes more or better home remedies than the 
onion. Cooked as a sauce and eaten freely it is a cure for constipation. 
Cut into slices and sprinkled with sugar, a syrup is formed which is 
excellent in croup, the dose being a teaspoonful every fifteen to twenty 
minutes, till relief is had. A crushed onion poultice will extract the 
heat and pain of a burn or scald. The squeezed juice of the onion, mixed 
with sugar, and given in teaspoonful doses every three or four hours, is 
highly recommended as a cure for bronchitis. 

Boiled and mixed with flaxseed meal and a little vinegar it makes an 
excellent poultice which, placed across the chest and under the armpits, 
has been found efficacious in pneumonia. Raw sliced onions placed in 
a sleeping room where diphtheria, scarlet fever or other contagious disease 
is present, seem to act as a magnet in drawing the germs of disease. Onion 
syrup, prepared by sprinkling sliced onions with sugar, and taken in tea- 
sponful doses every fifteen minutes, until relief is obtained, is a favorite 
home remedy for croup. Free use< of onions on the table is a preventive 
of constipation. An application of crushed onions to burns extracts the 
fire and relieves the pain. In bronchial affections onions afford a remedy, 
in the form of a syrup taken in teaspoonful doses, three or four times a 
day, or oftener if the case be severe. 

OPIUM (Opium). 
(See Plate IX.) 

ORANGE (Aurantium). 

Definition. — The orange represents the fruit of small trees which 
grow in warm regions of the Eastern and Western Hemispheres. There 
are two forms, the sweet orange and the bitter orange. 

Use. — Like the juice of the lemon, orange juice may be taken in 
water as a cool drink, and is grateful particularly during the course of 
fevers. The different preparations of orange are pleasant as flavors. The 
preparation known as the elixir of orange is an agreeable vehicle for 
other remedies. 

OREGON WILD GRAPE (Berberis Aquaf olium). 

Where the root cannot be obtained, the fluid extract, which is known 
as Berberis Aquaf olium, may be purchased from druggists, the dose being 



ORGANIC MATERIALS. 1459 

one-half teaspoonful in water three times a day and also it is recom- 
mended as a douche, one teaspoonful in a cup of water being thus used 
night and morning. 

PEACH LEAVES (Amygdalus Persica). 

Physicians who have tried the virtues of peach leaves as a cure for 
jaundice speak of them with praise. Steep a handful of the bruised 
leaves or twigs in enough cold water to cover them. The dose is a fourth 
of a teacupful three or four times daily. A tea made of peach leaves or 
bark is purgative and good for worms. It should be given in tablespoonful 
doses to adults, until it operates. Children should take teaspoonful doses. 
In two to four tablespoonful doses every two hours it will check the 
the vomiting in cholera morbus and morning sickness. 

PENNYROYAL (Hedeoma-Hedeoma). 

(See Plate IX.) 

PEPPER, BLACK PEPPER (Piper). 

Definition. — Pepper is the unripe fruit of the piper nigra of India. 
Use. — Pepper is a condiment. It is stimulating to the digestive 
system and to the circulation. Pepper externally is an irritant. 

PEPPERMINT. 

Essence of peppermint, a teaspoonful to a tumbler of hot water, 
sipped occasionally, is both a preventive and cure of seasickness. Bruised 
and applied to the stomach it relieves nausea and vomiting. Given in- 
ternally it relieves colic in infants. 

PEPSIN (Pepsinum). 

Definition — Pepsin is one of the elements of the gastric juice. In 
cases of deficiency of this element there is presented one form of dyspepsia. 
The object, then, is to assist nature by replacing the pepsin. We there- 
for look to the lower animals for assistance and select the hog, calf or the 
sheep. The acid mucous secretion is scraped from the surface of the 
stomach, spread on a glass and dried in scales. Saccharated pepsin is pep- 
sin obtained from the gastric mucous membrane of the hog mixed with 
sugar of milk. It is a white powder of a disagreeable odor and taste. 
A solution of this is made and forms liquor pepsin. 



1460 MEDICAL MATERIALS. 

Manner of Using. — The powder may be used, or a rather pleasant 
liquid preparation called the wine of pepsin may be used. 

PERUVIAN BARK (Cinchona) . 

Uses. — This drug has somewhat lost its former popularity, being re- 
placed by quinine and other alkaloids obtained from the same bark. These 
alkaloids are the best vegetable tonic, as also the surest remedies in malaria. 
Quinine is also much used in fevers and inflammations. Many have a cer- 
tain objection to this drug because an excess causes headache, noise in the 
ears and other disagreeable symptoms. These are, however, temporary, 
and should not stand in the way of a careful use of the remedy. 

PINEAPPLE. 

A tablespoonful of the juice of the pineapple, taken every three hours, 
is recommended as soothing in sore throat. The same may be used as a 
gargle after each dose. 

PINK ROOT. 

This plant offers an old standby for worms. An ounce of the root, 
mixed with four drachms of senna, should be steeped in a quart of water. 
The dose is two tablespoonfuls twice a day. If the root is used in the form 
of a powder ; the dose is ten to twenty grains for children, and one to two 
teaspoonfuls for adults. 

POISON NUT (Nux Vomica). 

Definition. — Nux vomica is the seed of the strychnos nux vomica of 
East Indies. The seeds are disk-shaped, about an inch in diameter, and 
covered with silky hairs. 

Use. — Nux vomica is one of our best tonics, as also one of the most 
dangerous poisons. These properties principally belong to strychnine, an 
alkaloid. It is also a good bitter tonic, which property is especially effi- 
cacious in the nervous system. It is often used in the treatment of dys- 
pepsia. 

Manner of Using. — The tincture of nux vomica is the preparation 
usually employed. Strychnine is used advisedly. 

POTATO AS A CURE FOR ACHES AND PAINS. 

Recent discoveries indicate that the common potato contains proper- 
ties which, if properly applied, may relieve a number of aches and pains. 



ORGANIC MATERIALS. 14:01 

The medicinal properties of the potato are contained in its juice, and 
it is claimed on high medical authority that this juice produces wonderful 
results in curing swellings and other disordered conditions of the joints 
and muscles. In connection with the joints of the body there is to be 
found a fluid known as "synovia," which acts as a lubricant, and if through 
accident or disease this secretion ceases the joints become dry, feverish and 
painful and are unable to perform their functions. This condition is 
well illustrated by what is known as "white swelling" of the knee; the 
gland in the knee through which this lubricant (synovia) supplies the 
joint having become injured or diseased, the fluid escapes through the 
tissues and forms a swelling under the skin. Under ordinary treatment 
the trouble is not only difficult to remove, but even after the swelling 
has disappeared it is usually a long time before proper secretions are 
again set into activity and full use of the joint obtained. Among other 
instances where the stoppage of the flow of this fluid causes pain and 
trouble, may be mentioned gout, where the secretion is lacking in the great 
toe, and lumbago where there has been a cessation of synovic flow in the 
lumbar region. 

The constituent parts of the potato are chiefly starch and potash salts, 
the curative properties being contained in the potash salts, which are 
found in the liquid part of the raw potato. Owing to its dense character, 
considerable pressure is necessary to extract the potato juice ; after extrac- 
tion it must be boiled down to about one-fifth of its original bulk ; a small 
quantity of glycerine is then added as a preservative, in which form it 
may be used as a liniment or, with a mixture of lard, may be used as an 
ointment. The juice may be thus prepared at home or can be prepared by 
any druggist, the pharmaceutical name being extractum solani liquidum. 
The preparation is only used externally, being rubbed over the affected 
joints or muscles. Before application, hot fomentations should be ap- 
plied to thoroughly open the pores, being continued until the skin is 
thoroughly red; the liniment or ointment is then well rubbed in, and in 
the case of a joint, a protective bandage is applied. This operation 
should be repeated every three hours until the pain and swelling are re- 
lieved. In cases of lumbago the patient should rest in bed until the 
remedy has had full effect. A sprained ankle or wrist should be kept 
tightly bandaged for a few days over an application of the ointment. 

It is claimed that thus applied, not only does the potato juice quickly 
relieves pain, but that it so thoroughly re-establishes the synovic flow that 



1462 MEDICAL MATERIALS. 

normal condtion of the part is so completely secured that there is little 
likelihood of reoccurrence of the trouble. 



PUMPKIN (Curcurbita Pepo). 

The seeds of the pumpkin afford a well recognized remedy for worms, 
retention of urine and inflammation of bladder and bowels. Oil of the 
seeds operates as a speedy diuretic in doses of from six to ten drops four or 
five times a day. If a tea of the seeds be used as a diuretic, it may be 
drank freely at intervals of two to three hours. Pumpkin seeds are 
highly recommended for the destruction and removal of tapeworm. The 
seeds should be peeled and beaten in with sugar till a paste is formed. 
Then dilute with milk, and drink freely, always on an empty stomach. 
In the course of a few hours the patient should take an active cathartic 
for the removal of the tapeworm, composed of a tablespoonful of castor 
oil and a teaspoonful of turpentine. The drug-stores now furnish a fluid 
extract of pumpkin seeds for the destruction of tapeworm, the dose being 
from a half to a whole tablespoonful every three or four hours, followed, 
as before mentioned, by a large dose of castor oil and turpentine. 

PURPLE WILLOW HERB (Ly thrum Salicaria). 

Part used — the bark and root. 

It is demulcent and astringent, and is efficacious in diarrhoea and 
chronic dysentery. The dose of the powdered bark is about a teaspoonful 
two or three times a day. A decoction of the root is prepared by boiling 
an ounce in a pint of water and given in doses of a tablespoonful every two 
or three hours. 

RED PEPPER. 

Ked pepper is employed with great success as a gargle in scarlet fever. 
It is prepared by taking half a teaspoonful of the pepper and one table- 
spoonful of table salt to a half -pint of boiling water. Thoroughly mix and 
strain, and then add about half a teacupful of vinegar. Use frequently as 
a throat gargle, and give internally half a teaspoonful every hour to a 
child, doubling the amount for an adult. Eed pepper is also recommended 
as a cure for the grippe, in the form of a tea of the pod, or of the ground 
pepper, a teaspoonful to half a pint of water. Place a teaspoonful of the 
tea in a glass of hot water, and drink slowly every three or four hours. 



ORGANIC MATERIALS. 1468 

RED ROOT (Ceanothus Americanus) . 

A small, indigenous shrub, growing in the United States. The root 
is the part employed. Said to be useful in syphilitic complaints; given 
in the form of decoction; two drachms of the root to a pint of water. 
Dose: A teaspoonful four times a day. A strong infusion is useful in 
aphthous ulcers of the mouth, applied locally several times a day. 

RHUBARB (Rheum). 

Definition. — Rhubarb represents the root of a plant native in Asia. 

Use. — In moderate doses rhubarb acts as a purgative and stomachic. 
In chronic constipation it is an excellent remedy. It is useful in the sum- 
mer diarrhoea of children. 

Manner of Using. — The aromatic syrup is a favorite method of admin- 
istration. It may be given also in the form of pills. 

SALT IN MEDICINE. 

As Worm Cure. — For this purpose it is administered in large doses 
by the mouth, or, when the worms are lodged in the rectum, a strong 
solution is administered in the form of an enema. 

Catarrh. — A warm, weak solution of salt and water (a half to one 
teaspoonful of salt to a tumblerful of warm water) sniffed up the nose 
night and morning oftentimes leads to a speedy cure in mild cases. 

Cholera Morbus. — Salt solution by the mouth and as enemata is 
strongly recommended for this disease. 

Diarrhoea and Dysentery. — In these affections salt has been satis- 
factorily administered in combination with lemon juice. A half drachm 
of salt to a tablespoonful or two of lemon-juice diluted, and repeated 
every two hours till relieved. 

Emetic. — To produce vomiting the dose of salt is one or two table- 
spoonfuls in a tumblerful of water. A teaspoonful of mustard flour 
assists its action. 

Felon. — Take common salt, roast it on a hot stove till dry as possible. 
Take a teaspoonful of it, also a teaspoonful of pulverized castile soap and 
a teaspoonful of Venice turpentine; mix them well into a poultice and 
apply to the felon. Eenew twice daily, and in four or five days the felon 
will open, release the pent-up matter and get well. 



1464 MEDICAL MATERIALS. 

Fits, Apoplexy, Convulsions, and so forth — Salt placed on tongue dry- 
acts admirably in these affections. 

For External Application. — Salt is used for various external applica- 
tions. Thus, a saturated solution, applied with friction, is employed as 
a counter-irritant in glandular enlargements and chronic diseases of the 
joints. 

General Administration. — Common salt in small doses acts as a stimu- 
lant tonic and anthelmintic or worm cure; in larger ones as a purgative 
and emetic. It certainly promotes digestion, and the most universal an- 
imal appetency for it proves it to be a salutary stimulus in health. When 
taken in larger quantities than usual with food it is useful in some forms 
of dyspepsia, and, by giving greater tone to the digestive organs in 
weakly children, may correct the disposition to generate worms. On the 
sudden occurrence of hemoptysis or vomiting of blood it is usefully re- 
sorted to as an astringent in the dose of a teaspoonful, taken dry, and 
often proves successful in stopping the flow of blood. 

Heartburn — A few grains of table salt allowed to dissolve in the 
mouth and frequently repeated will ensure prompt relief. 

Hemorrhage. — On the sudden occurrence of bleeding or vomiting of 
blood it is usefully resorted to to stop the flow, in the dose of a teaspoonful, 
taken dry. 

History. — Salt is a necessary and indispensable seasoning of our food, 
and as such must doubtless have been known to and employed by the first 
individuals of our race. The earliest notice of it occurs in the writings 
of Moses (Genesis xix. 26 ; Leviticus ii. 13) and Homer (Iliad, lib., ix. 
214). It has received various names, such as common salt, culinary salt 
and chloride of sodium, and so forth. 

Hives. — Ordinary salt baths are of great value, promptly relieving 
the terrible itching. Two ounces of salt are added to about thirty gallons 
of warm water. 

Inward Uses — It is frequently used as an ingredient in stimulating 
enemata. The dose, as a tonic, is from ten grains to a drachm ; as a 
cathartic, though seldom used for that purpose, from two drachms to half 
an ounce. In doses of from half an ounce to an ounce, dissolved in four 
or five times its weight of water, it frequently proves a prompt and effi- 
cient emetic, invigorating rather than depressing the powers of the sys- 
tem. When employed as a clyster it may be used in the amount of from 
one to three tablespoonfuls dissolved in a pint of water. 

Local Application. — Externally applied in solution it is a stimulant, 
and may be used either locally or generally. Locally it is sometimes 



ORGANIC MATERIALS. 14:65 

employed as a fomentation in sprains and bruises; and as a general 
external application it forms the salt-water bath, a valuable remedy as a 
tonic and excitant in depraved conditions of the system, occurring espec- 
ially in children, and supposed to be dependent on the scrofulous diathesis. 
A pound of salt dissolved in four gallons of water forms a solution of 
about the strength of sea-water, and suitable for a bath. 

Malaria (Ague) — In the course of experiments made in Paris, 
France, common salt in half -ounce doses has been found very efficient and 
second only to quinine, but the dose being very bulky causes vomiting in 
many cases. But the suggestion is a valuable one, where quinine cannot 
be administered. 

Purgative. — For producing evacuations from the bowels it is em- 
ployed in the form of an enema. One or two tablespoonfuls of common 
salt dissolved in a pint or quart of starch water forms a very useful 
clyster. 

Salt and the Blood — It serves some important and essential uses in 
the animal economy. It is employed by the people of all nations, from 
the most refined to the most barbarous. It is an invariable constituent 
of the healthy blood. 

In moderate quantities it promotes the appetite, assists digestion and 
assimilation. 

Salt a Tonic. — In some diseases the moderate use of salt produces the 
effect of a tonic. It acts as a stimulant to the mucous membranes, the 
absorbent vessels and glands. 

Sore Eyes. — A small pinch of salt (about three grains) added to an 
ounce of clear, filtered, boiled water makes a very soothing and beneficial 
eye-lotion. Apply with a small tube or dropper several times daily. 

Sore Throat. — Gargling the throat with a weak solution of salt and 
water will often cure this difficulty without further treatment. 

Sprains and Bruises. — Half fill a bottle with common salt ; add good 
brandy till nearly full. Shake it well and allow to settle. Bathe the 
^part with a soft linen cloth or sponge. 

Stimulant. — As a stimulant it is rubbed on the chest in fainting, and 
so forth. 

Stomach Pains or Gastrodynia. — Salt in a teaspoonful dose, dry, is 
used in some cases with considerable advantage. 

Toothache Cure, Infallible — Pulverize and mix alum and common 
salt in equal quantities ; wet a small piece of cotton and cause the mixture 
to adhere to it ; place in the hollow tooth. A sensation of coldness will be 



1466 * MEDICAL MATERIALS. 

first produced, which will gradually subside and with it the tormenting 
toothache. 

NEW SALT EEMEDY FOR SUNSTROKE. 

Symptoms. — Throbbing in head, violent thirst, great restlessness; 
headache and fullness as if head would burst; red face, increased action 
of heart. 

In extreme cases of sunstroke, where the patient is often in an uncon- 
scious condition, with a very weak, rapid pulse, and at times almost im- 
perceptible, the injection under the skin of the forearm of a sterilized salt 
solution into the vein has been found most efficacious, and has been the 
means of saving many patients when the temperature has reached 109J. 

Treatment. — A vein of the arm is opened precisely as in the manner 
for bleeding, and a solution made by approximating one teaspoonful of 
common salt dissolved in one quart of water. This solution to be of the 
temperature of the blood, viz. : 98 § Fahrenheit. 

By pursuing this treatment the blood-vessels are filled, the rapid 
action of the heart diminished, pulse becomes stronger and regular, and 
in association with the regulated cold bath or cold applications to the 
surface of the body, consciousness is restored within a very few hours. 
Care should be taken that the treatment, especially the cold bath, is not 
applied to cases of heat exhaustion, where the temperature is frequently 
subnormal. There is no doubt but what this recently instituted treatment 
by salt injections has been the means of saving many patients who have 
been affected with sunstroke. In sunstroke the fluid in the blood-vessels 
being below the normal quantity, the salt injection takes the place 
of the lost pabulum. 

SARSAPARILLA (Sarsaparilla). 

Definition. — Sarsaparilla represents a root from Mexico, Central 
America and Brazil. 

Use — Sarsaparilla is an alterative. It is also a vehicle to disguise 
the taste of unpleasant drugs. 

SENNA OR SENA (Sena). 

Use. — A violent cathartic, with watery stools, having the disadvan- 
tage that it is apt to produce strong colic. Generally given with some 
aromatic. The most pleasant form is the preparation known under the 
name of compound licorice powder. 



ORGANIC MATERIALS 1467 

SKULLCAP (Scutellaria Lateriflora). 

Part used — the leaves. 

Very efficacious as a nervine and successfully employed in neuralgic 
and convulsive affections, St. Vitus' dance, delirium tremens and nervous 
exhaustion. An infusion of the dried leaves is made with half an ounce 
of the leaves to a teacupful of water, to be drunk during the day. It has 
been found useful in epilepsy. 

Description. — Its stem is erect, smooth and one or two feet high. 
The leaves are rather acute, opposite and supported upon long petioles. 
The flowers are small and of a pale blue color. 

SOAPWORT (Saponaria Officinalis). 

• Part used — the root and leaves. 

It has been used in venereal and scrofulous affections, cutaneous 
eruptions, and so forth. It appears to act as an alterative like sarsaparilla. 
It is given in the form of a decoction which may be taken freely. The 
expressed juice given in the quantity of half an ounce in the course of a 
day is claimed to be a specific in the cure of gonorrhoea. 

Description. — The root and leaves are inodorous, of a bitterish- 
sweetish taste. They impart to water the property of forming a lather 
when agitated, like a solution of soap, whence the name of the plant was 
derived. 

SPANISH FLIES (Cantharis Cantharides) . 

Definition — Spanish flies represent the dried body of a beetle found 
in the South of Europe, especially in Spain. 

Use. — Internally cantharides is a stimulant to the genito-urinary tract 
and externally it is employed as a counter-irritant. The tincture of can- 
tharides combined with other remedies is often used in the treatment of 
alopecia or baldness. 

Manner of Using. — When a blister is employed the part may be 
painted with cantharidal collodion or it may be covered with a rag spread 
with the cerate. Cantharides requires from six to ten hours to draw a 
blister, but it is better to remove the drug at the end of four or five hours. 

STARCH (Amylum). 

Definition. — Starch is a fine white powder, and is obtained from the 
seed of the zea mays. It forms a large part of rice, wheat and barley. 



1468 MEDICAL MATERIALS. 

Use. — When boiling water is added to starch a very convenient poul- 
tice is furnished for local inflammations. Starch, when mixed with water, 
is a convenient antidote to most corrosive poisons, as it is usually close at 
hand or can be readily obtained. 

Manner of Using. — Starch may be used locally or internally. It may 
also be used as the basis for an enema to be injected in the bowels. 

STONE ROOT (Collinsonia Canadensis). 

{See Plate I.) 

This plant is used in numerous complaints in practice. A decoction 
of the fresh root, one ounce to the pint of water, has been used with 
advantage in hemorrhoids or piles, catarrh of the bladder, gravel and 
dropsy. The dose is one tablespoonful four times a day. The leaves are 
applied in the form of fomentation to wounds, bruises and sores, and in 
cases of internal abdominal pains. 

SUGAR (Saccharum). 

Definition. — Sugar is a product of the sugar-cane of sub-tropical 
countries. 

Use. — Syrup which is used as a vehicle for the administration of 
drugs consists of 85 per cent, of sugar. Sugar of milk is a peculiar crys- 
talline sugar obtained from the whey of cow's milk by evaporation and 
purified by recrystallization. It is used in pharmacy. 

SWEET FERN (Comptonia Asplenif olia) . 

A shrubby plant. Grows in thin, sandy woods in New England. 
The root is the part used. Most useful in diarrhoea. Given in the form 
of decoction. Made with two ounces of the root, boiled in one and a half 
pints of water to a pint. Dose: A tablespoonful several times a day, as 
required. 

TANNIC ACID (Acidum Tannicum). 

Definition. — Tannic acid occurs in the form of pale yellow scales. 

Use. — The chief effect of tannic acid is that of an astringent con- 
tracting the tissues and checking secretion. It is used as a chemical anti- 
dote in cases of poisoning. 

Manner of Using. — As an antidote it is used in powder form, twenty 
grains being the amount usually given. 



-ORGANIC MATERIALS. 1469 

TARTARIC ACID (Acidum Tartaricum). 

Definition. — Tartaric acid appears as colorless crystals. It is obtained 
by the decomposition of cream of tartar found in old wine casks. 

Use. — This acid is one of the constituents of a Seidlitz powder, which 
is laxative in its effect. Rochelle salt, also laxative, is potassium and 
sodium tartrate. 

Manner of Using. — The acid or its salts are used in solution in quanti- 
ties to suit. 

TEA (Camellia). 

Definition. — This represents an infusion made from the dried leaves 
of the Chinese tea plant or Camellia Thea. It contains a substance known 
as theine. 

Use. — Tea is a stimulant removing a sense of fatigue. While this is 
the ordinary effect of the use of tea there are some, particularly those of 
a nervous temperament, who cannot partake of it without ill effects. 

TOBACCO (Tabacum). 

Definition. — The leaves of the tobacco plant represent the part used. 
The tobacco plant is indigenous to the southern portions of this country. 
It was carried to Lisbon by the Spaniards and from there to France by 
Nicot in 1560. 

Use. — When persons not accustomed to tobacco indulge in it emesis 
or vomiting, with great muscular relaxation, results. It is a stimulant 
to the salivary and intestinal secretions. Nicotine is a rapidly acting 
poison resembling hydrocyanic acid in its fatal effects. The power of in- 
creasing secretions along the alimentary canal, the stimulation of peri- 
stalsis and the function of the kidney are proper arguments in favor of 
moderate use of tobacco. 



TOMATOES (Lycopersieum Esculentum) . 

The tomato remedy for cholera infantum meets with much favor 
by those who have tried it. It is prepared by adding sugar to peeled 
ripe tomatoes. The dose is a teaspoonful every half hour until relieved ; 
then continue with like doses every two or three hours till a permanent 
cure is effected. Some remarkable cures are mentioned in connection 
with this simple remedy. Do not give the seed or pulp of the tomato. 



14*70 MEDICAL MATERIALS.^ 

TRAILING ARBUTUS (Eplgae Repens). 

A small, trailing plant, ovate leaves and small, fragrant flowers. It 
has been employed with marked success in diseases of the urinary organs 
and of the pelvic viscera generally. The leaves and stems are the parts 
used. An infusion is made with two ounces of either to one and a half 
pints of water, boiled to one pint. Dose : A tablespoonful three or four 
times a day. 

TURPENTINE TREE. 

This species of pine yields the oil and spirits of turpentine so 
useful in the cure of diseases. Application to the back of the neck of a 
cloth thoroughly wetted with spirits of turpentine will afford speedy re- 
lief in cases of fits and convulsions. Five drops of the spirits on a little 
sugar, swallowed slowly, and once or twice a day will cure sore throat. 
In cases of dysentery, ten drops on a little sugar taken every four hours 
usually effects a cure. A turpentine liniment, valuable in cases of sprains, 
bruises and rheumatism, is made of equal parts of spirits of turpentine 
and vinegar, to which has been added the yolk of one egg. 

UNICORN ROOT. 

This is sometimes called star-root. It ranks as an excellent remedy 
for falling of the womb. Make it into a strong tea, and take half a tea- 
spoonful three times a day. 

VALERIAN (Valeriana). 

(See Plate XIV.) 

WAH00 (Euonymus Atropurpureus). 

Small shrub, which, in autumn, from their rich red color, have 
obtained for them the name of burning bush. Most effective in the 
different forms of dropsy. The root is the part employed. Given in 
the form of decoction, one ounce to the pint of water. Dose: A wine- 
glassful three or four times a day. 

WALL PELLITORY (Parietaria Officinalis). 

Part used — the bark. 

It is used in complaints of the urinary passages, dropsy and febrile 
affections in the form of a decoction made with an ounce of the bark to a 



ORGANIC MATERIALS. 1471 

pint of water, the dose of which is a tablespoonful every three or four 
hours. The expressed juice is also used and the fresh plant applied in 
the form of a poultice to painful tumors. 

WATER HEMLOCK (Phellandrium Aquaticum). 

Part used — the seeds. 

They have been used moist successfully in chronic pectoral affections, 
such as bronchitis, pulmonary consumption, asthma, and so forth, and in 
dyspepsia and intermittent fever. The dose is from five to six grains 
every three or four hours. 

Description. — The seeds have been used for a considerable time in 
the treatment of disease. They are from a line to a line and a half in 
length, narrow above, somewhat compressed, marked with ten delicate 
ribs. Their color is yellowish brown, the odor strong, their taste acrid 
and aromatic. In over-doses they produce vertigo, intoxication and other 
narcotic effects. 

WAX (Cera). 

Wax is a concrete substance prepared by the apis mellifica. It forms 
the honeycomb. It is used to give consistency to ointments and suppos- 
itories. 

WHITE MUSTARD (Sinapis Alba). 
(See Plate V.) 

WHITE OAK BARK. 

It has been used successfully to cure the leucorrhea or whites. Boil 
an ounce of the root in a pint and a half of water down to a pint. Use 
as an injection. 

Or, employ as an injection one-half ounce of the fluid extract of 
Canadian pine (Pinus Canadensis) to a pint of tepid water. Use this 
twice a day with a syringe, or white oak bark one ounce to a pint. 

WHITE POND LILY. 

A tea of this plant injected to the neck of the womb is highly recom- 
mended as a cure for ulceration of that organ. At the same time the tea 
should be taken internally as an accessory treatment, the dose being half 
a teacupful two or three times daily. If the fluid extract of the plant is 
used, the dose should range from four to twenty drops three times a day. 



1472 MEDICAL MATERIALS. 

WILD INDIGO (Baptisia Tinctoria). 

Part used — the root. 

It has proved useful in scarlet fever, typhus fever and in that state 
of the system which attends gangrene or mortification. It is highly 
recommended as an external application to obstinate and painful ulcers. 
It is given in decoction made in the proportion of an ounce of the root 
to a pint of water, of which two tablespoonfuls are administered every 
four or eight hours. 

WILD YAM. 

This plant has come into modern favor as a remedy for appendicitis. 
It is used by mixing a teaspoonful of the extract in a half tumbler of 
water, and taking a teaspoonful of the mixture every half hour. When 
relief comes diminish the dose to once every hour or two. This treatment 
is regarded by some doctors as the best the profession affords. 

WINTERGREEN TEA BERRY (Gaultheria). 

Definition. — TVintergreen represents the leaves of a small plant grow- 
ing in Xorth America. 

Use. — Taken internally the oil is antiseptic and antipyretic. This 
latter refers to its property of reducing the temperature. It is used in the 
treatment of articular or inflammatory rheumatism. Locally the oil com- 
bined with olive oil makes a good application for rheumatic pains. 

Manner of Using. — The oil is used internally and locally. 

WORMSEED (Santonici Semen). 

Part used — the seeds. 

They contain a volatile oil, to which its virtues have been ascribed. 
But it owes its efficacy to a peculiar principle which it contains called 
santonin, used in the treatment of worms. The dose is from one to four 
grains twice a day. The dose of the powdered seeds is from ten to thirty 
grains, which should be repeated morning and evening for several days 
and then followed by a brisk cathartic. It has also been employed with 
success in intermittent fever. 

YELLOW ROOT (Hydrastis Canadensis) . 

Part used — the root. 

Possesses the virtues of the ordinary bitters and popularly employed 
as a tonic. Used in dyspepsia and stomach affections, and as a topical 
application to ulcers and sores in the form of a decoction made with a 



ORGANIC MATERIALS. 1473 

drachm of the dried root to a pint of water and a syringeful injected three 
times a day. It is most useful in gonorrhoea. 

YERBA REUMA. 

Fluid extract of yerba reuma is a favorite cure for catarrhal affec- 
tions. It is used by pouring a small quantity of the liquid into the hollow 
of the hand, placing the finger on one nostril and sniffing the liquid into 
the other nostril. Then do the same with the other nostril. This should 
be repeated four or five times daily. If the catarrhal discharge is copious. 
the nostrils should first be cleansed by previous sniffs of warm water ; and 
if the discharge be offensive a half teaspoonful of carbolic acid may be 
added to the water. 

HOW TO PREPARE HERBS. 

When a plant has reached the stage of its growth when all its prop- 
erties are fullest it is the proper time to gather it. 

Roots. — The best time to gather roots is before the sap rises in the 
spring, but they may be taken after the leaves have dried in the fall. 

Barks. — Gather in the fall or early spring, and, after removing the 
outside portion of the bark, cut and put in a dry place. 

Berries and Fruits. — Hang in a cool, dry place or spread on tables 
or shelves. 

Seeds and Flowers. — When they have fully ripened, place to dry in 
a shady place. 

Medical Herbs. — Gather any time while blooming, before the autumn 
frosts, and dry in the shade. 

Leaves. — Should be collected when the bloom is on the plant, and 
hung or spread in a current of air so as to be hastily dried. 

All druggists know that tin canisters are the best in which to keep 
powders, where they can be dry and in a dark place roots in barrels or 
wooden cases and extracts and tinctures in jars and bottles away from 
the light. 

How to Prepare Herbs for Use. — To make an effusion or decoction, 
take one to two ounces of the plant, bruise, and add a quart of water. 
Tinctures are made by taking two ounces of the powdered article and 
adding a quart of alcohol and letting stand two weeks. Essences are made 
by dissolving one to two ounces of the essential oils in a quart of alcohol. 
Infusions or teas are made by taking a half cupful of the herb and allow- 
ing to simmer slowly over the fire. Decoctions are made in the same way, 
only make sure to extract the full strength from the herb. 



1474 MEDICAL MATERIALS. 

HOW TO MAKE TINCTURES. 

Tinctures, in the pharmaceutical sense of the term, are solutions of 
medical substances in alcohol or diluted alcohol, prepared by maceration, 
digestion or percolation. 

Only Dry Ingredients. — In the preparation of the tinctures the medi- 
cine should be in the dry state, and properly comminuted by being 
bruised, sliced or pulverized. It is usually better in the condition of a 
coarse than of a very fine powder, as in the latter it is apt to agglutinate, 
and this presents an impediment to the penetration of the menstruum. 

The Mixing. — When several substances differing in solubility are em- 
ployed they should be added successively to the splint ; those least soluble 
first, those most so last, as otherwise the menstruum might become satu- 
rated with the ingredient for which it has the strongest affinity, and thus 
be rendered incapable of dissolving a due portion of the others. 

The Care Needed. — Care should always be taken to keep the vessels 
well stopped in order to prevent the evaporating of the alcohol. The 
materials should be frequently shaken during the digestion or macera- 
tion, and this caution is especially necessary when the substance acted 
on is in the state of powder. The tincture should not be used until the 
maceration is completed, when it should be separated from the dregs 
either by simply filtering it through paper, or, when force is requisite, by 
first expressing it through linen, and subsequently filtering. 

Narcotic Tinctures. — Tinctures prepared by adding alcohol to the ex- 
pressed juices of plants have been long in use. The tinctures of some of 
the narcotic plants, as those of conium, hyoscyamus and belladonna, are 
prepared in this manner. To the expressed juice, after it has stood 
twenty-four hours and deposited its feculent matter, alcohol of .0838 is to 
be added in the proportion of one part by measure to four of the juice, 
and after another period of twenty-four hours the liquor is to be filtered. 
This proportion of alcohol is sufficient for the preservation of the juice, 
while it causes the precipitation of the mucilaginous matter. But, though 
these preserved juices are often energetic preparations, yet it is obvious 
the tinctures prepared from the fresh plant must be still more efficient, 
as they contain necessarily not only the soluble active matter of the juice 
but that also which is left in the solid residue of the plant. 

Keeping of Tinctures — Tinctures should be kept in bottles well 
stoppered in order to prevent evaporation, which, in some instances, might 
be attended with serious inconvenience, by increasing their strength be- 
yond the official standard. 



ORGANIC MATERIALS. 1475 

Doses of Tinctures. — Medicines are most conveniently administered 
in tinctures which act in small doses, as the proportion of alcohol in which 
they are dissolved is insufficient to produce an appreciable effect. Those 
which must be given in large doses should be cautiously employed in this 
form lest the injury done by the menstruum should more than counter- 
balance their beneficial operation. This remark is particularly applicable 
to chronic cases, in which the use of tinctures is apt to lead to the forma- 
tion of habits of intemperance. 

HOW TO MAKE FOMENTATIONS. 

A sort of partial bathing by the application of cloths which have 
been previously dipped in hot water or in some medicated decoction. They 
act chiefly by virtue of their warmth and moisture, except in the case of 
narcotic fomentations, where some additional effect is obtained. 

A Dry Fomentation is a warm, dry application to a part, as a hot brick 
wrapped in flannel, a bag half filled with chamomile flowers made hot, and 
so forth. 

Fomentation of Herbs. — The herbs ordinarily sold by the apothecary 
for this purpose are southernwood, poppy heads, chamomile flowers, each 
two parts; bay leaves, one part. Four ounces of these to six pints of 
water. 

HOW TO MAZE COMPRESSES. 

Folded pieces of lint or rag so contrived as, by the aid of a bandage, 
to make due pressure upon any part, according to their shape, direction 
and use. Compresses have been called long, square, triangular, split, 
uniting, cubiform, and so forth. 

The compress of the hydropathists is a cloth well wetted with cold 
water, applied to the surface near the supposed seat of disease, securely 
covered with a dry cloth, and changed as often as it becomes dry. It is 
sometimes covered with a layer of oiled silk to prevent evaporation. 

HOW TO MAKE DECOCTIONS. 

Decoctions are solutions of vegetable principles obtained by boiling 
the substances containing these principles in water. Decoction is pre- 
ferred to infusion as a mode of extracting the virtues of plants when the 
call for the remedy is urgent and the greatest possible activity in the 
preparation is desirable. The process should be conducted in a covered 
93 



1476 MEDICAL MATERIALS. 

vessel, so as to confine the vapor over the surface of the liquid, and thus 
prevent the access of atmospheric air which sometimes exerts an injurious 
agency upon the active principle. The boiling, moreover, should not as 
a general rule be long continued, as the ingredients of the vegetable are 
apt to react on each other, and thus lose to a greater or less extent their 
original character. The substance should, if dry, be either powdered or 
well bruised ; if fresh, should be sliced, so that it may present an extensive 
surface to the action of the solvent. 

All vegetable substances are not proper objects for decoction. In 
many the active principle is volatile at a boiling heat, in others it undergoes 
some change unfavorable to its activity, and in a third set is associated 
with inefficient or nauseous principles, which, though insoluble or but 
slightly soluble in cool water, are abundantly extracted by hot liquid at 
the boiling temperature, and thus injure the preparation. In such cases 
infusion is preferable to decoction. Besides, by the latter process, more 
matter is often dissolved than the water can retain, so that upon cooling 
a precipitation takes place and the liquid is rendered turbid. When the 
active principle is thus dissolved in excess, the decoction should always be 
strained while hot, so that the matter which separates on cooling may be 
mixed again with the fluid by agitation at the time of administering the 
remedy. 

As a general rule glass or earthenware vessels should be preferred, 
as those made of metal are sometimes corroded by the ingredients of the 
decoction, which thus becomes contaminated. Decoctions, from the mu- 
tual reaction of their constituents as well as from the influence of the air, 
are apt to spoil in a short time. Hence they should be prepared only 
when wanted for use, and should not be kept in warm weather for a 
longer period than forty-eight hours. 



BOOK XIV 

Treats of Alcohol and Narcotics. Alcoholism and 
the Tobacco and Drug Habits are fully discussed and 
the newest and best cures given. 



Accessory Treatment for Drunken- 
ness 1483 

Alcohol and Ambition 1480 

and Conscience 1480 

and Narcotics 1479 

a Non-necessity 1481 

Use of 1479 

and Will Power 1480 

Effect of on Brain 1483 

Bad Effects of 1480 

Habit, Growth of 1481 

Hereditary Effects of 1481 

Alcoholism 1479 

Accessory Treatment for .... 1483 

Gold Cure for 1482 

Keely Cure for 1482 

Anodynes for Children 1489 

Cigarette Habit 1485 

Colic Cures 1489 

Cure of Tobacco Habit 1485 

Drink Habit, Gold Cure for 1482 

Keely Cure for 1482 

Drug Habit, The 1488 

Drunkenness, Gold Cure for 1482 

Gold Cure for Drunkenness 1482 

Administration of 1482 



Benefits from 1484 

Effects of on System 1482 

Formula of 1482 

In Last Stages of Habit 1483 

Habit, Force of ...*■ i486 

Headache Powders 1489 

Hereditary Effects of Alcohol ....1481 

Keely Cure, The 1482 

Narcotics 1485, 1488 

Nicotine 1485 

Reasons Why a Boy Should Not 

Use Tobacco 1487 

Smoke Habit 1485 

Soothing Syrups 1489 

Table of Temperate and Intemper- 
ate Life Chances 1484 

Temperate and Intemperate Life 

Chances 1484 

Tobacco, Facts Regarding Use of. .1485 

Tobacco Habit 1485 

Cause of i486 

Excuse for 1485 

Uselessness of i486 

Users, Adult i486 

Why a Boy Should Not Use 
It 1487 



1477 



Book XIV 



ALCOHOL AND NARCOTICS 

ALCOHOLISM— ITS TREATMENT AND CURE. 



Use of Alcohol. — The habitual and excessive use of alcoholic bev- 
erages is harmful in the extreme to the moral nature. Startling facts 
corroborate this opinion. They are historic. Scarcely a community is 
exempt from the evils of intemperance. One result most common is the 
loss of self-respect. Men addicted to this vice descend to the grossest 
immoralities. Before the taste and burning desire for liquor was acquired 
they were decorous and dignified ; but, degraded by the demoralizing 
appetite, they present the most pitiable spectacle of self-humiliation, all 
moral excellence disowned or lost. Nor is this result common to men of 
moderate talents or low extraction. 

Degrades Genius — Some of the brightest geniuses have exiled them- 
selves from the social circle of which they were ornaments, or have been 
banished therefrom, because of their violation of the courtesies and con- 
ventionalities of polite life. They have deliberately forfeited that con- 
servative element in human nature on which are based true dignity and 
manliness. 

Destroys Social Affections. — This baneful habit makes fearful inroads 
on the social affections. Friendships of long standing have been broken 
up because of the unreasonable exactions on patience and sympathy de- 
manded by the inebriate. Drunken husbands have exercised a tyranny 
over refined, cultured and amiable wives till, after long years of endur- 
ance, the sufferer has gone down broken-hearted to the grave. These 
are not cases confined to a few families; they are numbered by the 
thousands. 

Crushes Paternal Feeling". — The paternal relation has been made the 
occasion of untold pain to children who have become under the rule of 

1479 



1480 ALCOHOL AND NARCOTICS. 

an intemperate father the heirs of privation, cruelty and neglect. The 
paternal feeling has gradually been crushed out. There are records of 
feminine frailty of like character where the mother-instincts have been 
so far obliterated that one shudders to think of a degradation so abject 
being possible to the womanly nature. 

Loss of Ambition. — Loss of manly ambition is one of the sad results 
of this habit. The foe has invaded the precincts of the bar, the senate- 
chamber, the sacred desk, and hurled down to the dust brilliant men, who 
sacrificed honor, purity, holiness, popular affection and flattering pos- 
sibilities of wealth and fame at the shrine of this evil. This is a melan- 
choly page in the history of many great names. 

Stifles Conscience. — The great moral monitor, the conscience, often is 
made to hush its admonitions and become silent or dead. Acts the most 
abhorrent to men sober, by men drunk are committed without shame. 
Inflamed by a species of madness produced by drink, men perpetrate 
the darkest deeds. In fact, criminals have fortified their failing courage 
by repeated draughts of liquor to nerve them to the commission of some 
premeditated crime. Our civil tribunals are tortured with cases which 
would never be brought into court but for crime committed by men in 
a state of intoxication. So enormous, so brutal, have been some offences 
against the rights of society, and of individuals as well, that serious doubts 
arise whether the criminal has a conscientious scruple. The wreck of 
this high moral authority and guide is a sad monument of depravity. 

Destroys the Will. — There is another great moral force which is not 
exempt from the ravages of intemperance — the will. This power is the 
crowning glory of human nature. It is a gift of imperial authority with 
which man is dowered. When that is enfeebled or destroyed, the creature 
is unmanned, the sceptre falls from his hands. This regal quality may 
be enslaved by the vice of intemperance, and then the fate of the un- 
fortunate victim is sealed. There is then no prospect, no promise, of 
reformation. The farther the victim goes, the greater the momentum 
toward the inevitable doom. The facility of wrong-doing and the ten- 
dency grow in a fearful ratio, until he that was a strong man in will- 
power is enslaved, and is impelled along on the down grade to the last 
asylum, the grave. 

General Evil Effects. — Thus we trace the effects of a habit that has 
been a problem to physician, philosopher, jurist and minister. It is a 
question interesting to all students of human nature. The humanitarian 
is startled at the ruin the evil entails on the moral nature. The philan- 



ACTUAL EFFECT OF ALCOHOLIC LIQUORS ON THE 
HUMAN STOMACH AND INTESTINES. 





A healthy stomach 



Effect of a few glasses of intoxicants 




A stomach after ten or fifteen days 
continuous drinking. 




Last stages of an ulcerated stomach of 
an habitual drinker of intoxicants. 




Last stages of delirium tremens 




Effect of intemperance on the 
intestines . 



ALCOHOLISM. 1481 

thropist cannot contemplate unmoved the arena of disaster on which 
scenes so terrible transpire. The ravages of the monster are universal 
in their extent and complete in their character. The keenest moral sense 
is deadened, ennobling aspirations are extinguished, moral beauty is 
eclipsed. Chastity is ridiculed, virtue defamed, honesty despised, honor 
debased. Passions reign, selfishness is supreme. All excellence loses its 
lustre. These and many others are the bitter fruits of this appalling evil. 

Growth of the Habit. — Young and brilliant minds, noble and generous 
natures, yield most easily to the pressure of high artificial stimulation. 
At the beginning of the formation of the habit the effect on body and 
mind is invigorating and inspiring for a season. Life becomes during 
the delusive inflation a delirium of delight. The victim feels richer, 
more generous, more genial. The present is radiant and rosy, the future 
aflame with an aureole of glory. To these ignitable souls drink seems 
the elixir of life, the fabled nectar of the gods. But at the last, when the 
chains of habit are riveted, the victim, no longer free, but a slave, ex- 
periences all the horrors of remorse and self-condemnation. But his 
will is too enfeebled to break the shackles or resist the wand of the 
enchantress. He is numbered with that vast army, nearly one hundred 
thousand strong, who annually hasten to that dreary domain where the 
drunkard's journey ends. 

Hereditary Effects. — These unfortunates often leave behind to their 
offspring a legacy of mental and moral derangement. In a work entitled 
A Physicians Problems the history of four generations of a family is 
given to illustrate this theory of heredity. The facts are related as cor- 
roborative of the opinion that mental and moral tendencies and char- 
acteristics of the offspring are in a large measure affected by the vicious 
habits of intemperate parents. Homicidal and suicidal inclinations, mel- 
ancholy, disordered affections, gross impulses, were tracked along down 
to the fourth generation, when, fortunately, the race terminated. The 
reader is referred to the collection of facts in the book named as of great 
scientific import on this subject. 

Other Food Sufficient. — There are those who have never experienced 
in themselves the dreadful effects of intemperance, having never used 
intoxicating liquors. The abstinence in these persons — and they are 
numerous — appears to favor the impression that except in disease no 
other stimulus is needed for a full mental, moral and physical manhood 
than that which food, rest, occupation and pure air supply. The moral 



1482 ALCOHOL AND NARCOTICS. 

well-being of the human race would no doubt be best subserved by plain 
diet, pure emotion and high thought. 

THE GOLD CURE FOR DRUNKENNESS. 

The Gold Cure for drunkenness, including the Keely Cure and some 
other systems, has many ardent advocates and unquestionably has made 
some wonderful cures. Without claiming for it all that these advocates 
do, we give beloAv what we believe to be the most approved Gold Cure 
formula, and also state the claims of its supporters. 

Formula of the Cure — While the treatment of nervous exhaustion, 
alcoholism, and so forth, is more particularly hygienic and dietetic, yet it 
is often impossible to dispense entirely with drugs. Recently the fol- 
lowing formula has been widely recommended in such cases : 

FORMULA. 

Arsenious acid 19 grains 

Tribromide of gold 14 grains 

Bromine water sufficient 

Distilled water sufficient 

Ten minims of this solution for injection equals one-thirty-second grain of 
gold tribromide. In this form it should be given by a physician. 

The physiological action of this remedy is most remarkable. It is an 
active tonic, powerful sedative and destroys the appetite or cravings for 
alcoholic stimulants. 

Its Effects on the System. — In those forms of dyspepsia caused by 
indulgence in alcoholic stimulants, which are associated with the forma- 
tion of gases, acid eructations and fermentative action in the contents of 
the stomach, in fact, where there is a retention or over-production of 
noxious products, the indications are to prevent the absorption of poison- 
ous material or to destroy this poison within the organism by stimulating 
the liver and to eliminate the poison through the skin, kidneys and 
intestines. This the cure accomplishes in a most marked degree, and 
many claim will give entire relief. 

Combating the Evil. — Our knowledge of the method in which drugs 
remove the cause of disease and counteract its effects greatly increases 
our power of lessening suffering, but we require something more. We 
must combat the evils produced by disease at all points of attack. 

Administration of the Cure — The more full our knowledge of the 



ALCOHOLISM. 1483 

mode of action of the new agents, the better our information about their 
effects upon the organs and tissues, the less likely our judgment concern- 
ing them goes astray. Knowledge of the action of drugs must be com- 
bined with careful observation of their curative influence. Therefore, 
having secured the right drug, it must be administered as the old painter 
mixed his colors, "with brains." The question of age, sex, constitution, 
dosage, and so forth, must all be considered. Individuals of susceptible 
nervous temperament will require minute doses, frequently repeated. 
If we are treating a local lesion we apply our remedies right to the spot. 
So drugs have their affinities, and, given in the proper indications, go 
straight to the diseased area. So with the cure, in nervous prostration 
from excesses it relieves because it is a diffusible, non-reactive stimulant, 
keeping the threadbare areas constantly bathed in fresh blood and giving 
them an opportunity to recuperate. 

Effect of Alcohol. — We know that the presence of alcohol in the 
blood directly lessens the efficacy of respiration in proportion to the 
quantity present. In other words, it produces that condition in which 
we have a congested state of the brain. It is manifested by headache, 
delusions, mania, and so forth. 

Accessory Treatment. — For the persistent retching and vomiting, or 
for the headache and wakefulness following a debauch, teaspoonful doses 
of fluid extract of coco, with a little elixir valerianate of ammonia, in 
conjunction with the cure, will be found a palatable, prompt and uniform 
restorative. 

The Most Modern Cure. — It is claimed by its advocates that this system 
is the most modern, scientific and rational, and the most eminently satis- 
factory method of destroying the craving and appetite for alcoholic stim- 
ulants which has yet been discovered and that it permanently reinvigorates 
the functions, and, in fact, all the functions of the body. 

Cures Even Last Stages. — It is claimed by its advocates that this treat- 
ment takes a person suffering with the drink crave or habit, even if he 
has reached the stage of delirium tremens, and within three or four weeks 
restores him to perfect health without loss of time from business or work, 
and effectually destroys all appetite for liquor to which he was a slave 
before commencing the treatment. 

Take Regularly. — It is to be emphasized that the medicine is to be 
taken regularly four or five times a day. After a few days' use an im- 
provement in the general health should be noticeable. The medicine if 
scientifically administered produces no ill effects. On the contrary, it 



1484 ALCOHOL AND NARCOTICS. 

builds up the system, tones up the nerves, improves the appetite and 
strengthens every function of the body and will destroy the diseased 
appetite for alcoholic stimulants, whether the patient is a confirmed 
drunkard or a "tippler" — or a social drinker. 

Perseverance Necessary. — One of the greatest obstacles in using this 
remedy is the over-confidence of the patient who discontinues the medi- 
cine when he begins to feel all right. It is a fatal mistake to imagine he 
is cured then. His system is by no means free from alcohol. If he were 
to die at this stage of the treatment — that is, a couple of weeks after 
using the medicine — and his brain be removed, it would be found so 
saturated with alcohol that it would burn with a blue flame, as an alcohol 
lamp does when a lighted match is applied. Not only is the body still 
impregnated with alcohol, but the nervous organism is not sufficiently 
restored to withstand the temptation which is sure to rise up as an evil 
spirit before him and lure him again to destruction. 

Benefits from the Start. — The benefit of the medicine is felt from the 
beginning, and the patient is afforded relief at once. After three days 
he refuses liquor voluntarily, and each day the desire decreases until a 
complete cure is effected. 



TEMPERATE AND INTEMPERATE LITE CHANCES. 

An intemperate person's chance of living is — 

At 20 years of age . = 15.6 years. 

At 30 " = 13.8 " 

At 40 " . . = 11.6 " 

At 50 " = 10.8 " 

At 60 " . . = 8.9 " 

A temperate person's chance of living is — 

At 20 years of age . = 44.2 years. 

At 30 " = 36.6 " 

At 40 " = 28.8 " 

At 50 " = 21.25 " 

At 60 " = 14.285 " 

The average duration of life after beginning the habit of intem- 
perance is — 



TOBACCO HABIT. 1485 

For laboring men, mechanics, etc. 18 years. 

For merchants, traders and commercial 

men : 17 " 

For professional men 15 " 

For females 14 " 



TOBACCO HABIT AND CURE. 

The use of tobacco in one form or another is so universal that to decry 
its use is apt to meet with well-fought opposition by a large section of the 
world's inhabitants. Nevertheless there are many and strong arguments 
against its use. It is true that it has the power of increasing secretions 
along the alimentary canal, the stimulation of peristalsis and the function 
of the kidneys when used in moderation, and it is also undeniable that 
many users of tobacco remain healthy and live to old age. Yet the argu- 
ments against its use are many, and those which follow are worthy the 
consideration of both users and nonusers. 

Nicotine. — There is no deadlier poison in nature than Nicotine. A 
drop or two of nicotine is sufficient to cause death. Like all poisons it is 
highly stimulating for the instant, soon to be followed by its death-like 
effects. It is the peculiar poison which tobacco in any and all of its forms 
yields. The tobacco chewer, snuff taker, cigar smoker, and cigarette 
fiend, no matter what his or her reason be for indulgence in the weed, 
is simply administering poison to the vitals. 

Excuse for the Habit. — To be sure, the administration of poison to 
oneself through the agency of the plug, cigar, cigarette or snuff is not 
immediately dangerous. Many excuse such unwise administration on the 
plea that tobacco calms their nerves and conduces to sleep and comfort. 
Others say it is a sedative that conduces to thought. It is generally sup- 
plied to soldiers on the theory that it keeps them contented in camp, en- 
ables them to beter withstand the fatigue of long marches, and in a 
limited sense supplies the lack of food. But most, if not all, of these 
claims are imaginary. They are made, as a rule, by slaves of the habit, 
and as a justification of their folly. 

Tobacco Facts The boy or girl who uses tobacco before reaching 

maturity is sure to wreck the nervous system and take a long step toward 
idiocy or insanity. Perfect, clean, energetic and acceptable manhood or 
womanhood is impossible for a youthful tobacco poisoner. No matter 
how slow the administration of the poison may be, it is relatively quicker 



■ 
1486 ALCOHOL AXD XAECOTICS. 

in its action than upon older people, because young nerves are the more 
tender and sensitive, more easily affected. As between the user and non- 
user of tobacco the latter is preferred every time. The youth who uses 
tobacco before maturity is his own greatest enemy, and readily ranks as a 
crass fool. 

Adult Tobacco Users — It is to be doubted whether any sane adult 
ever deliberately learned the tobacco habit. They either imitate others, 
lest they appear odd, or the habit has crept insidiously on them. Again, it 
is to be doubted whether a sane man exists who does not deprecate the 
habit and wish he were rid of it, and this deprecation exists in spite of 
the fact that he is ready for excuses for indulging the habit. In this 
respect tobacco users are open to the charge of inconsistency. 

The Force of Habit. — Habit is a hard master, a veritable tyrant. It 
gloats in its triumphs and laughs while its slave writhes. So tyrannical 
and brutal is it that, as in the case of alcohol, it causes such degeneracy 
of tissues and organs as to take rank with actual disease, that of alcohol- 
ism. This is in some sense true of the tobacco habit. The difficulty 
of ridding oneself of it leads to the belief that it really weakens the will 
power and those forces which contribute to moral self-control. 

Uselessness of the Habit. — Xo non-user of tobacco ever felt the worse 
or expressed regret over his abstentation. Xo user of tobacco ever denied 
that the habit is — 

1st. A filthy one, in that it begets frequent spitting of stained saliva 
by ch'ewers, sickening smoke odors by smokers, and discharge of dis- 
colored mucous by snuffers. Add to this the disgustingly odorous smoke of 
the cigarette fiend, and then wonder what worse in the way of filth can 
be realized. 

2d. Xo matter what the natural constitution or the excuse, the habit 
is a dangerous one. It grows by what it feeds upon, and leads to gradual 
and insidious wreckage of the finer sensibilities and active nerve forces. 

3d. It is an expensive habit, often entailing poverty, and always 
diminishing the recompense of labor. In the families of those who earn 
meagre support its expensiveness is almost the equivalent of robbery of 
wife and children. Destitution lies in the wake of tobacco almost as 
surely as in that of alcohol. 

4th. It is an inconvenient habit and very often interferes with work, 
however much some may claim that it increases the ability to work. 

Is There a Cure? — Yes. But not outside of the man's self. To in- 
troduce tobacco substitutes is not a cure, for very often the whole to- 



TOBACCO HABIT. 148? 

bacco habits consists in the mere presence of a mere quid in the mouth or a 
cigar in the mouth. To keep the nervous system up to the tobacco tone 
by means of drugs would be to introduce into the system something which 
might lead to worse results than nicotine poison. It is all with the man. 
He should bring his mightiest will-power to bear upon the habit. He 
should never forget all the inconveniences and harmful results of indul- 
gence. Bear them in mind; magnify them, if possible. Shape up every 
fibre to combat the situation. Eesolve to be a free man. Persevere in 
the resolve. Weaken at no point of conflict nor at any time. Two or 
three weeks of abstentation will brace the will-power. It will feel en- 
couraged by triumph, will grow stronger and stronger, and finally rejoice 
in entire mastery of the habit. 

ONE DOZEN GOOD REASONS WHY A BOY SHOULD NOT USE TOBACCO. 

1st. Cigarettes or tobacco in any form hinder the growth and injure 
the nerves and health. 

2d. Cigarettes foster the tobacco habit, and may make any boy a 
slave to it. 

3d. The cigarette habit does not help a boy in his lifework, and 
may prevent him from obtaining a good position in business. 

4th. Most all reliable business establishments refuse to employ boys 
who smoke cigarettes. 

5th. The following are among the poisons and drugs used in the 
manufacture of cigarettes: Arsenic, Creosote, Nicotine, Opium, Salt- 
petre, Tonca flavoring and Kum, all of which are harmful. 

6th. Cigarette smoking makes a boy dull and stupid, impairs his 
memory and prevents his advance in school. 

7th. Smoking creates an unnatural thirst, which may lead to drink- 
ing intoxicating liquors. 

8th. Smoking is a selfish habit which may cause annoyance, dis- 
comfort and distress to others. 

9th. Tobacco affects the eye, ear and nose, or sight, hearing and 
smelling, and also the heart. 

10th. It costs more than most boys can afford to pay to have their 
nerves and health ruined. 

11th. Smoking is a useless and expensive habit, and always does 
harm in a greater or less degree. 

12th. It is also a filthy habit and defiles the body, and anything 



1488 ALCOHOL AND NARCOTICS. 

that denies or injures the body is a sin against God, who created man 
in His own image. 



THE DRUG HABIT. 

Narcotics in General. — The most common narcotic in use is probably 
tobacco, but cases which demonstrate its injury to the morals are so few 
that no dogmatic opinion can be given, except that its excessive use in 
the cigarette form, as also in the ordinary ways of chewing, smoking and 
snuffing, has a tendency to foster in the young inclinations destructive 
of a high moral tone. Hasheesh, opium, chloral, when used habitually 
and excessively, have been known so to injure the health and disarrange 
the mental action that the moral sense protests against their use. Under 
the prescription of a physician they may be used to allay pain or produce 
sleep in restless invalids, but the unprofessional use of them is extremely 
fatal to mind and morals, dulling and stupefying one and producing 
erratic action in the other. The excessive habitual use of these artificial 
stimulants creates a morbid moral state unfavorable to the promptings 
of duty, and promoting a condition unsuited to meditation on moral sub- 
jects, especially where the victim is deprived temporarily of the stimulus. 
The longing, the irrepressible sense of uneasiness, the restlessness, which 
the sufferer, deprived of his habitual ration, endures, indicates a moral 
as well as a mental state unhealthy and perverted. 

At a conservative estimate there are to-day from three to Hrve thou- 
sand Americans — male and female — who are incurably addicted to the 
smoking of opium twice a day, and this is only one item in a startling list, 
for irrefutable statistics prove that from New York to San Francisco, and 
from Canada to the Gulf of Mexico, there is a steady increase also in the 
consumption of acetanilid, acetphenetidin, antipyrin, phenacetin, caffein, 
codein, dionin and heroin. 

There has been a steady increase also in the use of other drugs that 
are almost if not quite as destructive to mind and body as opium. Of 
cocaine, the most insidious of known narcotics, a drug that wrecks its 
victim more swiftly and surely than even opium, there is an enormous 
quantity being used in this country. Despite the enactment of drastic 
laws looking to the suppression of illicit traffic in cocaine, it is estimated 
that between 125,000 and 175,000 ounces are annually consumed in this 
country. The drug has many legitimate uses, but of the vast quantity 
annually consumed, it is estimated that over fifty thousand ounces go to 
wreck the bodies, minds and souls of its unhappy victims. 



THE DRUG HABIT. 1489 

Hundreds of thousands of Americans are constantly using "head- 
ache powders" that contain acetanilid, a dangerous drug, other thousands 
cannot sleep without swallowing a quantity of chloral hydrate, which is 
the "knock-out drops" of the professional thief. It is not too much to 
say that any girl, if she be so minded, can obtain opium, morphine, co- 
caine, or any other of the habit-forming drugs as easily as a factory girl 
can buy her cheap and fiery spirits. Nor is the statement exaggerated 
that in boudoirs there are far more drugs consumed than there are alco- 
holic beverages in smoking rooms. 

The sanitariums are crowded with drug victims. The American, by 
incessant work, and by the continual strain on the nervous system neces- 
sitated thereby, frequently finds himself run down, and suffering from 
dyspepsia, neuralgia, and various other ills and pains — sure symptoms 
that the body is rebelling against its abuse. Instead of endeavoring to 
recuperate by rational and sane methods, the sufferer drugs himself into 
insensibility with some pet "cure." Apparently he does not understand 
that pain and lassitude are the red flags hung out by Nature to show 
that there is danger ahead. 

It has long been known to the medical profession that colic cures, 
children's anodynes, "infants friends," teething concoctions, etc., contain 
habit-forming drugs, but the majority of mothers have been and still are 
"ignorant" of this fact ! Lest any suspicion or fear should be aroused in 
the mind of the mother by the fact that the presence of opium, morphin, 
chloroform, cannabis indica, or some other harmful drug is declared upon 
the label, the manufacturer or dealer endeavors to allay such fear by state- 
ments of the following character: "Contains nothing injurious to the 
youngest babe." "Mothers need not fear giving this medicine to the 
youngest babe, as no bad effects come from the continued use of it." 

Notwithstanding the fact that these representations have been elim- 
inated or modified so as to comply with the letter of the Pure Food Law, 
mothers, because of past representations and the fact that the false im- 
pressions left by them have not been corrected, believe that these soothing 
remedies are neither harmful nor habit-forming, and give them with a 
feeling of security, with the result that in many instances the baby is put 
to sleep never to awake again. Numerous cases of this character are on 
record. In some instances in which the remedy is freely used, there is 
developed a case of infant drug addiction. As soon as the effect of one 
dose passes away, the child becomes irritable and fretful, with the result 
that another dose is administered. The craving is met and the child is 



1490 ALCOHOL AND NARCOTICS. 

quiet, a condition which is similar in every respect to drug addiction 
among adults. 

The chief agents of soothing syrups are well known to be opium, 
morphin, heroin, codein, chloroform, and chloral hydrate in some com- 
bination. A serious element of danger in the use of soothing syrups is 
the fact that the nurses often use them, unknown to mothers, for putting 
children to sleep. 

The head of a big wholesale drug house in New York testified in 
court some time ago that samples of a certain catarrh "cure" were being 
given away in ISTew York City with the object of creating an appetite 
for them, and thereby increasing their sale at the expense of the moral, 
mental, and physical health of the community. The vaunted values of 
patent medicines offered as remedies for asthma, catarrh, coughs, colds, 
consumption and hay fever depend in nearly every case upon the presence 
of certain powerful drugs, such agents as cocaine, chlorohydrate, codein, 
heroin, morphin, opium and nicotine being present. 

The medical profession, State boards of health, pharmacy boards and 
others interested in the public welfare have instigated a vigorous crusade 
against the indiscriminate sale of cocaine or mixtures containing it, but 
there are many ways found by the unscrupulous for evading the law. 
Another difficulty is that street vendors obtain these poisons in various 
ways and peddle them. The ingenuity and cunning of these peddlers is 
astonishing. For example, one was discovered carrying about a supply 
of morphin and cocaine in a book hollowed out for the purpose. The edges 
of the leaves and one of the covers were glued together, and the body of 
the pages cut out, thus leaving a book-like box, which was innocent look- 
ing and well adapted for the devilish business. 

There are on the market to-day over thirty "mail order treatments" 
for drug victims, whose cunningly worded advertisements have lured for- 
tunes into the pockets of their unscrupulous vendors. It is usually repre- 
sented by the exploiter of these "treatments" that the habit can be success- 
fully treated at home, by the particular treatment advertised, and its com- 
position is a profound secret, known to him alone. In most instances they 
contain the very drug or drugs for which the treatment is advertised and 
sold. 



BOOK XV 

Describes the various schools of medicine and 
methods of healing. It is divided into eleven chap- 
ters, each chapter being as complete as it is possible 
to make it in a book of this character. 



HOMEOPATHY. 

Abscesses 1497 

Apoplexy 1497 

Anus 1497 

Arms 1497 

Asthma 1497 

Back, Pains in 1499 

Bed Sores 1498 

Bladder 1498 

Inflammation of 1503 

Bleeding 1498 

Blood Poisoning 1499 

Boils 1498 

Bones 1499 

Bowels, Inflammation of the 1503 

Bronchitis 1498 

Bruises : 1499 

Burns 1499 

Cancer 1499 

Carbuncle M99 

Catarrh in the Head 1499 

of the Stomach 1499 

Chest, Stitches in 1499 

Chicken-pox 1500 

Chills and Fever 1500 

Cholera Infantum 1500 

Cholera Morbus 1500 

Cold 1500 

Colic 1500 

Constipation 1500 

Consumption 1500 

Cough 1500 

Cramps 1500 

Croup 1 500 

Diarrhoea 1501 

Diphtheria 1501 

Dropsy 1 501 



Dysentery 1501 

Dyspepsia 1501 

Ear 1501 

Eczema 1501 

Erysipelas 1503 

Eyes 1502 

Face 1 502 

Fainting 1503 

Feet 1502 

Felon 1502 

Gout *. . . 1503 

Grippe 1502 

Headache 1503 

Heartburn 1503 

Heart, Palpitation of the 1505 

Hives 1503 

Homoeopathy 1495 

Inflammation of Bladder 1503 

of the Bowels 1503 

Jaundice 1 503 

Leucorrhea 1503 

Lumbago 1504 

Malaria 1504 

Measles 1504 

Menses, Suppression of the 1502 

Menstruation, Copious 1502 

Painful 1503 

Tardy t 502 

Mind 1504 

Morning Sickness 1504 

Mouth 1504 

Mumps t 504 

Neuralgia 1504 

Neurasthenia 1504 

Nose-bleed 1504 

Pains 1505 

Palpitation of the Heart 1505 

Palsy 1505 



94 



1491 



1492 



IOTEX TO BOOK XV. 



Piles 1505 

Pleurisy 1505 

Pneumonia 1505 

Quinsy 1505 

Rheumatism 1505 

Scarlet Fever 1505 

Sleeplessness 1506 

Small-pox 1506 

Sore Nipples 1506 

Sore Throat 1506 

Spasms 1506 

Suppression of the Menses 1502 

Toothache 1506 

Typhoid Fever 1506 

Ulcers 1506 

Urinary Difficulties 1506 

Varicose Veins 1507 

Vertigo 1506 

Warts 1507 

Whooping-cough 1507 

Women, Diseases of 1507 

Worms . . 1507 

OSTEOPATHY. 

Cardiac Plexus, The 1515 

Cause of Disease 1512 

Drugs Harmful 1511 

Nervous System, The 1514 

Osteopathic Examination 1512 

Osteopathy 1508 

Essential Principles of 1513 

Object of 1512 

Practical 1517 

Requirements of 1510 

Pulmonary Plexus 1515 

Solar Plexus 1515 

Spinal Column 1516 

Subluxations 1516 

Therapeutics 1513 

Treatment in Osteopathy 1517 

Vertebra, The 1516 

MASSAGE. 

Abdomen, Treatment of 1521 

Local Massage 1523 

Manipulation in Massage 1520 

Massage 15 18 

Duration of 1522 

General 1522 

General Treatment in 1518 



of the Legs 1522 

Methods of 1519 

Treatment of Abdomen 1521 

CHIROPRACTIC. 

Chiropractic 1524 

Principles of 1525 

ILLUSTRATIONS 

Spinal Foramena 1525 

Normal and Pinched Nerves 1525 

HYDROPATHY. 

Ablution '. 1529 

Acute Cholera Infantum 1541 

Affusion 1532 

Anemia 1 542 

Baths, Different Kinds of 1537 

Chest Compress, The 1535 

Cholera Infantum \ . . 1541 

Chronic Rheumatism 1542 

Cold Full Bath 1536 

Rub 1533 

Compresses, Different Kinds of... 1535 

Consumption 1542 

Douche, The 1538 

Drip Sheet Bath 1533 

Dyspepsia 1543 

Functions of the Skin 

General Ablution 1531 

Gout 1542 

Half Bath, The 1531 

Hammock Bath 1538 

Head Compress, The 1535 

Hot Compress, The 1536 

Hot Fomentation Compress, The.. 1536 

Human Skin 1528 

Hydropathy 1527 

Hydrotherapy 1527 

In Chronic Affections 1530 

Special Diseases 1539 

Internal Use of Water 1543 

In Acute Infectious Diseases .. 1543 

In Gastric Catarrh 1543 

Lack of Blood 1542 

Measles 1540 

Neuralgia 1542 

Physiology 1528 

Pneumonia I54Q 



INDEX TO BOOK XV. 



1493 



Poorly Nourished Subjects 1543 

Properties of Water ' 1529 

Russian Bath 1539 

Scarlatina 1540 

Sheet Bath 1532 

Skin a Heat Regulator 1528 

Steam Bath 1538 

Sunstroke 1541 

Throat Compress, The 1535 

Tub Bath 1536 

Turkish Bath 1539 

Typhoid Fever 1539 

Value of Water 1529 

Warm Full Bath 1537 

Water-Cure 1527 

Internal Use of 1543 

Well-nourished Subjects 1543 

Wet Compress, The 1535 

Pack, The 1534 

In Chronic Diseases 1534 

ECLECTIC MEDICINE. 

Acute Bronchitis 1554 

Asthma 1555 

Bites and Stings 1553 

Bronchitis, Acute 1554 

Chronic 1554 

Chicken-pox 1552 

Chronic Bronchitis 1554 

Cold 1553 

Conditions of Disease 1545 

of Health 1545 

Continued Fevers 1548 

Coryza 1553 

Diphtheria 1552 

Dysentery 1556 

Eclectic Diagnosis 1546 

Medicine 1545 

Treatment 1546 

Enteric Fever 1548 

Febrile Diseases 1546 

Influenza 1553 

Intermittent Fevers 1547 

Intestinal Worms 1556 

Measles 1 55° 

Pertussis 1555 

Poisonous Bites 1553 

Poisonous Stings 1553 

Rubeola 1550 

Scarlatina 155* 

Scarlet Fever 1551 



Stings and Bites 1553 

Tonsillitis 1553 

Typhoid Fever 1548 

Typhus Fever 1550 

Varicella 1552 

Whooping-cough 1555 

Worms, Intestinal 1556 

JAPANESE TREATMENT. 

Acute Gastric Catarrh 1568 

Aneurism of Aorta 1568 

Angina Pectoris 1568 

Asiatic Cholera 1564 

Asthma 1567 

Bronchitis 1567 

Burns, Cure for 1570 

Cancer of the Stomach 1569 

Canine Rabies 1562 

Carbolic Acid Poisoning 1570 

Cardiac Insufficiency 1568 

Cerebro-Spinal Meningitis 1563 

Chancre 1 565 

Chicken-pox 1562 

Cholera, Asiatic 1564 

Nostra 1562 

Chronic Gastric Catarrh 1568 

Convulsions, Curing 1570 

Croup 1564 

Croupous Pneumonia 1563 

Dilatation of the Stomach 1569 

Diphtheria 1564 

Dysentery 1562 

Endocarditis 1568 

Epidemic Cerebro-spinal 

Meningitis 1563 

Erysipelas 1563 

Gastric Catarrh 1568 

Ulcer 1569 

Gonorrhea 1565 

Grippe 1564 

Infantile Colic 1570 

Infectious Diseases 1561 

Inflammation of the Mouth 1568 

Intestinal Catarrh 1569 

Japanese, Care of Skin Among. ... 1559 

Characteristics of the 1557 

Treatment of Disease 1557 

Jaundice 1569 

Laryngeal Catarrh 1567 

Leprosy 1 565 

Malarial Fever 1563 



1494 



INDEX TO BOOK XV. 



Measles 1561 

Morphine Poison 1570 

Mouth, Inflammation of 1568 

Mumps 1562 

Nervous Dyspepsia 1569 

Palpitation 1568 

Opium Habit, Cure of 1570 

Pericarditis 1568 

Plague, The 1563 

Pleurisy 1567 

Pregnancy Nausea 1 570 

Pulmonal Emphysemata 1567 

Relapsing Fever 1563 

Rheumatic Diseases 1563 

Joints 1570 

Round Worm 1569 

Scarlet Fever 1561 

Seat Worm 1569 

Small-pox 1562 

Snake Bites 1570 

Syphilis 1565 

Taking the Pulse 1570 

Tape Worm 1569 

Tetanus 1565 

Tuberculous Diseases 1563 

Typhoid Fever 1564 

Vaccination 1562 

Worms, Different Kinds of 1569 

Wounds, Poisonous 1570 

Whooping-cough 1562 

Yellow Fever Treatment 1563 

ILLUSTRATIONS 

Japanese Lady (Middle Class) 1558 

Japanese Ladies (Upper Class) 1558 

GERMAN TREATMENT. 

Ague 1579 

Boils 1580 

Bright's Disease 1573 

Cancer 1574 

Catarrh 1576 

Chicken-pox 1572 

Cholera Morbus 1576 

Cold 1581 

Consumption 1580 

Croup 1582 

Diphtheria 1581 

Dyspepsia 1582 

Felon 1582 



German Medical Treatment 1571 

Gonorrhea 1579 

Gout 1583 

Itch 1574 

Jaundice 1584 

Kneipp Cure 1571 

Mumps 1585 

Rheumatism 1585 

Scarlet Fever 1586 

Small-pox 1586 

Syphilis 1583 

Whooping-cough 1587 

Worms 1573 

ELECTRICITY. 

Anemia 1588 

Catarrh 1588 

Consumption 1588 

Diabetes 1589 

Dyspepsia 1588 

Electricity in Medicine 1588 

Epilepsy \ . . 1588 

Falling Sickness 1588 

Fits 1588 

Kidney Disease 1589 

Nervous Debility 1588 

Neuralgia 1 589 

Palsy 1589 

Paralysis 1589 

Rheumatism 1589 

Sciatica 1589 

X-ray, The 1589 

MENTAL HEALING. 

Christian Science 1602 

Hypnotism 1595 

Mental Healing 1591 

Mesmerism 1592 

Mind-cure 1598 

Telepathy 1601 

Trance in Hypnotism 1597 

HUMAN SCIENCE. 
Human Science 1604 

Object of 1604 

Language of the' Hand 1613 

Palmistry 1613 

Phrenology 1606 

Principles of 1607 

Physiognomy 1610 

ILLUSTRATION 

Character Lines of the Hand 1617 



Book XV 



MEDICAL SCHOOLS 

PART I. 
HOMOEOPATHY 



The father of homoeopathy, Samuel Christian Friedrich Hahnemann, 
was born at Meissea, Germany, on the 10th of April, 1755, and died in 
Paris on the 2d of July, 1843. 

In 1790, while engaged in translating into German the Materia 
Mediea of Cullen, a Scotch physician, he was struck with the similarity 
between the recorded effects of cinchona (Peruvian bark) and some of the 
symptoms of Fever and Ague. After careful experimentation upon him- 
self and many others through a period of six years, he announced in 1796 
as a curative law that medicines act upon the principle of similia similibus 
curantur, or in other words that the symptoms of disease in an individual 
may be best removed by medicines which cause similar symptoms when 
administered to healthy persons. It naturally follows that remedies ad- 
ministered upon this principle must be given in small or minute dosage 
or else the patient's condition would be made worse. Hence the practice 
of attenuation of remedies by dilution or trituration. 

The employment of serums, bacterias and vaccines which at the pres- 
ent time is more or less popular, is also a vindication of homoeopathic 
ciples. Homoeopathic physicians are in accord with all that tends to the 
improvement of the curative art and the prevention of disease. Their 
broadmindness and cultural requirements are probably best shown by 
quoting the definition of an homoeopathic physician as officially adopted 
by the American Institute of Homoeopathy : 

"A homoeopathic physician is one who adds to his knowledge of medi- 
cine a special knowledge of homoeopathic therapeutics. All that pertains 
to the great field of medical learning is his by tradition, by inheritance, 
by right." 

1495 



1496 HOMOEOPATHY. 

ADMINISTRATION OF THE MEDICINES AND REPETITION OF DOSES. 

Doses for Adults — The medicines may either be administered dry, by 
placing them on the tongue, or dissolved in water. In most cases four 
or five globules should be placed dry on the tongue. 

Infant Doses — For infants one globule will be amply sufficient for a 
dose. If the tongue is dry add a few drops of water. Even new-born in- 
fants are able to swallow that. 

Dosage in Solution. — Where repeated doses of the medicine at short 
intervals are required the appropriate remedies should be administered 
in solution, in water. Fill a tumbler half full of pure water, put eight 
or ten globules — or, if a trituration, as much as will lie on the point of 
a penknife — of the medicine into the water and mix it thoroughly. When 
thus prepared, a dessertspoonful to adults, or a teaspoonful to children, 
may be given at a time. 

Following Symptoms — If the patient is worse after the first or sec- 
ond dose the symptoms are either the same, but worse, or there are new 
symptoms instead of, or in addition to, the former ones. In the latter 
case give another remedy. In the former case when the medicine aggra- 
vates the symptoms and makes the patient temporarily worse (which is, 
nevertheless, a good sign) the patient should cease talcing it, and wait 
for the effects. Should the aggravation be violent it may be relieved by 
smelling camphor or sweet spirits of nitre. 

Relieving Pain. — It sometimes happens that the most violent pains are 
increased very much by the smallest dose of the suitable remedy. In such 
cases give a spoonful of black coffee, and as soon as the aggravation has 
ceased repeat the remedy. If made worse again repeat the coffee, and so 
on until the improvement is permanent. 

Tincture and lotion. — With regard to the external application of the 
tincture of arnica, ruta, and so forth, a lotion of sufficient strength for 
most purposes may be made by putting five or six drops of the tincture in 
half a tumbler of water. It may be applied to the injured part three or 
four times a day, or as often as mentioned under each particular case. 

DISEASES AND THEIR HOMEOPATHIC TREATMENT. 

The diseases are given in their aphabetical order, so that they may 
be referred to quickly. 

Homoeopathy differs from the other regular schools of medicine merely 



HOMOEOPATHY. 1497 

in the treatment of the disease, in that it treats the individual patient and 
not the disease per se. 

Consequently, as the cause, symptoms and diagnosis of each disease 
are given elsewhere in the book, in this chapter we will confine ourselves 
to the homoeopathic treatment. 

Abscesses. — An acute abscess should not be poulticed with warm bread 
and milk or linseed poultices, except in extreme cases. It is much better 
to use nothing but warm or cold water. Hepar or mercurius hasten the 
suppuration. 

If the suppuration should continue for a considerable length of time 
use silicea. When hard places remain, mercurius will be useful. For 
hard and swelled glands on the neck and under the chin and ears use mer- 
curius, dulcamara, calcarea carbonica, and so forth. 

Anus. — Intolerable itching, rathania ; cracked or fissured, graphites ; 
burning, aloe; red or sore, arsenicum .; moist and itching, petroleum. 

Arms. — Numb feeling, ignatia; covered with purplish spots, pain in 
axillary gland, kali carb ; rheumatic pain in jonts, ledum ; elbow or wrist 
hot and swollen, mercurius ; arms and shoulder lame in wet weather, rhus 
tox. ; painful on motion, bryonia ; eruptions at bend of elbows, sepia ; 
offensive sweat in arm pits, silicea or sulphur; herpes at elbow, thuja; in- 
voluntary jerking, agaricus ; wrist as if sprained, bryonia or rhus tox. ; 
cramp and dead feeling, calcarea carb. 

Apoplexy — Bleeding is sometimes practiced. If the pulse is slow and 
full, face red or purple, give opium; put a few globules of it upon the 
tongue and use some globules dissolved in a pint of water as an injection, 
if the pulse is very weak give lachesis in the same way. 

If it was preceded by nausea, or if the patient vomits when he re- 
covers, give antimonium tartaricum; if not better in half an hour, use 
a solution of the same remedy as an injection. Aeon., bell., nux vom., etc. 
may also be required. 

Asthma. — Ipecacuanha will be indicated where there is a feeling of 
constriction about the chest, accompanied by nausea or vomiting. 

Arsenicum for the most violent attacks, especially those occurring in 
consequence of suppressed catarrh, or in persons with weak lungs. 

Bryonia or apis are of great benefit, particularly when exercise ag- 
gravates the disease, and when it arises from suppressed or tardy erup- 
tions. Bryonia when the paroxysms come on at night and are attended 
by pain in the bowels. Apis if the neck feels as if it were compressed. 



1498 HOMCEOPATHY. 

Xux vomica and lachesis are often beneficial when the patient is 
forced to sit stooping forward. 

Belladonna is most suitable when the attacks are made worse by 
motion. 

Arnica is indicated when not only exercise but even speaking or blow- 
ing the nose aggravates the symptoms. 

Cepa and euphrasia if children awake suddenly in the night with a 
suffocating cough. 

If the chest feels constricted give glonoine. 

Cinchona when there is whistling and wheezing in the chest. 

Coffea in very sensitive persons who are liable to attacks of asthma 
in consequence of mental emotions. Aconite, pulsatilla, nux vomica, 
ignatia, chamomilla, and stapisagria are also given in these cases. 

Chamomilla is also serviceable when there is frequent inclnaton to 
cough. 

Rhus when there is very labored breathing. 

Sulphur for short, wheezing, obstructed respiration with fear of 
suffocation. 

Bed Sores — Applications of cold water are often beneficial. 

When water alone will not effect a cure, dissolve in it a few drops of 
arnica tincture. 

If there appears to be danger of mortification, give cinchona and 
wash the spots with the same medicine dissolved in a little water. 

Bladder — See Inflammation of Bladder, Hemorrhage of Bladder. 

Bleeding — See Hemorrhage. 

Boils. — Arnica will lessen the pain and inflammation. 

Sulphur in cases where there is a frequent return of boils. 

Belladonna if it present a fiery-red appearance. 

Hepar where the suppuration is too slow and scanty. 

Mercurius if the suppuration is profuse and the swelling remains. 

Lachesis for very painful boils which become bluish and form rapidly. 

Bronchitis. — Aconite when the skin is hot and dry and pulse hard 
and frequent. 

Pulsatilla if there is less heat and more coldness of the hands and 
feet. 

Tartar emetic in all cases when the rattling of phlegm in the chest is 
remarkable from the first. 

Belladonna when there is severe headache, aggravated by coughing, 
and oppression of the chest. 



HOMCEOPATHY. 14:99 

Lachesis if short, hurried respiration and anxiety with dry, fatiguing 
cough. 

Bryonia if cough is dry, with pain in head and chest. 

Phosphorus if the respiration continues oppressed. 

Bruises. — Apply to injured parts cloths dipped in cold water, and 
administer arnica internally. 

In very severe cases, followed by fever, give aconite. 

A lotion of arnica tincture, in the proportion of half a teaspoonful 
to a tumbler of water, may also be used. 

Should suppuration ensue, hepar must be given. 

Burns. — Apply heat, wet or dry. Bicarbonate of soda will remove 
pain. Soap is a good remedy. Lime water and sweet oil or linseed oil 
and lime water in equal parts is effective. 

Back. — Severe pain as if it would break, belladonna; lumBago, bry- 
onia and rhus tox. ; crick or stiffness in the back, rhus tox. ; lame back 
with piles, aesculus hip. ; pain in small of back, carbo veg. ; pain as from 
long stooping, pulsatilla. 

Blood Poisoning. — Lachesis. 

Bones — Diseased, silicea; syphilitic decay of, aurum; bone pains, 
eupatorium perf. 

Cancer — Arsenicum ; from blow, conium. 

Carbuncle.— Arnica given at the very first may lessen the pain. If 
bo, nux vomica will remove the remaining symptoms. Arsenicum as soon 
as it is spreading. Hepar if the patient is weakened by the copious dis- 
charge. Silicea for pain and moderate burning. Lachesis if bluish spots 
or blue blisters appear. 

Catarrh, in the Head. — Camphor a tincture, in drop doses every half 
hour for a few hours, may abort the cold. Mercurius is the principle 
remedy in influenza. Hepar if the symptoms have been better and be- 
come worse again. If ineffective, give belladonna. Cepa for ordinary 
catarrh. Lachesis in catarrhs of the severest kind. Arsenicum when the 
nose feels stopped up and yet runs. Nux vomica when the above shows 
no improvement in twelve hours. 

Catarrh of the Stomach. — Ipecacuanha should be given first, and then, 
if necessary, one of the following remedies : Rheum if there is diarrhoea 
of a thin, slimy character. Veratrum when the symptoms are violent and 
accompanied by vomiting of bile, and so forth. Capsicum if accompanied 
by burning in the throat. 

Chest — Stitches, bryonia ; tightness, phosphorus, stannum. 



1500 HOMCEOPATHY. 

Cramps. — Of calves, plumbum ; with diarrhoea, veratrum alb. ; in 
fingers, feet, toes, etc., cuprum. 

Chicken-pox. — This disease rarely requires medical assistance. When, 
however, there is a considerable degree of fever, aconitum may be given. 
When there is much headache, belladonna. 

Chills and Fever. — See malaria. 

Cholera Inantum — Antimonium crudum where the tongue is coated 
white or yellow; dryness of mouth with thirst; nausea with vomiting; 
offensive, slimy stools and so forth. Arsenicum if the child is very weak,, 
pale and emaciated. Bryonia where the diarrhoea comes on in hot weather. 
Ipecacuanha if given in the commencement of the disease will often arrest 
its progress at once. 

Cholera Morbus. — Ipecacuanha if the attacks of vomiting predom- 
inate. J^ux vomica where there is anxiety, pain in the abdomen, tenes- 
mus and so forth. Veratrum should the disease grow worse with cramps, 
weakness, shriveling, cold, clammy perspiration, and so forth. 

Cold — See Catarrh. 

Colic. — Chamomilla is suitable for children, also for grown persons 
when blue circles appear around the eyes. ISTux vomica when there is con- 
stipation. Mercurius for violent, twisting colic. Pulsatilla when there 
is stinging pain in the bowels. Colocynthis is the principle remedy for 
colic. It is to be given when the pains are very violent, constant, or 
only cease for a short time, and then recommence with greater violence. 
Cinchona for flatulency. 

Constipation. — ISTux vomica in persons of sedentary habit. Bryonia in 
warm weather. Lachesis when there is a feeling of weight and oppression. 
Xatrum muriaticum in tedious cases. 

Consumption. — Treat in the beginning according to the symptoms that 
arise. (See Cough and Hemorrhage of the Lungs.) 

Cough. — When catarrh is accompanied by cough, or when a dry cough 
remains after the first symptoms have disappeared under the action of 
other medicines, give mix vomica. If the cough is dry and excites retch- 
ing or vomiting, ipecacuanha. If it is hollow and causes vomiting, carbo 
vegetabilis. If accompanied by tough expectoration, chamomilla. If it 
is moist or loose, ferrum phos or pulsatilla. 

Croup. — If children waken suddenly at night and begin with a chok- 
ing cough, give antimonium tartaricum. Where there is great agitation, 
give aconite every ten, twenty or thirty minutes, according to the urgency 
of the case. Spongia is indicated if the voice is rough and the cough hoi- 



HOMCEOPATHY. 1501 

low. Hepar if the voice is only lisping and the cough crowing. Phos- 
phorus and carbo vegetabilis have saved life when all else has failed. 

Diarrhoea — Ipecacuanha in children with screaming, tossing and un- 
easiness. Chamomilla for children when they want to be carried con- 
stantly. Pulsatilla for watery and offensive diarrhoea with burning pain 
and soreness of the anus. Sulphur for green, slimy diarrhoea. Anti- 
monium crudum for watery diarrhoea with disordered stomach. Rheum 
for sour, thin, fermented diarrhoea, common with children. Cinchona in 
all kinds of diarrhoea occurring in debilitated persons. 

Diphtheria. — Bryonia when patient is quickly prostrated and com- 
plains of pains everywhere. Belladonna when patient is restless and com- 
plains of sore throat. Lachesis when, after belladonna, by next evening 
there is no marked change for the better. 

Dropsy — Dropsy may be due to disease of the heart, lungs, liver, kid- 
neys or peritoneum. The treatment of the various forms is given under 
the different diseases causing it. 

Dysentery. — Mercurius when there is an urgent desire to evacuate. 
Nux vomica if much straining before and during stool, but relief after- 
ward. Mercurius sublimatis when first much bile is discharged, and then 
blood or slime. Cinchona for epidemic and periodic dysentery. Vera- 
trum if the discharge is watery, with bloody mucus and flakes swimming 
in it. Colocynthis for extreme pain in the bowels. Sulphur in all pro- 
tracted cases. 

Dyspepsia — Nux vomica if caused by dissipation and late hours. 
Chamomilla when there is a bitter taste in the mouth, bitter eructations, 
vomiting of mucus or bile. Antimonium crudum when the patient feels 
sick at the stomach and the tongue is coated or blistered. Bryonia when 
the stomach is disordered and the patient feels cold and chilly. Ipecac- 
uanha when there is a catarrhal state of the stomach. 

Ear. — Oozing raw and sticky behind the ear, graphites; bloody dis- 
charge, petroleum; green discharge, mercurius or pulsatilla; growths, 
polypi in ear, thuja ; hearing defective, calcarea carb. ; earache, pulsa- 
tilla; chronic discharge of blood and matter (oror'rhoea), capsicum; red- 
ness, burning and itching as if frozen, agaricus; ichorous discharge, 
arsenicum. 

Eczema. — Dry and scurfy even in hot weather, alumina ; humid and 
sticky, graphites ; chronic eczema, bran-like, arsenicum ; after ointments 
and external applications have been used unsuccessfully, hepar sulph. ; 



1502 HOMOEOPATHY. 

itching intensely, mezereum; scabby, easily bleeding after vaccination, 
thuja; burning, sulphur; watery, rhus tox. 

Eyes. — Tired from overwork, ruta; corner of lids raw, graphites; 
twitching of eyelids, agaricus; puffy swelling, apis; inflamed, aconite; 
hot and burning, belladonna; blinking, watery, red and inflamed, euph- 
rasia. 

Face. — Scaly herpes on cheek, anacardium; pimples and pustules, 
antimonium crud. ; puffy and swollen under the eyes, apis ; burning 
pimples, arsenicum ; moist, scurfy eruptions, calcarea carb. ; eczema, moist 
around mouth and on chin, graphites ; lips cracked and bleeding, ignatial ; 
fiery red eruptions, hypericum; itching tetter around nose and mouth, 
ledum; raw spots from scratching, mezereum; itching and pimples on 
forehead, sarsaparilla ; yellow tetter around mouth, yellow across nose, 
sepia; blood boils, silicea; dry itching eruption, staphisagria ; "black- 
heads," sulphur; greasy skin, thuja or natrum mur. ; rough skin, acne, 
berberis. 

Felon. — At the beginning, mercurius; follow with arsenicum; to 
allay the pain, ammonium carb. 

Feet — Itching, ledum ; sweating, silicea ; stinking feet and arm-pits, 
sweaty and sore, petroleum; feet waxy and swollen, apis; pain in heel, 
cyclamen ; very painful callosities, lycopodium ; bunion, hypericum ; frost 
bitten or feeling as if, agaricus ; cramp in, sulphur ; fidgety, zincum ; sole 
painful and hard, baryta carb. ; cold and damp, calcarea carb. ; cracked 
skin of, hepar sulph. ; tender and sweaty, petroleum. 

Grippe. — With dry fever, restlessness and racking cough, aconite; 
sudden onset of the disease with alarming prostration, arsenicum; shiv- 
ers, prostration, bone pains, aching, eupatorium perf. and gelsemium, 
alternately; frontal headache, sneezing, fluent coryza, rheumatic pains, 
limbs heavy, indisposition to move, dry cough, chest painful, bryonia (a 
good remedy) ; for lingering effects, chronic grippe, lycopodium. 

Tardy Menstruation. — Pulsatilla especially for females of a mild, easy 
disposition. Cocculus when the patient suffers from nervous symptoms. 
Belladonna if there is* a rush of blood to the head. Apis if flow is ir- 
regular. Nux meschata for women with an irregular, scanty, black flow. 
Phosphorus for women of a delicate constitution. Arsenicum in cases 
with great weakness. 

Suppression of the Menses. — Aconitum when it arises from fright. 
Bryonia for unmarried women. 

Too Copious Menstruation. — Ipecacuanha for too great a flow. Crocus 



HOMOEOPATHY. 1503 

particularly when the discharge is dark colored. Platina when attended 
with bearing down pains. Chamomilla with thirst, coldness of the ex- 
tremities and sometimes fainting. JSTux vomica when the menstruation 
continues too long or returns again. 

Painful Menstruation. — Belladonna when there is severe pain in the 
back with a rush of blood to the head. Chamomilla when the pains re- 
semble labor pains. Coffea for nervous excitement. 

Erysipelas — Aconite in cases with much fever. Belladonna with 
acute shooting pains, heat and tingling. Rhus if small or large blisters 
appear. Bryonia when the disease attacks the joints. Arsenicum and 
sulphur in cases terminating in ulceration. 

Fainting. — If it arises from fright, coffea, opium or aconitum. From 
loss of blood, a few drops of wine and afterward cinchona. When pro- 
duced by sudden emotions, ignatia or chamomilla. If preceded by nau- 
sea, ipecacuanha. 

Gout. — ISTux vomica for first attack. Aconitum for violent fever. 
Arnica when the pain in the joints resembles that of a spasm. Pulsatilla 
when pain flies quickly from one joint to another. Calcarea when the 
attacks return at every change in the weather. Colocynthis if limbs re- 
main stiff afterward. 

Headache. — Glonoine when the attack comes on suddenly. Aconite 
when the pain is very severe and over the whole head. Belladonna when 
the pain is deep seated. Pulsatilla when pain is dull and oppressive. Rhus 
when there is burning, throbbing pain. 

Heartburn — Nux vomica often helps. Cinchona if it comes espe- 
cially after eating. Carbo vegetabilis if cinchona does not help. Capsi- 
cum if none of the above give relief. 

Hives. — See Rash. 

Inflammation of Bladder. — Aconite for the most common causes when 
there is painful urging. Pulsatilla if there are pressing, cutting pains. 
Belladonna if pains are piercing. Colocynthis if the urine becomes sticky 
and gelatinous. 

Inflammation of the Bowels. — Aconite at the commencement. Ipe- 
cacuanha when the pains are worse in front. Bryonia when the pain and 
fever are violent. Chamomilla if the pains are dull. 

Jaundice. — Opium, mercurius, cinchona, hepar, sulphur, lachesis and 
chamomilla have all been used with good results. 

Leucorrhea. — Calcarea carbon ica when the discharge is milky and 
often attended by itching. Pulsatilla when the discharge is thick like 



1501 HOMOEOPATHY. 

cream. Cocculus if the discharge is mixed with blood, J^atrum muriat- 
icum when the discharge is copious. Sulphur for inveterate cases when 
the discharge is yellowish. 

Lumbago — Aconitum if accompanied by much fever. Bryonia when 
the patient walks in a stooping posture. ISTux vomica when the affected 
part feels as if bruised. 

Malaria. — Cinchona as soon as you feel unwell. Ipecacuanha if no 
better after twelve hours. Arsenicum when the different stages are not dis- 
tinctly marked. Arnica when the cold stages come on early in the morn- 
ing. Yeratrum when there is external coldness with internal heat. Sam- 
bucus when sweating is very profuse. Belladonna and hyoscyamus when 
two or more attacks occur in the twenty-four hours. 

Measles — Aconite, the chief medicine, is especially indicated when 
the fever is violent. Pulsatilla and euphrasia when the catarrhal symp- 
toms predominate. Belladonna when the throat becomes sore. Ipecac- 
uanha for arresting vomiting. Bryonia when the eruption is imperfectly 
developed. 

Morning Sickness. — Ipecacuanha, nux moschata, veratrum and phos- 
phorus have all proved beneficial in the nausea and vomiting of pregnancy. 

Mumps. — Mercurius is the principal remedy. Belladonna or hyoscy- 
amus if the swelling is very red. 

Mind — Fear, dread, aconite; fixed thoughts, iodium; suicidal 
thoughts, aurumn ; well known things and places seem strange, gloucinum ; 
silent grief, ignatia ; hears voices, anacardium ; delirium with bright eyes, 
belladonna ; to prevent "stage fright," anacardium. 

Mouth — Sore mouth, borax; parched, bryonia; ulcerated, kali chlo- 
rium; teeth loose, gums spongy, mercurius; bitter taste, bryonia, nux 
vomica ; blistered, staphisagria. 

Neuralgia. — Aconitum if there is redness and heat of the face. Bella- 
,donna if the pain is most violent under the eye. Platina for boring, 
cramp-like pain. Colocynthis for rending and darting pain. Arnica for 
heat and throbbing. Bryonia for heat and pressing pain. 

Nose-Bleed. — Arnica when caused by a blow, fall and so forth. Pul- 
satilla for women. Aconite for plethoric individuals. Carbo vegetabilis 
when nose bleeds frequently and from slight causes. Rhus when brought 
on by great exertion. 

Neurasthenia. — Nervousness following fever, ambra ; coldness of back 
and shoulders, ammonium mur. ; sensation as if one could not breathe; 
asafoetida ; great exhaustion in the morning, calcarea carb. ; weakness, 



HOMOEOPATHY. 1505 

antimoniiim crud. ; acrid discharge, arsenicum ; ulcerated, foetid, aurum ; 

Nose. — Ked, pointed, cracked, alumina ; sore, cracked, crusty nostrils, 
in farm room, pulsatilla ; swollen and painful chronic inflammation, phos- 
phorus ; dirty, bloody, foetid, nitric acid ; red, swollen, shining, painful to 
touch, mercurius. 

Palpitation of the Heart — Aconite, chamomilla, veratrum, coflea and 
opium, when caused by mental emotions. Xux moschata when accom- 
panied by fainting. Cinchona for persons with a sour stomach. 

Pain. — Bruised like, arnica ; bones ache, eupatorium perf. ; burning, 
arsenicum ; slowly increase and decrease, stannum ; periodical, shifting, 
wandering, pulsatilla ; worse by motion, bryonia ; must move for relief, 
rhus tox. 

Palsy. — Wasting palsy, plumbum ; argentum nit. ; shaking palsy, tar- 
tanula hisp. 

Piles. — Aconite when blood is discharged. ]^ux vomica when there 
is a burning, pricking pain. Apis for small stinging, biting tumors. Cap- 
sicum when the tumors are much swollen. Ignatio for violent stitches 
which penetrate deeply. Chamomilla, when the blood flows freely. 

Pleurisy. — Aconite is the chief remedy. Bryonia for acute, shooting 
pains in the chest. 

Pneumonia. — Aconite in the beginning. Bryonia for cough with 
rusty-colored sputum. Mercurius for profuse sweats. Antimonium tar- 
taricum when there is oppression of the chest. Sulphur for frequent, 
weak faint spells, and so forth. Arsenicum when there is great prostra- 
tion with anxious restlessness. 

Quinsy. — Hepar in the beginning. Mercurius when the tongue is 
furred and flabby. Lachesis when there are white or gray patches on the 
throat. 

Rheumatism. — Aconite if there is high fever, dry, hot skin, thirst and 
redness of the cheeks. Belladonna when the pain is chiefly in the joints. 
Mercurius and pulsatilla when the pains are worse at night. Khus for 
red and shining swelling of the joints. Cinchona for pains which are 
aggravated by the slightest touch. Aconite, bryonia, calcarea carbonica, 
dulcamara, mercurius or sulphur, in chronic rheumatism for pains which 
are excited or made worse by the slightest chill. Calcarea carbonic, dul- 
camara, rhus toxicodendron and hepar sulphuris in chronic rheumatism 
when the attacks are assisted by bad weather. 

Scarlet Fever. — Aconite at the beginning. Belladonna and mercurius 
in the simple forms when the eruption*is bright red. Bryonia when the 



1506 HOMEOPATHY. 

eruption does not come out well. Pulsatilla for great restlessness. La- 
chesis and lycopodium, when the eruption is dark in color and scanty. 
Arsenicum when the ulcers in the throat turn livid about the edges and 
emit an offensive odor. 

Sleeplessness — Coffea, opium, aconitum and ignatia when due to ex- 
citing events. Pulsatilla when due to excess of coffee and tea. Chamo- 
milla when due to complaints of the bowels. 

Small-Pox — Aconitum if there are congestions to the head and lungs. 
Belladonna if there is delirium with headache. Bryonia if the eruption 
is delayed. Yariolinum is the most important remedy. 

Sore Nipples.— Tincture of arnica previous to confinement will pre- 
vent them. Arnica internally and bathing the nipples with a solution 
of ten drops of tincture of arnica to a half tumbler of water several times 
a day. 

Sore Throat. — Aconite for difficulty and pain in swallowing and speak- 
ing. Ignatia, nux vomica and Pulsatilla when there is a constant feeling 
as if there were a lump in the throat. Bryonia, rhus and capsicum when 
the throat is painful on being touched. Sulphur for frequent or constant 
sore throat. 

Spasms. — Chamomilla if there is convulsive jerking of the limbs, and 
so forth, followed by drowsiness. Belladonna when the child starts sud- 
denly from sleep with pupils dilated, and so forth. Ignatia when the 
cause is unknown. Coffea in weak and nervous children. Ipecacuanha 
in asthmatic children. 

Typhoid Fever. — Baptisia, bryonia, rhus tox., phosphoric acid, arsen- 
icum and hyoscyamus are chiefly used. 

Toothache. — If iu decayed tooth, mercurius ; in sound teeth, spigelia ; 
intense throbbing and redness, belladonna; when relieved by cold water, 
coffea ; in recently filled teeth, arnica. 

Ulcers. — Arsenicum when they burn greatly. Carbo vegetabilis when 
they smell offensively. Lachesis when they spread. 

"Urinary Difficulties. — Pulsatilla, belladonna, cinchona, silicea or stra- 
monium in inability to retain urine during pregnancy. Aconite, Pulsa- 
tilla, arnica, nux vomica, belladonna, mercurius, hepar, colocynthis, apis, 
cepa and opium for difficulty and pain in making water. 

Vertigo. — Aconite, when nausea, eruptions and vomiting are present. 
Pulsatilla or antimonium crudum, if there be a disordered stomach. Nux 
vomica, chamomilla, pulsatilla, rhus or coculus if it occurs while eating 
or after a hearty meal. 



HOMCEOPATHY. 1507 

Varicose Veins — Hamamelis, internally and externally; tending to 
ulcerous condition, carbo veg. 

Whooping Cough. — Aconite at the commencement. Dulcamara if 
brought on by a severe cold. Pulsatilla for loose cough with vomiting. 
!Nux vomica, belladonna and hepar when the cough is dry. Ipecacuanha, 
veratrum, carbo vegetabilis, cina, caprum, metallicum and arnica give 
good results. 

Warts. — Warty, fungous excrescences, fig warts and polypi, thuja; 
warts on nose and eyebrows, etc., causticum; in pale, nervous unhealthy 
persons, staphisagria ; in great crops of warts on hands, f errum picricum. 

Women. — Delayed menses, pain in back, pulsatilla ; with yellow color 
of skin, etc., sepia ; with cramps, cuprum ; with fever, belladonna. Pain- 
ful with headache and chilliness, calcarea carb. ; with nervous excitement, 
coffea; writhing pain, nux vomica; sour stomach, heaviness, wants open 
air, pulsatilla; too soon, every two weeks, hysterical, ignatia; headache, 
shivering, calcarea; irregular, pulsatilla; with sick headache, sulphur; 
too scant, pulsatilla ; yellow color of skin, excoriating, sepia ; chilly, milky 
discharge, calcarea carb. ; vertigo, throbbing headache, belladonna ; from 
stooping, staggering blindness, numbness, headache every other day or 
one-sided, pulsatilla ; bitter taste, bilious, nux vomica. 

Worms. — Ipecacuanha, carbo vegetabilis, pulsatilla, cinchona and nux 
vomica are useful remedies. Aconitum, cina, mercurius, belladonna and 
lachesis for colic caused by worms. Sulphus and calcarea for tape worms. 



95 



MEDICAL SCHOOLS 



PAKT II. 
OSTEOPATHY 



In a consideration of this subject it is well to have in mind that it 
is not something which may be practiced off hand after cursory study, 
even though the works studied be the best extant. No layman of intelli- 
gence, no matter how much he might have read about surgery, would at- 
tempt to cut off a man's leg except under the most dire circumstances 
and the securing of a surgeon were impossible. Surgery requires years 
of study and years of practice to make proficient, and in osteopathics 
years of study and practice are quite as essential in so far as the obtain- 
ing of results is concerned. So thoroughly is this fact now recognized 
that already in a large and growing number of states the professional 
practice of osteopathy is by law restricted to those who have taken a 
regular collegiate osteopathic course and received their degree of Doctor 
of Osteopathy (D. O.). Taking the Philadelphia College of Osteopathy 
(governed by the laws of the State of Pennsylvania) as an instance, the 
course is four years, the matriculation and first two years of the course 
being practically indentical with that of the medical profession, the last 
two years, however, materially differing in that while the medical student 
largely devotes his time to the study of medicines and their effects, the 
time of the osteopathic student is most chiefly given to the study of 
higher anatomy and physiology, the nerve centers and their branches, 
the nervous cells themselves, the muscles and fibres and the minutest co- 
relationship of all of them with the spinal cord and vertebra, in dissec- 
tion of the human cadaver with relation to these matters and in practical 
work on the living body with the object of being able to recognize normal 
and abnormal conditions by a feeling with the hands. 

1508 



OSTEOPATHY. 1509 

The high place and professional standing of the properly licensed 
osteopathic physician is thoroughly recognized by the medical profes- 
sion and it is of daily occurrence for the most eminent physicians and 
surgeons to refer their patients to osteopaths of proper qualifications. But, 
as in the medical profession there are "quacks," so in osteopathy there 
are those who are not professionally qualified and when such men under- 
take the curing of all diseases and declare that osteopathy is the alpha 
and omega in the treatment of all disease, they not only do detriment to 
the science of osteopathy, but they become a menace to society. 

It will be apparent from the foregoing that no mere chapter, such 
as the present, can furnish sufficient information to enable the reader, 
without further study, to proficiently undertake the exercise of oste- 
opathic practice, even in its simpler forms. It is intended to outline here 
simply the salient features. To do more would require a large volume 
devoted exclusively to the subject, after the study of which much prac- 
tice in actual manipulation would be essential. 

The science of osteopathy was discovered by Dr. A. T. Still, of 
Kirksville, Mo., and was first propounded in 1874. There have been 
innumerable definitions of osteopathy, but it may be briefly referred to 
as the science and art of curing without the use of knife or drugs. One 
of the best descriptions given has been that of J. Martin Littlejohn, M. D., 
D. O., Ph. D., LL. D., F. S.S.C., F. K. S. L., etc., in an address before 
the Royal Society of Literature, London. Dr. Littlejohn said: 

"Osteopathy is based on an accurate knowledge of the anatomical 
structure and physiological functions of the body organism. Nature has 
placed within the body certain vital forces, vitalized fluids, and vitalizing 
processes and activities, which, in harmonious accord with one another, 
maintain the equilibrium of the body mechanism; any disturbance of 
these forces, fluids or processes and any interference with their activity, 
circulation or distribution involves the absence of harmony and inter- 
ference with the body order. Osteopathic manipulation aims to re- 
store these to their normal condition, so that the body may regain its 
normal functional equilibrium and form. In this way osteopathy claims 
that life is revitalized and strengthened by vital forces, vitalizing fluids 
or processes, disease being removed or overborne by getting rid of an 
abnormal structural alignment that produces disharmony in the body and 
prevents normal functional activity." 

Before taking up the subject of Osteopathy in detail it may be well 



15 10 OSTEOPATHY. 

to define certain words which will be used in this article and which, ex- 
cept professionally, are not in common use: 

Atlas — The first vertebra of the neck, articulating immediately with 
the skull, thus sustaining the globe of the head, whence the name. 

Ganglia — Plural of ganglion. 

Ganglion (pi. ganglia) — (a) A mass or knot of nervous matter, in- 
cluding nerve cells, usually forming an enlargement in the course of a 
nerve; (b) a node or gland in the lymphatic system, as a lymphatic 
ganglion. 

Pia Mater — The delicate and highly vascular membrane immediately 
investing the brain and spinal cord. 

Plexus (pi. plexuses) — A network of vessels, nerves or fibers form- 
ing a distributing center. 

Pneunvogastric — Of or pertaining to the lungs and the stomach and 
here used as respects the pneumogastric nerve. 

Splanchnic — Of or pertaining to the viscera ; visceral. 

Subluxation — This word belongs peculiarly to osteopathy and chiro- 
practic and is seldom used in other systems of therapeutics. "Luxation" 
means a dislocation and consequently subluxation means a partial or 
minor dislocation. 

Viscera — Plural of viscus. 

Viscus — One of the great organs, as the brain, heart or stomach, in 
the great cavities of the body — especially used in the plural (viscera) and 
applied to the organs contained in the abdomen. 

Vasomotor Center — The chief dominating or general center which 
supplies all the unstriped muscles of the arterial system with motor 
nerves, situated in a part of the medulla oblongata (posterior part of 
brain connected with the spinal cord) ; a center of reflex action by the 
working of which afferent impulses are changed into efferent — vasomotor 
impulses leading either to dilation or constriction of the blood vessels. 

We shall now briefly consider the requirements of and the claims 
for osteopathy: 

Requirements of Osteopathy. — Osteopathy demands an exact and most 
thorough knowledge of the anatomy or structure of the human body. It 
requires an intimate acquaintance with the physiology and functions of 
the various tissues, fluids and organs. Add to this a comprehensive study 
of psychology or the workings of the mind. It also includes a knowledge 
of the chemistry and physics of the human mechanism. 

Nature Herself Can Cure — By study and experiments, osteopathy 



OSTEOPATHY. 1511 

claims to have discovered certain laws of nature and methods of cure 
within the body itself. By the application of these methods, according 
to osteopathic practice, nature, herself, may remove the disease and cause 
the body to again regain its health and strength. This occurs not from 
any stimulation caused by drugs, but in accordance with certain me- 
chanical principles residing in the body itself. 

The Body a Machine. — Osteopathy regards the body as a wonderful 
mechanism, and treats it as an intelligent machinist would treat a com- 
plicated machine with which he was perfectly familiar. 

The Human System Perfect. — The human system is regarded as be- 
ing perfect. Man is believed to have been created complete, having within 
himself the power to regain health and vigor. Were such not the case, 
it is argued, the human body would be incomplete, and man would have 
to look outside for the relief of disease. 

By an exhaustive study of the anatomy or structure, and the physi- 
ology or functions of this human body, it is observed that man is a com- 
plete being, capable of performing his own physical and mental acts when 
in health. 

Disease is regarded as simply disorder. To restore health, the dis- 
ordered parts must be corrected. 

Drugs Harmful. — Osteopathy believes the giving of drugs for the cure 
of human ills to be both unreliable and unscientific. It absolutely denies 
the curative properties of drugs. It so regards the whole system of drug 
treatment as unnatural and destructive to health. 

Disease Not an Entity. — The osteopath does not look upon disease as 
a definite enemy which must be attacked by some foreign force. Disease 
is regarded as a disorder of the normal structure of a part, causing some 
disorder of the normal function of the body. 

The Human Body a Perfect Machine — The human body is looked 
upon as a perfect machine. Order is considered the first law of health. 
If in order, the human machine will do its work properly and run its 
allotted time. 

What Osteopathy Does. — Osteopathy endeavors to discover and correct 
all mechanical disorders in the human machine, and to direct the recup- 
erative power of nature within the body to the cure of disease. It claims 
that if there is an unobstructed nerve and blood supply to and from all 
parts of the well-fed man, the effects called disease will surely disappear. 

Treatment. — The treatment is by manipulation. According to Dr. 
A. T. Still, exciting the nerves causes muscles to contract and compress 



1512 OSTEOPATHY. 

venous flow of blood to the heart. The bones can be used as levers to 
relieve pressure on nerves, veins and arteries. Treatment is chiefly by 
manipulations of the spinal column and adjustments of subluxated ver- 
tebra. 

Object of Osteopathy. — The object of osteopathy is to permit a perfect 
freedom of all fluids, forces and substances pertaining to life. It en- 
deavors to restore the harmonious action of all the parts, which must 
ensue when they are unirritated by any cause. It aims to maintain the 
complete circuit of the motor, sensory and sympathetic nerves. 

Cause of Disease — The cause of the disease, according to osteopathy, 
may be dislocated or subdislocated bone, ligament, cartilage or muscle, 
causing inhibition or irritation of a nerve fiber or an obstruction of an 
artery, vein, lymphatic or some fluid of the body to which the affected 
nerve or vessel is distributed or connected. 

These osteopathic disorders are not necessarily surgical dislocations, 
but are parts out of line, out of proper adjustment. They comprise slight 
displacements of various structures, chiefly bones and ligaments, with 
muscular contractions, little adhesions, contractions from cold, irritation 
or other outside influences, causing unnatural pressure upon vessels or 
nerves. 

Osteopathic Examination. — The patient is examined from the phy- 
sical standpoint. In the eyes of the osteopath he is a machine out of 
order. By his knowledge of the details of the human machine, when in 
health, the osteopath feels able to detect the disorders that are present 
in disease. 

Through a highly developed sense of touch and a knowledge of 
anatomy, the osteopath claims to be able to discover the slightest anatom- 
ical disorder. The conditions present and the symptoms shown are used 
as clues to find the cause of the disease. By means of these signs and 
symptoms the nerve supply of the diseased part is traced to its origin 
and the course of the blood channels is followed from the parts diseased 
to the exact region where the abnormal condition is caused. When the 
primary lesion, or the point where the disease is caused, is located, treat- 
ment begins. 

Dr. Littlejohn is authority for the following: 

Diagnosis. — "Osteopathic diagnosis is reduced to the discovery or at- 
tempted discovery of the cause or causes of a disease. Conditions may 
be summarized under the heads: 



OSTEOPATHY. 1513 

"(1) Misplacements of bone, cartilage, ligament, muscles, membrane 
or organs of the body; 

"(2) Disturbances in the fluids of the organism, including the blood, 
the lymph and other secretions of the body; and 

"(3) Disorders or derangements by tension, impingement, thicken- 
ing, induration, and so forth, of the nervous system, including its cen- 
ters, ganglia, plexuses and fibres. 

Therapeutics. — "Following up this line of physiological thought, the 
osteopathic therapeutics is simplified and will consist of the correction 
or the removal of the cause or causes of disease. 

"Corresponding with the diagnostic points, we find: 

"(1) Scientific manipulations that aim to correct displacements in 
the bony and other tissue structures of the body, in its membranes or 
organs ; 

"(2) Scientific manipulations that are designed to rectify the dis- 
turbances in the circulation of the body fluids and to restore them to their 
normal condition, especially blood conditions and defects in the blood 
circulation and distribution; and 

"(3) Scientific manipulations that utilize the nervous system with 
its fibers, ganglia and centers with the view of correcting the nervous dis- 
orders, toning up the general system or its local parts, promoting trophic 
conditions of the nerves and muscles and stimulating a normal correla- 
tion of the physic with physiological and vegetative functions of the 
human system. 

The Essential Principles of Osteopathy. — "The essential principles of 
osteopathy may be set down thus: 

"(1) Health is natural; disease and death between the time of 
birth and old age is unnatural; 

"(2) All bodily disorders are the result of mechanical obstruction 
to free circulation of the vital fluids and forces, and the continuity of 
nerve forces. 

"(3) The impediments in the way of free fluid circulation and un- 
interrupted nerve force are found in osseous displacements, contracted 
muscles, ruptured ligaments, constricted or dilated vessels, hypertro- 
phied tissue substance or congested conditions of the tissues. 

"(4) These abnormal conditions represent not only the change in 
structure or function on the part of particular portions of the organism, 
but also produce physiological disorganization of the vital forces of the 
body, producing an irritable condition either of overstimulation or in- 



1514 OSTEOPATHY. 

hibition resulting in excessive activity, partial activity or inactivity of 
the vital forces and processes. 

"(5) In the restoration to the normal the main purpose in operative 
manipulation is to co-ordinate the vital forces, to restore harmony in 
the vital functions and thus aid nature in the elimination and checking 
of disease conditions.'' 

The Nervous System — The nervous system occupies a very important 
place in the study and practice of osteopathy. For convenience of refer- 
ence it is commonly divided into the cerebro-spinal nervous system and the 
sympathetic nervous system, but in fact they are parts of one whole, each 
cell only being capable of perfect life so long as it is able to reciprocally 
communicate with all other cells through the central nervous system, all 
thus connecting with the spinal cord in the vertebral column. A thorough 
study of the chapter on Anatomy and Physiology will show the relation- 
ship of the nervous system to the whole body, but in respect of osteopathy 
it is necesary to delve still deeper and understand the working of every 
nerve cell. In the so-called sympathetic system, especial attention is 
drawn to the ganglia, the plexuses and the communicating fibers. The 
lateral chains of ganglia are placed one on each side of the vertebral 
column and are connected with the cerebro-spinal nerves by well-marked 
cords. The visceral ganglia are found between the coats of viscera and 
are known as the peripheral apparatus. The principal plexuses are four 
in number, but there are many branches or subsidiary plexuses. The 
first of the four, the pharyngeal, is situated around the larynx and 
pharynx; the second, or cardio-pulmonary, lies in the thorax; the third, 
or solar plexus, encircles the coeliac axis and superior mesenteric artery; 
and the fourth is the pelvic plexus, which governs the generative organs 
and rectum. The ganglia and plexuses are all intimately connected with 
each other by numerous nerve fibers, and the whole constitutes the sym- 
pathetic nervous system. "The function of the sympathetic system is to 
control the calibre of blood vessels, the plain muscle fibers and the actions 
of the secretory and excretory glands." (Tasker.) "In general it may 
be said that the sympathetic presides over involuntary movements, nutri- 
tion and secretion, holds an important influence over temperature and 
vaso-motor action, and is endowed with a dull sensibility." (Kobinson's 
Abdominal Brain.) It has been scientifically demonstrated that the sym- 
pathetic system may in a certain sense have an independent action, "but 
it is to be borne in mind that under normal conditions the cerebro-spinal 
nerves can influence these activities, either repressing or augmenting them. 



OSTEOPATHY. 1515 

The ganglia of the sympathetic contain (a) nerve cells, (b) afferent fibers, 
(c) efferent fibers, — and are, therefore, governing centers. They are 
able to reecive sensation and transform this into motor impulses, and 
hence are, in a measure, independent. The cervical portion of the gang- 
liated cord contains three ganglia, which are designated as superior, mid- 
dle and inferior, according to position. These ganglia are important to 
the osteopath because they are in a measure affected by direct manipula- 
tion, i. e.j pressure can be transmitted to them through the soft tissues 
over them." (Tasker.) 

The plexuses are of such importance in osteopathic practice that 
they deserve especial mention, particularly the cardiac, the pulmonary 
and the solar: 

(a). The Cardiac Plexus — This consists of a superficial and a deep 
division, and is situated at the base of the heart and in the concavity of 
the arch of the aorta. It is formed by fibers from the pneumogastric and 
cervical cardiac sympathetics ; also cardiac branches from the second, 
third and fourth dorsal segments of the spinal cord. The cardiac nerves 
form the cervical sympathetic chain all entering the cardiac plexus, but 
with variable distribution. The superficial cardiac plexus receives the 
"left superior cardiac nerve of the sympathetic and the left inferior cer- 
vical cardiac branch of the pneumogastric." (Morris' Anatomy.) The 
deep cardiac plexus receives all the other cardiac nerves. 

(b). Pulmonary Plexus. — "The anterior pulmonary plexus is formed 
by a branch of the pneumogastric and the sympathetic. Its branches en- 
ter the lung on the posterior aspect of the bronchus." (Tasker.) 

(c). Solar Plexus (Sometimes called the Abdominal Brain). — "The 
coeliac or solar plexus supplies the viscera in the abdominal cavity. It 
consists of a great network of nerves and ganglia, situated behind the 
pancreas and the lesser peritoneal cavity and in front of the aorta and 
crura of the diaphragm. It surrounds the coeliac axis and root of the su- 
perior mesenteric artery, extending downward as low as the pancreas 
and outward to the suprarenal glands. This plexus and the ganglia con- 
nected with it, receive the great, the small and the least planchnic nerves 
of both sides, and some filaments from the right vagus (pneumogastric) 
nerve. It distributes filaments which accompany, under the names of 
plexuses, all the branches from the front of the abdominal aorta." 
(Gray's Anatomy.) The branches of the abdominal aorta, as subsidiary 
plexuses, take their names from the arteries they accompany — as, the 
phrenic or diaphragmatic plexus; the suprarenal; the renal; the sper- 



1516 OSTEOPATHY. 

matic and ovarian; the gastric; the splenic; the hepatic; the superior 
mesenteric ; the aortic; the ultimate distribution of the branches being to 
the muscular and secretory tissues of all the abdominal viscera, and to 
the muscular coat of the arteries supplying these viscera. The solar 
plexus is the greatest of all the plexuses. "It is connected with almost 
every organ in the body, with supremacy over visceral circulation, with 
a control over visceral secretion and nutrition, with a reflex influence over 
the heart that often leads to fainting and may even lead to fatality.'' 
(Byron Robinson's Abdominal Brain.) 

The Vertebral or Spinal Column — It is held by osteopaths that through 
the general nervous system and its accessories the spinal vertebra is in 
direct relation with all parts of the body and that if the anatomy of the 
body be thoroughly understood and there be full knowledge of all the 
nerves, nerve cells, muscles, cords, etc., and their accessories, as also of 
the nature of their respective reflex actions, disease in any and all parts 
of the body may in most cases be checked and cured by a proper manipu- 
lation of the vertebra, arteries, nerves and muscles; or in some cases of 
other points, such as the shoulder, etc., but primarily the vertebra, for it 
is a fundamental principle of osteopathy that a perfect adjustment of the 
spinal vertebra is essential to healthy organism and therefore not only is 
special study given to the vertebra, the spinal cord and the nerves emanat- 
ing therefrom, but in treatment of all disease especial care is given to 
manipulation of the spine and to perfect adjustment of the subluxated 
vertebra. 

Many authenticated instances are given in osteopathic works of ef- 
fects produced on different organs by manipulation of certain parts of 
the vertebra. Referring to some of these cases, J. Deason, Sc. B., M. S., 
Ph. G., D. O., Director of the A. T. Still Research Institute, says: "The 
secretions of the kidneys can be increased from 25 to 100 per cent, by 
stimulatory treatment applied to the eleventh and twelfth thoracic seg- 
ments of the spine. The secretion thus produced often remains in- 
creased for two or three hours or longer, during which time the water 
content of the body is greatly reduced. The significance of such treat- 
ment is apparent. If the toxin content of the blood can be materially 
reduced, as experimental evidence shows it can be, this is a very efficient 
method in infectious fevers." 

Subluxations.-^-A subluxation may be very slight, yet be the cause of 
serious physical disorders, directly, indirectly or reflexively. Dain L. 
Tasker, D. O., D. Sc. O., Professor of Theory and Practice in the Pacific 



OSTEOPATHY. 1517 

School of Osteopathy, says : "In order to get at a true understanding of 
what subluxation is we must make a careful study of the structures which 
form a point and their vital manifestations. The bones of the skeleton 
are bound together by ligaments and muscles. The opposing surfaces of 
bones forming movable joints are covered with cartilage. The muscles 
execute and the ligaments or soft parts around a point limit the motions 
of the articulation. All movable articulations have their bony parts 
maintained in their normal relations either by the form of the bones and 
cartilages attached to them or by the equal tension of all the controlling 
muscles. Enarthrodial joints (i. e., ball and socket joints) have freest 
movements and yet are the least dependent on muscles for retention of 
their normal position. Air pressure and the form of the bones are re- 
sponsible for the integrity of these joints. These joints are less frequently 
subluxated than those possessing more limited motion. Arthrodial joints 
(i, e., semi-flat or qualified ball and socket joints) depend upon the equal 
tension of their governing muscles to keep the opposed surfaces in their 
proper relations. Co-ordination of the muscular tension is usually so per- 
fect that the joint surfaces are perfectly opposed to each other. The dis- 
turbance of this nicely balanced muscular tension results in the drawing 
of one or both bony surfaces away from their true relations ; not entirely 
but sufficiently to make it possible for the physician's ringers to note the 
change." Dr. Tasker then refers to subluxations of the atlas, or first 
vertebra, and continues: "The complete dislocation of this bone from the 
occiput means death; intermediate positions, subluxations, mean both 
irritation of nerves direct, and both direct and indirect disturbances of 
circulation; direct disturbance by pressure exerted on arteries and veins, 
indirect disturbance by excitation of vaso-motor nerves." 

PRACTICAL OSTEOPATHY. 

In etiology, symptoms and prognosis osteopathy does not materially 
differ from the other schools. It is in diagnosis and treatment that oste- 
opathy stands alone. 

Osteopathic Treatment. — The mode of treatment is a scientific 
manipulation by which the dislocation is reduced. The manipulation is 
based on the physical laws governing the actions of the human machine. 

The osteopath not only applies the mechanical principle which is 
indicated in each separate case, but adopts other scientific agencies. Every 
move made by him in treatment is with the definite purpose of correcting 
the anatomical disorders. 



MEDICAL SCHOOLS 



PART III. 
MASSAGE AS A TREATMENT OF DISEASE. 



General Description. — Massage is a method of treating abnormal con- 
ditions by various manipulations whereby the muscles, nerves and blood- 
vessels are treated by scientific rubbing, rolling, kneading, moulding, 
thumping, squeezing, pinching, slapping, etc., the blood thereby being 
hastened along its course. 

The treatment has been abused by many unscrupulous impostors, and 
in consequence there is a prejudice against massage with many people. 
Of its therapeutic value, when judiciously used, there can, however, be 
no doubt, but it is unwise as a rule to use massage without the advice of 
the family physician. Massage is not applicable in pregnancy, it is not 
permissible where there is a collection of pus, in acute inflammations of 
the joints, inflamed veins, fragile arteries, wounds of the skin, nor, gen- 
erally, may it be used in those conditions in which it is not desirable to 
increase the circulation or where for any reason the patient cannot bear 
handling. In cases such as we have cited, it may have injurious and even 
dangerous effects. In short, while massage, if properly applied, is of un- 
doubted value in the treating of certain ills, nevertheless it must not be 
used haphazardly. 

In respect of such ills as massage is applicable to, the effect of the 
manipulations is to promote nutrition, either general or local, to relieve 
congestion, to aid in the removal of waste products, and in the absorption 
of effusions and abnormal deposits. In the main, the influence is felt in 
the cutaneous, muscular and nervous structures, upon the digestive and the 
nutritive functions, and upon certain of the internal organs. 

Bv/ alternate contraction and relaxation, the muscles are exercised as 
fully as possible without exhaustion, and the blood is propelled with 
greater activity, thus permitting its life-giving qualities to reanimate and 
restore vitiated and worn-out tissues. 

Respiration and secretion are likewise increased and proper action 

1518 



MASSAGE AS A TREATMENT OF DISEASE. 1519 

of the intestines promoted. By reflex action on the nerves of sensation, 
massage frequently gives relief from pain. A rise of temperature usually 
accompanies a treatment by general massage, and where confined to a 
limited area, a local rise of a number of degrees may occur. 

Methods of Massage. — Any knowledge of the technical details of mas- 
sage which can be obtained from text-books or lectures is at best but 
superficial and theoretical, for the manual dexterity essential for the 
proper application of massage requires long and continued practice on 
the human body, and its intelligent execution also requires a proper 
knowledge of anatomy and physiology. 

There are a number of methods of giving massage, but those gen- 
erally in use may be classified as coming under the Swedish, German or 
French systems. The Swedish is vigorous, bracing and literally followed 
is only applicable to strong, muscular, hardy people. It exercises the 
muscles to the bone, and is supposed to give the same benefit at each treat- 
ment as would a walk of several miles, yet without producing like fatigue. 
The German treatment is really a modification of the Swedish system, 
some of the exercises being omitted and substituted by baths. The treat- 
ment is much more gentle than the Swedish and is suitable for most pa- 
tients unless they have been reduced to a weakened condition by long ill- 
ness. The French system is merely a delicate manipulation, chiefly used 
by French ladies in what is sometimes called "Beauty Culture," being de- 
signed to keep the skin free from wrinkles and blemishes. The French 
treatment as a rule is confined to the face, neck, arms and hands. It un- 
doubtedly advantageously develops the parts treated and enables ladies 
who systematically make use of it to retain their beauty to an age that 
will rarely happen without. French massage is not of any special value 
in the treatment of disease but it sometimes is of benefit to invalids by 
giving them a refreshed feeling from the manipulation of the skin. 

There can be no question as to the need of having some regular 
system — that is to say, in treating any one patient there should be some 
regular system followed out in the same way on each occasion when treat- 
ment is given. Just which system to use must depend upon the condi- 
tion of the patient. It would be absurd to give the strong, vigorous 
Swedish treatment to one convalescing from a long illness. The full 
Swedish treatment even to the ordinary well man would be apt to bruise 
his muscles and therefore do more harm than good, yet to a football player 
or other athlete whose muscles were strong and hard the Swedish treat- 
ment would be of value. Common sense and consideration of the condi- 



1520 MASSAGE AS A TREATMENT OF DISEASE. 

tion of the patient must be factors in deciding what to do in each case. 
With those who are weak or delicate the treatment must at first be very 
light from day to day, as the muscles become accustomed to the treatment, 
the pressure may be increased and more force used in manipulation. 

Manipulation. — The room in which massage is given should be warm 
and free from draughts and care should be taken that the patient is really 
in condition to receive treatment. For instance, it is usually dangerous to 
give general massage in typhoid fever, owing to the tender condition of 
the bowels, and in cases of weak heart the increase in circulation from a 
vigorous massage might prove disastrous. Do not massage a moist skin. 
If the patient has been perspiring, first give a cooling sponge bath of 
alcohol or alcohol and water. Each part of the body before and during 
massage should be rubbed over with olive oil, vaseline, or cocoa butter. 
If there be a heavy growth of hair it may be advisable to shave, as other- 
wise manipulation may give pain and irritation of hair follicles, result- 
ing in abscesses. If for any reason it is undesirable to shave, then extra 
precaution must be taken in connection with each and every treatment 
that irritation is not caused at the hair roots. Do not rub such parts in 
the opposite direction from which the hair grows. In giving massage over 
the breasts or navel use a circular motion from left to right. There need 
be no fear of getting too near the bone in massaging deep muscles, yet 
be very careful that the manipulations over the bowels and vital organs 
are not excessive. There is an erroneous idea with many people that the 
patient should always be rubbed toward the end of the fingers and toes. 
On the contrary the rubbing should be toward the patient's heart, because 
the veins which carry the impure blood back to the heart and lungs to 
be freed from impurities lie near the surface, and by rubbing toward the 
heart the desired return of the poisoned blood is accelerated. 

The patient should be placed on a raised couch or table, narrow 
enough to permit of manipulation from either side. The patient should 
lie flat on the back with all muscles relaxed. The patient should draw 
his knees up when the abdomen is being treated, as this relaxes the ab- 
dominal muscles. After treating all parts of the front of the body, the 
patient should lie with the face downward and the muscles of the back 
receive their treatment. 

Begin with the head and using the finger-tips rub the scalp in a brisk, 
energetic manner, so as to induce circulation. The face should be mas- 
saged with a rotary motion, commencing with j:he chin and working up- 
ward toward the ears until a healthy glow is obtained. The neck should 



MASSAGE AS A TREATMENT OF DISEASE. 1521 

then be treated in the same manner. The arms are next in order. Com- 
mence at the tips of the fingers and make a few strokes upward to the 
shoulder in order to start circulation. This also prevents chilliness and 
should be followed in respect of each part of the body as it may be ex- 
posed. Now commence the regular massage of the hands and arms, start- 
ing with the tips of the fingers and rubbing each finger joint separately 
with a circular movement. Work in the direction of the palm, following 
the palmar bones to the wrist, carefully manipulating each joint. It is at 
the wrist that the real work of massaging the long muscles begins. Grasp 
the arm with the two hands and manipulate the thumb sides away from 
each other, as if dividing or parting the muscles from the bone. This 
should be carried out through the entire length of the arm. This same 
parting manipulation applies also in the treatment of the legs and all parts 
where there are long muscles. 

The next movement is that of wringing or twisting the muscles more 
or less in the same way that one might wring a wet cloth. The effect of 
this is to drive the blood from the muscles and stimulate the nerve centers. 
The next manipulation is that of kneading the muscles. Place one hand 
on the under side and one on top, and grasping with a firm grip of the 
hands use the balls of the thumbs to roll the muscles with a slow rotary 
motion from left to right. This manipulation should be repeated in re- 
spect of each and every muscle. Now go back to the tips of the fingers 
and commence a series of squeezes, working on each muscle with quick, 
firm grasps. This has a tendency to accelerate the flow of blood to the 
heart. The elbow joint should be given very careful attention and every 
spot thoroughly exercised. Now whip or flay the arms with finger-tips, 
using a light staccato stroke, which is best obtained by shaking the hands 
from the wrist. Before treating the larger muscles in this way they 
should be pounded with the sides of the open hands, the fingers extended. 
The motion is just as if one were chopping or hacking. The same pro- 
cedure is carried out with the shoulder and hip joints, care being taken to 
work in as deeply as possible. 

To massage the chest, the hands are laid flat, greater weight being 
placed on the thumb sides. Manipulation should be rotary from left to 
right. Little or no pressure should be given over the nipples. Now. 
using the thumbs and index fingers, grasp the flesh near the short ribs 
and by rolling motion work the muscles upward. Do this several times. 

Work That is Necessary in Treatment of the Abdomen. — The patient 
having drawn the knees up to relax the muscles, the hands should be 



1522 MASSAGE AS A TREATMENT OF DISEASE. 

placed, flat on the bowels near the hips, and using wrist force, the hands 
rolled firmly but gently forward to the tips of the fingers. In doing this 
use a rotary motion from left to right. Thorough manipulation should be 
given over the liver and if properly treated great benefit frequently ensues 
in cases of torpid liver, constipation and similar troubles, but in treating 
the abdomen it is better to err on the side of gentle manipulation than 
to run any risk of doing injury by severe work. 

The legs are treated in the same manner as the arms, but because ot 
deeper muscles, extra force is necessary. Each movement should be gone 
over several times when treating the legs and the large, deep muscles will 
stand thumping, hacking and slapping with the open hand to an extent 
that is not possible with the arms. 

The patient should now turn on the face and the back of the body and 
the limbs treated in a similar manner to that just described. Commence 
with the back of the head and neck. Massage the base of the brain and 
all down the spinal column very thoroughly, the idea being to stimulate 
the nerve centers which are located here. The treatment of the back gen- 
erally is the same as that of the chest. The spine should be flayed until 
it has a reddish glow, but do not use undue force. 

In general massage the extremities should be treated first, the mo- 
tion always being in the direction of the long axis of the bone and ex- 
tending from the ends toward the body or trunk. After general massage 
has been given as above described, it will usually be found beneficial to 
use a few simple movements such as the following: 

Commence with the hands. Rotate each finger from right to left 
four times, then the same number of times in the opposite direction. The 
wrist should be treated in the same way. Then raise and straighten 
the forearm, having the patient use slight resistance. Then grasp the 
wrist and elbow and extend the arm to its full length, and then move it 
in a large circle — four times one way and four times in the opposite 
direction. Treat the feet and legs in a similar manner. These movements 
are refreshing to the patient after the somewhat fatiguing manipulations 
of the general massage. 

The duration of a single treatment should be from forty to sixty 
minutes for general massage. Local treatment of course takes less time. 
The main movements employed, as will be seen, are stroking, pounding, 
kneading and percussion. The tips of the fingers and the balls of the 
thumbs are principally, though not exclusively employed, and the action 



MASSAGE AS A TREATMENT OF DISEASE. 1523 

is a free one from the wrist. After treatment a period of rest of at least 
an hour should be observed. 

It is sometimes asked whether massage may not be given through 
thin clothing without exposing the body. Such treatment is of course pos- 
sible, but to gain the full benefit of manipulation it is essential to work 
directly upon the body. 

Local massage is found very beneficial in many ills, and is recom- 
mended for congestion of the liver, gall stones, neuralgia, headache, ner- 
vous prostration, paralytic affection, St. Vitus' dance, writer's cramp, 
muscular rheumatism, stiff joints, sprains, curvature of the spine, obesity 
and various other troubles. 

While massage is recommended for sprains, it is necessary to make 
sure that there has been no fracture. Having ascertained that there has 
been no fracture and that' the bones are all in proper place, massage 
treatment may be used. Eaise the ankle and massage evenly and lightly 
for half an hour or more, the idea being to drive the blood away from the 
spot, where it would be likely to settle because of torn ligaments. If 
properly executed, massage of a sprain will relieve pain and reduce swell- 
ing. Massage with the back of the thumbs, using a circular motion, also 
gently use the parting movement already described. In the case of a 
bruise the idea in massage is to thoroughly drive the blood through the 
bruised part until new circulation is established. Both in respect of 
sprains and bruises the part should be bathed and subjected to hot fo- 
mentations after the massage and then properly bandaged. In the case 
of a bruise after-discoloration will often be avoided by binding a piece of 
well-pounded raw beef over the part for a few hours. 

In the foregoing description of general massage some particulars 
are given as to massaging the face, but this is not intended as indicating 
the manner of using massage to retain or increase the beauty of the face. 
In the chapter entitled "Self Care for Women" there will be found a de- 
scription of massage for these purposes, and which is quite distinct from 
the use of massage in treatment of disease as described in this present 
chapter. 



96 



MEDICAL SCHOOLS 



PAKT IV. 

CHIROPRACTIC 



Chiropractic was discovered by Dr. D. D. Palmer at Davenport, 
Iowa, in 1895. 

This science is based npon the fact that all disease is due originally 
to a condition in the individual, rather than to external influences. This 
condition is recognized by all schools of medicine as the "predisposition" 
or "lack of resistance." To illustrate: Thousands of persons continually 
inhale the germs of tuberculosis, yet only a small per cent, contract the 
disease. Scientists have answered this by showing that the germs only 
affect those who have weak lungs or a lack of resistance. Any physician 
will tell you that germs do not affect healthy people. 

If this statement can be accepted, then why bother so much about the 
germs that do not affect 99 per cent, of the people when it is admitted 
that there is a condition existing in the other 1 per cent, that makes them 
predisposed to disease and easily affected. Why not find out and correct 
the cause of this condition or predisposition and so allow nature to use 
her natural protection against these baleful external influences. 

Chiropractors, therefore, feel that this condition of predisposition is 
by far the most important part of all disease, and their work is confined 
solely to its correction, for even after a disease has fully developed, if 
tins condition can be eradicated, nature can readily restore normal health. 

While this condition of predisposition has been recognized by medical 
practitioners for many years, there is nothing in medical literature that 
will tell you what this condition really is. 

Dr. B. J. Palmer, a son of Dr. D. D. Palmer, has been the greatest 
factor in the development of Chiropractic as a science, and was the first 

1524 



CHIROPRACTIC. 1525 

to discover the real fundamental cause of disease. He maintained that 
the predisposition was simply a lack of function and that it was due to a 
partial displacement of a vertebra, with the result that the spinal nerve 
emitting from the cord would be "pinched/' thereby interfering with the 
flow of nerve impulses. 

Dr. G. H. Patchen, of New York, who has done a great deal of 
research work in Chiropractic, state the basic principles of this science 
as follows.: 

1st. That all nerves originate in the brain, converge at its base, form- 
ing the spinal cord which passes out of the skull, through an opening called 
the foramen magnum, into and through the center of the spinal column. 
From the spinal cord nerve filaments emerge, on each side of the spinal 
column, through a small opening between each consecutive pair of verte- 
brae, from whence they proceed to the parts and organs into which they 
severally terminate. 

2d. That the vitality and activity of every organ, tissue and cell 
of the body is maintained and controlled by an inherent force or energy, 
which is transformed or individualized by the brain, and then transmitted 
to these respective parts, in the form of mental impulses, through the 
channels provided by the nerves. 

3d. That when the transmission of mental impulses is normal both 
in volume and rapidity of delivery, or, in other words, when 100 per cent, 
of mental impulses reaches each organ and tissue in the body in a normal 
speed, all functions are perfectly performed, with a result which is known 
as health. But when the normal flow of mental impulses is interfered 
with, in any manner, the vital activities of the tissues and organs which 
these mental impulses severally maintain is either increased or diminished 
according to the degree of interference, the result in either case being a 
condition which is recognized as some form of disease. 

4th. That the only place where interference with the flow of mental 
impulses to a degree sufficient to cause deranged functional activity, or 
disease, can occur, is at the intervertebral foramina, the little openings 
between the vertebrae, on either side of the spinal column, already men- 
tioned. At any of these places a slight misalignment or sublaxation of a 
vertebra may so press upon the nerves passing out through it as to inter- 
fere, more or less seriously, with their conductive power. 

5th. That Chiropractic affords an exact and scientific method of de- 
termining the location of any vertebra which, on account of its misalign- 
ment, is responsible for nerve compression, and also an original, unique 



1526 CHIROPRACTIC. 

and most etiective manner for correcting this abnormal condition, by 
means of the hands alone, using either the spinous or transverse processes 
of the vertebrae as handles or levers. 

Chiropractors correct these vertebral displacements by placing their 
patient on a divided bench and giving with their hands what they term 
an "Adjustment." 



MEDICAL SCHOOLS 



PAET V. 



HYDROPATHY, WATER-CURE OR HYDROTHERAPY. 

History. — The use of water in the treatment of disease was practiced 
by the most skilled of all the Greek physicians, Hippocrates, 400 years 
before the time of Christ. Zechariah spoke of Christ as the healing 
fountain, and, in the thirty-sixth Psalm, David speaks of the fountain 
of life, showing that water was considered a healing agent even at that 
time. It was very extensively used by the Romans at the time of their 
highest development. During the middle ages it fell into dissue, along 
with many other rational agents. From time to time, however, men of 
more penetration than their fellows tried to restore it to general use, but 
usually only succeeded in arousing interest for a short time. Dr. James 
Currie, well • known as the editor of an edition of Burns , poems, who 
practiced in Liverpool from 1780 to 1805, was the most prominent advo- 
cate of hydrotherapy during the eighteenth century. He published a 
book entitled "Medical Reports on the Effects of Water, Cold and Warm, 
in the Treatment of Fevers." 

Father of •Modern Hydrotherapy — But it was a German farmer, named 
Priessnitz, who must be called the founder of modern hydrotherapy. In 
the year 1840 nearly sixteen hundred persons visited Graefenberg to be 
treated by him. His patients came from all parts of the world, and when 
cured they became missionaries of the new treatment. Schools were 
started not only in Europe, but in this country also. There is every 
reason to believe that the water-treatment has now secured a permanent 
place among the remedies used in combating disease. Professor Wilhelm 
Winternitz, of Vienna, is to-day the leading advocate of this method of 
treatment. 

Definitions. — Hydrotherapy is not a good term, since it is derived from 
two Greek words, which mean respectively, water and to suffer. It would, 
therefore, mean strictly water-suffering. The term water-cure is a good 
one, but may not be considered entirely scientific. Hygienic medicine is 
another term sometimes used for this method of treatment, but it is not 

1527 



1528 HYDROPATHY OR WATER CURE. 

sufficiently distinctive. A far better name, however, is Hydrotherapy, 
which means healing by water. This expresses with entire correctness 
the end sought by those who practice this form of medication. It is not 
confined to the use of cold water only, as some have supposed. That idea 
may have arisen from the fact that Priessnitz was a special advocate of 
cold water. 

Hydrotherapy — Hydrotherapy includes the application of water, inr 
ternally and externally, in any form and at any temperature. It may 
vary from solid or fluid to vapor ; from ice to steam Mineral waters are 
not used in hydrotherapy. They are not needed. There is, however, 
no objection to such waters being used if they are available. 

Physiology. — The effects of water upon the body are produced by its 
heat or cold and the manner in which it is applied. In order to under- 
stand this action it is necessary to consider the structure of the skin or 
outer covering of our bodies. It is an exceedingly complex and sensitive 
part of us. 

The Human Skin. — The skin is very elastic, and this is due to the 
presence of a network of elastic fibres in its deeper parts. Many very 
small muscles are also present in the skin. When they all contract at 
once the appearance known as "goose-flesh" is produced. Great numbers 
of tiny glands are present, and their openings on the surface are called 
pores. But more important than any of these are the fine blood-vessels 
and nerves which are so numerous that it is impossible to pass the finest 
needle point into the skin without causing pain and bleeding. Through 
these the application of water can affect the entire system most pro- 
foundly. 

FUNCTIONS OF THE SKIN. 

Nerve Endings. — The fine nerve endings in the skin guard the body 
like an army of sentinels. They warn us of too great heat or cold, or 
draughts or threatened injury. Wherever these nerves are the more 
numerous there the sense of heat and cold is the more acute. 

Skin Excretions. — The chief materials given off by the skin are 
watery vapor and urea, both of which are contained in the sweat; also a 
gas known as carbon dioxide. Urea, however, is more freely removed 
from the body by the kidneys. The amounts of these several constituents 
can be increased or decreased in a wonderful degree by applications to the 
skin of water at varying temperatures. 

Skin a Heat Regulator. — The human body is remarkable in its power 



PRACTICE OF HYDROTHERAPY. 1529 

to live under conditions so exceedingly variable. It can exist amid the 
burning heat of the tropics, or surrounded by the icy blasts of Greenland. 
The skin is one of the main agents in making this possible. So remarkable 
are its powers that in a hot climate it helps to cool the body, while in cold 
climates it prevents the waste of heat. 

PROPERTIES OF WATER. 

Value of Water. — The value of water as an agent in treating bodily 
ills rests in : First, its power of absorbing and transmitting heat and cold ; 
one pound of water will absorb eight times as much heat as a pound of iron, 
and yet not be any hotter than the iron; second, its flexibility .; water 
can be used in the solid, liquid or gaseous state; its volume increases 
seventeen hundred times in passing from ice to steam; third, its fluid 
form enables us to control it so easily and well that we can apply it at 
pleasure to any portion, or all of the body, as we desire, and for any 
length of time; fourth, the ease with which pressure can be applied to 
any part of the body through the force of the stream used. Any or all 
of these properties can be used at the same time in treating diseases by 
hydrotherapy. 

Action of Water in Health. — The most important means employed in 
hydrotherapy is the application of water to the skin surfaces. It acts 
upon the nerve endings by heat, cold and impact. The nerves transmit 
the effects to the brain, where it may be switched off and sent to any part 
of the body. Thus the amount of blood at the body surface can be in- 
creased or decreased. The speed of the blood current can be altered and 
the blood itself improved. More blood can be sent to the brain, thus 
securing greater mental activity ; or less blood being sent there sleep will 
follow. The pulse can be increased or decreased in force. The breathing 
may be increased in frequency and depth. The muscular system, too, is 
affected by the increased activity and the kidneys do more work. The 
body temperature can be directly affected. It is raised by hot and lowered 
by cold water. Three conditions, however, will be found to modify the 
last statements; these are the degree of temperature used, the length of 
time it is allowed to act and the manner in which it is applied. 

THE PRACTICE OF HYDROTHERAPY. 
Ablution. — This is the simplest and most widely-used method of 
applying water. It is effective in many diseases and is a good introduc- 
tion to the other more active measures. 



1530 HYDROPATHY OK WATER CURE. 

Definition. — Ablution is the application of water by the hand, with- 
out or with a bath-glove or washcloth. Sponges are not rough enough. 
The bare hand or a rough cloth can be made to produce just as much fric- 
tion as is desired. 

Method of Applying. — Have ready several vessels of water at the tem- 
peratures desired. In acute fevers with a temperature above 101 degrees 
Fahrenheit, first the patient should be stripped completely and covered 
with a blanket, remove the pillow, roll the patient upon his left side in the 
portion of the bed away from the one where you desire to work ; lay upon 
the bed a rubber sheet or oil cloth, covered by a blanket. This should be 
so placed that its near edge will overhang the bed, while the remainder is 
tucked against the patient's back. He is then rolled over again toward 
the nurse, while the rubber sheet and blanket are smoothed out on the 
opposite side of the bed. The patient can now be rolled upon his back, 
and you are ready to begin the bath. If the patient is a child he can be 
lifted from the bed, wrapped in a blanket, while the rubber sheet is being 
adjusted. Beginning with water at 65 degrees, first wash the face, dip 
the hands into the water and rapidly but gently apply it to the part, using 
gentle friction ; next go to the chest, forearms, back, abdomen and legs as 
far as the knees.. Repeat the process in the same order, but with water 
at a lower temperature, and so on until water at a temperature of 50 
degrees is used. The ablution is continued until slight chilliness is pro- 
duced. When the effect is sufficiently marked the patient is dried and 
allowed to remain perfectly quiet, with only a sheet or light blanket over 
him. Do not attempt to replace the nightgown until reaction is fully 
established. If sleep follows let the patient remain undisturbed until he 
awakes. 

In vigorous persons with high temperatures the effect may be made 
more pronounced by not drying the parts, but by simply spreading a 
sheet over the patient and allowing him to dry gradually. Care must be 
taken not to produce chilling. 

In Chronic Affections. — Ablution is useful as a beginning treatment. 
It may be used in the following way: A bed is prepared as described 
above; the patient is then stripped and laid upon the under blanket, with 
the arms raised above the head. The blanket is then folded over the 
body and between the limbs, hugging the surfaces closely at all points. 
The arms are now brought down close to the sides and the other side of 
the blanket laid over all and tucked in around the neck and under the feet. 
This should be done in a warm room and the patient given sips of cold 



TREATMENT OF ABLUTION. 1531 

water to drink at intervals of a few moments to promote sweating. More 
covers may be used if needed. After a half to one hour the patient's 
face is bathed in water at 50 degrees Fahrenheit. The blankets are now 
loosened and each part — arms, chest, back, abdomen and limbs — bathed 
in turn in water at 80 degrees. They are then dried and replaced under 
the blanket. A dry rubbing with hands or a towel follows and a short 
period of exercise is then ordered if the patient is able. If unable to 
exercise he should remain in bed and take a cup of warm liquid food. 
Morning is the best time for this procedure, but is useful whenever it can 
be had. 

General Ablution. — The next step in the training is a general ablution. 
The patient stands in twelve inches of water at 95 degrees, and is quickly 
washed from head to foot by pouring water upon him and rubbing at the 
same time. The heat of the water will vary with the patient and his 
length of training, from 80 degrees to 50 degrees. The great importance 
of care in these measures cannot be too deeply impressed upon all who 
undertake them. In chronic conditions the patient must be wooed back 
to health slowly, realizing all the while that a very small accident may 
destroy the results of weeks of patient care. It is not sufficient to advise 
a sick man that he should bathe in cold water every day. He must know 
just how, when and where, and also how long the bathing should proceed, 
and what changes are needed and when they should be made. 

When May Ablution be Used? — General ablution may be used in feb- 
rile diseases to reduce fever and at the same time prevent its rise. In 
mild cases of infectious fevers like measles it may be all that is necessary 
throughout the attack; typhoid fever, in which the temperature does not 
go above 102^ degrees; in severer cases more extended baths are indi- 
cated. In chronic cases of anemia and chlorosis, which are due to poverty 
of the blood, tuberculosis of the lungs, rheumatism, gout and loss of ner- 
vous tone. In the most severe cases of the last class it is a good intro- 
duction to more severe treatment. 

The Half Bath. — How applied: Into an ordinary bath-tub enough 
water is run to cover a patient's hips and limbs. The temperature may 
Tary from 85 to 70 degrees. The patient enters the bath, or, if too weak, 
is placed in it. A wet towel is wrapped about his head and the nurse pro- 
ceeds to bathe his face and then dash the water over his body with a ladle. 
At the same time the patient's back is rubbed by the attendant, while the 
patient himself rubs his own chest and abdomen. Cold water is added 
gradually and the process continued until the patient shivers. He is then 



1532 HYDROPATHY OR WATER CURE. 

removed before chilling ensues and dried before returning to the bed. 
This is a more stimulating procedure than ablution. 

When Used. — In chronic diseases, after the wet pack or procedures 
vet to be described, the half bath naturally follows to insure the closing of 
the pores and general reaction. It should continue from five to ten min- 
utes. The patient should be rapidly dried, and in fever cases this may be 
done in bed. 

Affusion. — Definition : Affusion is a bath by pouring. 

How Applied. — The patient may sit or stand in an empty tub or lie 
upon a rubber-covered cot while water is poured upon his head, shoulders 
and body in a stream from a bucket, pitcher or basin. The temperature, 
of the water may be varied from 65 to 50 degrees, and may be poured 
from different heights. The stimulation will vary with the temperature 
and height. The reclining and sitting postures are used for acute cases 
and the standing for chronic. 

Indications for its Use. — When patients are unconscious or delirious 
and seem absolutely exhausted, ablutions will often result in very sur- 
prising improvement. In advanced fever cases, when collapse is threat- 
ened, instead of injuring the heart action, they help it materially. In the 
collapse of children's diseases a warm half bath, with affusions over the 
head and chest, will often restore completely. In diseases of the lungs, 
when breathing is difficult ; in scarlet fever, with very high temperature, 
they will bring relief when all other methods fail. They are a better 
stimulant to the circulation than the most powerful medicines. In brain 
fever or meningitis, sunstroke and the brain symptoms of pneumonia they 
are the most useful agents known. 

The Sheet Bath. — Method of applying: Protect the bed by a rubber 
sheet, spread a blanket upon it, have ready-several linen sheets, a basin, a 
tub of water as cold as desired, 50 to 80 degrees, and nearby on a chair 
place a cup and sponge. The patient should be undressed and ready, 
wrapped. in a blanket or woolen gown. Wash the face with cold water and 
wrap a cold wet towel about the head. A sheet is now quickly wrung out 
of the water selected and spread evenly upon the bed. On this the patient 
is laid, and while he holds his arms up over his head one side of the sheet 
is brought over and tucked in on the opposite side and between the limbs. 
The arms are then brought down, and the opposite edge of the sheet is 
carried over and tucked in around the patient's neck and feet. In feeble 
patients the arms may be left out and bathed separately during the pro- 
cess. The first effect of this procedure will be a shock to the surface 



SHEET BATHS. 1533 

nerves by contact with the cold wet sheet. For a moment the breath will 
come in gasps and some shivering may follow. These quickly pass away 
as the nurse begins to rub the body by passing the open palms swiftly over 
all parts of the body and limbs. As soon as reaction follows, begin to 
pour water at 50 or 60 degrees temperature from the cup or squeeze it 
from the sponge over the body, rubbing at the same time with the other 
hand. Keep this up until the patient is cooled as much as desired or until 
he is on the verge of a chill. The combination of friction and cold water 
application through an enveloping sheet is an admirable way of securing 
the abatement of fever. To increase or prolong the effect allow the 
patient to remain in the cold sheet, covered by a blanket, from a half to one 
hour. If he sleeps do not disturb him until he awakes. When it is 
desirable to end the bath, remove the sheet, dry the patient quickly, place 
him in a dry bed and cover lightly. 

Drip Sheet Bath. — How applied : This is applied while the patient is 
standing. The room should be at 70 degrees or over. Place the patient, 
completely stripped, in a foot-bath of water at 100 degrees Fahrenheit and 
six inches deep. A sheet is now removed from a bucket of water at 70 
degrees and rapidly wound about the patient in the following manner: 
The right arm is held above the head while the edge of the sheet is placed 
upon the right breast. The sheet is then carried backward under the arm, 
which is now lowered, and serves to keep the sheet in place. The edge is 
now carried over the left shoulder, across the breast, over the right shoul- 
der, and tucked in snugly about the patient's neck. As soon as it is in 
place the nurse proceeds to stroke the body rapidly from head to foot over 
the sheet and slap it more or less vigorously. Water at 60 degrees is 
poured upon the head at intervals of a few moments and the rubbing con- 
tinued between the dashes of water. The process is kept up from five 
to ten minutes, according to the condition of the patient and his require- 
ments. At first it should be very short in order not to weary him ; grad- 
ually it can be lengthened as the power to react increases. After the 
bath dry rapidly, then rub with a warm towel or sheet. This bath is 
applied once a day and best during the afternoon. 

Uses of the Drip Sheet Bath. — Many chronic ailments are benefited by 
it, such as chlorosis, anemia, neurasthenia, intestinal catarrh, melancholia, 
neuralgias, pulmonary and bronchial diseases. Its application can be 
varied in a great variety of ways. 

The Cold Rub. — Definition: This is a modification of the drip sheet 



1534 HYDROPATHY OK WATER CURE. 

and is generally applied immediately after the patient arises in the morn- 
ing and while he is still warm. 

Application — A coarse linen sheet is wrung out of water at 60 to 75 
degrees and quickly wrapped about the patient in the manner described 
above. Friction is now applied rapidly over the sheet, accompanied by 
slapping, the object being to produce a definite reddening of the skin. 
This is only a short process, and when finished the sheet is dropped and the 
patient quickly dried. After dressing and drinking a cup of hot milk or 
cocoa the patient should take a walk in the open air. 

Uses.— In anemias of feeble patients, tuberculosis of the lungs, any 
case lacking in blood. 

The Wet Pack. — How applied: The method is very similar to that 
described in the preparation for ablution. The body is, however, first 
enveloped in a wet sheet in the manner described, so that it will lie in con- 
tact with every part of the body. The sheet should be wrung out of water 
at 70 degrees, or even as low as 60 degrees. Over this a blanket is folded 
so snugly that all outside air is excluded. A wet towel is folded about the 
head like a turban. If the patient feels cold more blankets are placed 
over him. He should remain in the pack from a half hour to an hour. 
It should be followed by some form of cold application to restore tone to 
the skin. A half bath, heat bath or cold ablution will serve this purpose. 

Uses. — If it is desired to abstract heat the sheet should be 60 to 70 
degrees. When it has become warm replace by one a few degrees colder 
on a fresh bed, and so on until the desired body temperature is reached. 
It is estimated that five baths, each of ten minutes, will equal a full bath 
of fifteen minutes' duration. With temperatures varying between 100 
and 103 degrees this is an excellent procedure. When used to quiet rest- 
lessness and promote sleep the higher temperature of water is used, say 
70 degrees, and the patient is allowed to remain in the pack until he 
awakes ; he is then given a rapid cold ablution. The wet pack is useful in 
most of the acute fevers at the outset. The addition of salt or other 
medicines to the water is sometimes advised. 

In Chronic Diseases. — In these cases the pack should not be quite as 
low in temperature. The cold stage lasts longer, reaction comes on more 
slowly, but when it does the soothing and refreshing effect is very evident. 
The whole body is in a sort of water poultice. It is valuable in functional 
nervous diseases, hysteria and some heart troubles. In tuberculosis of the 
lungs, with fever, it is found very effective. In diabetes, rheumatism, 



SHEET BATHS. 1535 

gout and digestive disorders, anemia and chlorosis it has proved very 
effective. 

The Wet Compress — This is probably the most extensively used of all 
hydriatic procedures. It is in fact a local wet pack. 

Method of Use — Several folds of old linen or cotton, gauze or cheese- 
cloth, sufficient to cover the part to be treated, are wrung out of water at 
the proper temperature and placed upon the part. A dry flannel or piece 
of oiled silk or rubber band sufficient to cover the compress follows, and 
over this a retaining bandage. 

The Head Compress — Take a linen towel wrung out of water at 60 to 
75 degrees and apply it like a turban to the heacf. This is used to prevent 
congestion of the brain and during all hot baths and wet packs. 

The Throat Compress. — It should be made and applied as follows : A 
piece of flannel, 8 x 24 inches, is made ready ; then a compress of soft linen, 
four inches wide and long enough to reach from one ear under the chin 
to the opposite ear, is soaked in water at 60 degrees and laid upon the 
throat ; the flannel bandage is next placed on it and drawn up snugly over 
the head, to be fastened by pins. A slit for each ear to be cut in the 
flannel if it is uncomfortable. Two bandages are made so that one can 
be dried while the other is in use. In children it is wise to first put a 
band around from the back of the head to the forehead, to which the upper 
bandage can be pinned at the intersections. 

The Chest Compress — Make two jackets out of three folds of old linen. 
They should be large enough to reach from the neck to the waist and en- 
tirely around the chest. At the points, by measure, where the two arm- 
pits will come cut a deep slit so that the arms may sink in far enough to 
allow the ends to be pinned over the shoulders from front and back. Cut 
two pieces of closely-woven flannel of the same shape as the jackets, but 
about an inch larger in every direction. Roll up one of the compresses 
and wring it out of water at 60 degrees. Spread it upon one of the flannel 
covers and roll them up together halfway. Now, with the patient gently 
turned on to one side, spread the unrolled portion on the bed behind him, 
so that he can be rolled back upon it in just the right place, to fit. Now 
unroll the remainder and bring the ends together across the chest, fasten- 
ing them with safety pins. Also pin the portions at the top over the 
shoulders. This compress should be changed every half hour when the 
temperature is 102 degrees or over, hourly when the temperature is below 
that and down to 99|, when it should be stopped. Always have the fre?h 
compress entirely ready before loosening the first. Thus, one movement 



1536 HYDROPATHY OK WATER CURE. 

of the patient will be sufficient to remove the old and apply the new com- 
press. Use fresh water at 60 degrees each time and always rinse the 
compress between using to keep it clean. Continue the changing night 
and day unless the patient is asleep. By being so thorough and careful 
the patient's chest will never be without a compress except at the brief 
moment when one is being rolled from and the other being unrolled upon 
his body. If stupor and low muttering delirium are present, use water 
which is colder than 60 degrees, also throw a few dashes of ice water on 
the chest before placing the fresh compress. When insomnia is marked 
use water slightly warmer than 60 degrees. These methods are used in 
croupous and broncho-pneumonia. 

The Hot Fomentation Compress. — Two or three folds of flannel, as 
large as desired, are wrung out of boiling water, making it as dry as pos- 
sible. The part should be anointed with vaseline and the hot flannel 
applied as quickly as possible, so as not to lose any of its heat. Surround 
the patient with a dry blanket over the compress. It may be necessary to 
lead up through several temperatures before the very hot compresses can 
be used. These compresses should be renewed every ten or fifteen min- 
utes until the patient sweats. After the pain is relieved the body may be 
carefully uncovered and quickly rubbed dry or washed with water at 75 
degrees, accompanied by friction. In sciatica nothing exceeds this method 
of treatment. In lumbago and other muscular rheumatisms a hot fomen- 
tation each night will soon result in relief. 

The Heart Compress — Wring out a piece of linfen from water at 40 
degrees and lay it upon the heart. On this place a rubber coil and pass 
ice water through it. A flannel binder will keep all in place. This is 
especially useful in irregular heart action, due to nervous conditions, in 
rapid heart action in some very weak patients. It will also be effective 
even when digitalis has failed. It can be used in a course of severe fevers, 
such as typhoid. 

The Cold Full Bath. — By this is meant the placing of the entire body 
in water 10 to 30 degrees below the normal body temperature for from 
five to twenty minutes. It is this form of bath which has revolutionized 
the treatment of typhoid fever. Its application varies with the ends in 
view. In acute cases it should be applied as follows: A movable bath- 
tub is provided, if possible, and rather than use the ordinary house bath- 
room an improvised bath apparatus is advisable. 

Method of Applying a Tub Bath. — When the tub is ready the patient 
is stripped and a breech-cloth applied, or he may be left enveloped in a 



BATHS AND DOUCHES. 1537 

sheet. A stimulant is then given, either hot coffee or half an ounce of 
whiskey. Two attendants then lift him carefully from the hed and place 
him directly in the bath. A towel soaked in cold water is bound about 
his head. The head is supported by a strip across the tub or a rubber 
cushion. If neither of these are available one hand of the attendant must 
support the head while the other is employed in the rubbing process. Both 
attendants vigorously rub the patient from head to foot. From time to 
time fresh cold water is poured upon the head and face. The rubbing is 
an absolute necessity in this form of bath. There is always some shock 
when a patient is placed in cold water, but under brisk rubbing the surface 
is warmed and stimulated, so that there is a continuation of little shocks 
and reactions. As rapidly as the surface is cooled the blood is pushed for- 
ward and fresh hot blood from the deeper parts takes its place and is in 
its turn cooled. The process continues thus until the temperature falls 
sufficiently or the bath is continued long enough, or the danger of severe 
chill makes it wise to end the bath. The bed in the meantime has been 
spread with a blanket and dry linen sheets ; *the patient is lifted from the 
bath and placed upon the bed. The sheet and blanket are then folded 
over from one side under the raised arm and tucked between the limbs, 
then the other half over the arms, so enveloping the whole body. Very 
frequently he will fall asleep. If shivering is prolonged it is an evidence 
that the bath has been too cold or too long, and a change should be made 
at the next application. If reaction does not come on promptly hot v r ater 
bottles or bricks should be placed to the feet and between the limbs. Fric- 
tion must always be used in the cold bath treatment. If it is neglected 
the bath will really be a cause of increasing the fever by closing the pores 
and contracting the surface blood-vessels. 

The Warm Full Bath — The warm bath is one in water a little below 
the normal body temperature. Hot baths are those with the temperature 
above the normal body temperature. These baths should be arranged so 
that the temperature may be increased after the patient is in the water, 
either'by kettles of hotter water or by gradually increasing the water from 
a hot faucet. They should last from five minutes to an hour, according to 
the object sought and the conditions being treated. Their general effect 
is soothing, although the very hot baths are stimulating; for example, those 
of the Japanese at 130 degrees Fahrenheit. Warm baths are useful in 
relieving pain and nervousness, reducing temperature, the latter especially 
in children and infants. Care should be taken to dry thoroughly after 
baths and protect from draughts. 



1538 HYDROPATHY OR WATER CURE. 

The Hammock Bath. — The hammock bath is a means of applying the 
effect of water through long periods of time. An extra deep tub is used, 
the patient is swung upon a strong sheet which is fastened to the edges of 
the tub or to a framework over it, so that the water surrounds him up 
to his neck. Constant renewal, by the inflow of water at a given tempera- 
ture. 

The Douche. — This is the application to parts or the whole of the body 
of a stream or streams of water at varying temperatures. Moreover, the 
stream should be under different degrees of pressure. When the stream 
is made to take a form which is broad and flat it is called a fan douche. 
This is made by partially closing the outlet or nozzle by the thumb or 
finger. The shower bath is another form. In this the pressure ought to 
equal the fall from a cistern fifty feet above the outlet. The needle or 
circular bath is one in which the water is forced against the body in fine 
jets from all sides at once. The ascending or bidet douche is one in which 
a jet is directed upward from below, usually while the patient is sitting, 
and is used in rectal treatment to overcome piles. 

The Hip-Bath.- — The hip- or sitz-bath, as its name implies, is one ap- 
plied to the lower part of the body only. The bath is first prepared, then 
the patient stripped, a wet towel bound about the head and a warm blanket 
about the feet. Sometimes it is wise to add a hot-water bottle with the 
foot blanket. When the patient is in the bath the under side of the knees 
should not rest upon the tub; if they do a stool should be placed under 
the feet. Rapid friction should be used over the parts in the water by an 
attendant and also the patient himself. When the bath is over dry the 
patient and have him return to bed for a short rest, or, if an invalid, re- 
main there. Hot baths are 104 to 110 degrees Fahrenheit, cold baths as 
low as 50 degrees. All grades between these are used. The duration of 
hip-baths may vary very greatly. Hot hip-baths are used to overcome pain 
in the abdomen and pelvis, to reduce inflammation of the pelvic organs, 
to cure cystitis, urethritis, uterine hemorrhage, diarrhoea and dysentery, 
and especially vesical straining. 

Uses — Cold hip-baths of short duration are stimulating and are used 
to overcome muscular paralysis or loss of tone, in prolapsus of the rectum, 
spermatorrhea, prostatorrhea, impotence, weakness of the uterine liga- 
ments, prolapsus of the uterus, the leucorrhea of chlorosis, stoppage of 
the mouses, passive bleeding, constipation aud flatulency. 

Steam. — Yapor of water, with or without medicines, has been used 
for softening the mucus in case of croup, laryngitis, false-croup and 



HYDROTHERAPY IN SPECIAL DISEASES. 1539 

diphtheria. A tent or canopy is arranged over the patient and the steam 
conducted under this from one or more kettles kept heated hy alcohol 
lamps or any other available method. When nothing else can be found 
heat some bricks or stones and drop them into buckets of water under the 
tent until sufficient steam has been generated. Steam is also used to check 
bleeding by some surgeons; also as a cleansing agent in some operations 
for cancer. 

The Turkish Bath. — This, as its name implies, has come down to us 
from the Turks, and they obtained it from the Arabians. It consists first 
of a soujourn for a considerable time in a hot-air chamber, with a tempera- 
ture from 105 to 125 degrees. The patient remains in this room until 
he is in a thorough perspiration ; he is then laid upon a table and an attend- 
ant rubs him thoroughly with his hands and kneads the flesh from head to 
foot. The attendant scrubs him with soap and water, using a brush, and 
finally washes him off with warm water. After another short stay in the 
hot room the patient stands for a few moments under the shower bath and 
is then wiped dry. He then passes to what is known as the "cooling off" 
room, where he lies quietly upon a cot; the temperature of this room is 
usually 80 degrees. A quiet sleep will often follow the bath, and after it 
the patient should be rubbed with alcohol and take a cup of coffee or choco- 
late before dressing and leaving the bath. 

Russian Bath. — This bath differs from the Turkish in that the first 
chamber is filled with steam instead of dry air, and the final process before 
drying is a cold plunge into a tank or swimming pool. The latter may be 
replaced by pouring cold water over the bather. The last two methods 
are used to reduce flesh, particularly in corpulent individuals. In well- 
nourished, rheumatic and gouty patients, in neuralgic affections, in per- 
sons of this same class, these baths will be especially beneficial. 

HYDROTHERAPY IN SPECIAL DISEASES. 

Typhoid Fever. — The following methods may be used in treating this 
disease : 

1. Ablutions and compresses until the temperature has reached 103 
degrees, or when the cold baths are impossible. 

2. The cold bath; a bath at 05 degrees, lasting fifteen minutes, when- 
ever the temperature rises to 102-1- degrees, in the rectum. 

3. If this method is not advisable the Ziemssen half-hour baths may 
be used, where the water is reduced graduallv from 90 to Y0 degrees. 

97 



1540 HYDROPATHY OR WATER CURE. 

4. In very weak, nervous patients, coming under treatment in the 
second week or later, only five- or ten-minute baths at 88 to 95 degrees, fol- 
lowed by short cold effusion, or a wet pack, should be risked. The tem- 
perature and duration of the bath can be altered with the improvement of 
the patient. 

5. The hammock bath, as described above, can be substituted in treat- 
ing very timid patients. 

Measles. — With a temperature at 103 degrees a bath of ten minutes 
in water at 95 degrees is very soothing. It should be repeated every four 
hours and the water temperature reduced five degrees each time until the 
desired effect is produced. The patient generally falls into a quiet sleep 
after such a bath. When the full bath cannot be given ablution may be 
used rapidly, but without friction. Cerebral symptoms should be over- 
come in this way. The half-bath can be very successfully used in measles. 
This may be repeated oftener than the full bath. Do not wait too long 
before beginning the water treatment. If the patient's nervous tone is 
kept high by the above methods there will be less likelihood of any lung 
complications beginning. 

Scarlatina. — In the early stages, before the diagnosis is sure, a warm 
full bath at 100 degrees, for a few minutes, will quiet the patient wonder- 
fully. If the heart action is feeble, the bath should be followed by a few 
dashes of cold water over the shoulders and chest, or the latter method 
may be used without the full bath. In urgent cases an effusion may be 
used every hour until reaction is sufficient and the heart is relieved by 
bringing the blood to the surface. When the eruption is well out and 
the mind clear there is not much need for treatment ; but when tempera- 
ture is high or mind clouded and congestion evident ablutions with water 
at 90 degrees, gradually reduced to 75 degrees, are very effective. The 
time occupied in a single ablution should be short, as it is the nervous sys- 
tem that we wish to affect more especially. The number of ablutions will 
depend upon the result obtained. It may be necessary to have them 
repeated every hour. 

Pneumonia — 1. In Children. — Begin bathing when the temperature 
reaches 103 degrees, or earlier if nervous symptoms are marked. The 
bath should begin at a temperature of 95 degrees and last for ten minutes. 
They should be repeated every four hours, and the temperature of the 
water decreased two degrees each time until 80 degrees is reached. Never 
omit friction. Between the baths, in bad cases, use the chest compress 
every one or two hours. If alarming symptoms appear, or heart failure 



TREATMENT OF SUNSTROKE. 1541 

is feared, place the child up to the waist in a bath at 100 degrees and dash 
several basins at 75 to 65 degrees over the shoulders. Follow this with 
rapid friction and drying. Repeat this process as often as every two hours 
if necessary. Crying and coughing are caused and they are a wonderful 
help in relieving the congestion. In less severe cases, wet packs, ice 
jackets or cold sponging may be sufficient. 

2. In Adults. — The greater difficulty in applying baths to adult pa- 
tients and the fact that practically as good results can be secured in 
another way, have led to the adoption of the latter plan, which is the 
chest compress. The full bath can be reserved for the more urgent cases. 
The warm half-bath and cold effusion to the chest are also exceedingly 
valuable in emergencies. 

The Chest Compress — This has been described in the foregoing pages. 
Do not neglect the careful observance of all the details. Usually a 
temperature of 60 degrees is best, but in cases with stupor or muttering 
delirium a lower temperature will be needed. Dashes of ice water can 
be used when the compress is being changed. If there is sleeplessness 
or excitability allow the compress to remain for two hours, or even longer, 
without changing; this will increase its soothing effects. 

Acute Cholera Infantum. — The element of shock in this disease is so 
decided that the attacks resemble sunstroke. The internal temperature is 
often very high indeed. Reaction must be secured quickly or it will be 
too late. It is sometimes necessary to proceed with these measures before 
attending to any of those which logically precede, as indicated above. 
Prepare a bath at 90 degrees, wrap a cold cloth about the child's head 
and have it supported by an assistant. Lower the child's body into the 
bath, holding it by the hands and feet. Begin gentle friction over the 
different parts of the body, arms and legs to the elbows and knees. Have 
another assistant remove water from the bath and replace it with ice water 
until the temperature falls to 80 degrees. Continue the bath ten minutes, 
or if shivering occurs before that time remove the child. If the tempera- 
ture has been very high follow the bath by a wet pack and a blanket over 
that. Put hot bottles to the feet and keep the head cool. If the symptoms 
are not so urgent a wet pack alone may secure the desired reaction. 

Sunstroke. — Put the patient upon a rubber-covered cot, cover him 
with a sheet, dash upon him, at intervals, dipperfuls of cold water, in the 
meantime keeping up constant friction over all parts of the body and 
limbs. Keep an ice-bag or cold cloth upon the head, and occasionally 
pour ice water upon the forehead from a height of six feet. The friction 



154:2 HYDROPATHY OR WATER CURE. 

must not be neglected under any circumstances. When the rectal tem- 
perature has fallen to 104 or 103 degrees wrap the patient in dry blankets, 
with hot bottles to the feet and limbs. Usually the patient will fall asleep 
and break out in a gentle sweat. If reaction does not occur and the tem- 
perature again rises repeat the above treatment. Continue thus until the 
temperature remains down. As soon as the patient can swallow give small 
drinks of ice water at frequent intervals. 

Anemia or Lack of Blood — Here we must distinctly understand that 
we are not to abstract heat from the body. On arising in the morning 
the bath should be taken as follows : In a room the temperature of which 
should not be lower than 68 degrees. Let the patient stand in water at 
100 degrees and pour over him water at 80 degrees and at the same time 
have him rubbed thoroughly and let him rub himself. Reduce the tem- 
perature of the water 2 degrees each day. Dry rapidly after the bath, 
dress and let the patient take a short walk in the open air. In weak 
patients the dry pack may precede the ablution. 

Consumption. — To give a consumptive patient full benefit of the 
water treatment it should be begun and carried out systematically. If 
the body is already well cared for the treatment can begin at once, if 
not, a good warm water and soap bath must be given on the first day, 
and then the following day proceed thus: Strip the patient entirely 
naked, wrap him in a blanket, cover him with other blankets and give 
small drinks of water at short intervals, say every ten minutes. During 
this dry pack the windows may be wide open even in winter. After an 
hour has passed wash the face with quite cold water and dry. Have a 
basin ready with water at 75 degrees, remove one arm from the covers 
and wash it briskly with the wet hand or with the hand covered by a 
bath glove. Rub well and then dry and replace. Do the same with the 
other arm, then the different parts of the body successively. At the end 
rub the entire body with a rough towel. Repeat this treatment daily 
until, by reducing the temperature 2 degrees daily, the water is used at 
60 degrees. 

Neuralgia. — In this trouble great relief has resulted from the various 
water methods of treatment. Especially good results have followed when 
rapid contracts of temperature have been used like that obtained in the 
Scotch douche. In sciatica this treatment has been wonderfully suc- 
cessful. 

Chronic Rheumatism and Gout. — These cases may be divided for treat- 
ment into two classes : 



INTERNAL USE OF WATER. 1543 

1. The Well-Nourished Subjects.— These should be given full baths 
for from eight to fifteen minutes, in water at 95 degrees, gradually raised 
to as high a temperature as can be borne; gentle massage to be given 
during the bath. Allow the patient to drink large quantities of water both 
during and between the baths. The bath should be followed by sweating 
between blankets. These baths should be given daily, or less often accord- 
ing to the patient's condition and progress. Between the baths cold wet 
compresses at 65 degrees can be bound upon the affected parts and 
allowed to remain until almost dry. Such compresses may be used during 
the night. A sweat in the cabinet for Rye to fifteen minutes followed by 
the douche at 100 degrees, reduced to 90 degrees during the progress of 
the bath, will be found very useful after the above courses. 

2. The Poorly Nourished. — Hot baths must be used very cautiously 
and infrequently in this class of treatment. Once or twice a week will 
be found sufficient. Ablutions gradually decreased in temperature are 
most effective. Scotch douches to the joints, followed by cold compresses, 
should also be used. As the patient becomes more used to lower tempera- 
tures the baths may be made more stimulating. More food will be taken, 
digestion improved and the patient gradually increase in weight and 
strength. 

Dyspepsia — Catarrhal and nervous types of this diseases are recog- 
nized. The treatment is similar to that for anemia. As a local stimulant 
the Scotch douche over the region of the stomach is very effective. The 
hygienic rules must be carefully remembered during the treatment of 
this condition. The daily cold plunge bath, or its equivalent, will be a 
great help. 

THE INTERNAL USE OF WATER. 

Effects. — Drinking cold water slows the pulse and makes it stronger 
and fuller. Hot water weakens and makes it rapid. Cold water is the 
best diuretic, warm water the best diaphoretic or sweating agent. 

Acute Infectious Diseases. — The method of using cold water ex- 
ternally in the treatment of acute diseases has been detailed in the 
previous pages, but the good effects of that treatment will often be lost 
unless enough. cold water is given internally. At least a glassful of cold 
water should be drunk every two hours by a patient suffering with fever. 
The drinking of so much water insures a good flow of urine and increases 
the perspiration. 

Gastric Catarrh A pint to a pint and a half of water, taken a half- 



1544 HYDROPATHY OR WATER CURE. 

hour to an hour before meals so hot that it cannot be drunk but only 
sipped, will cleanse the stomach and prove an excellent stimulant to the 
muscular walls of that organ. This method of treatment has been very 
widely employed, but has often failed because the water was not drunk 
at a sufficiently high temperature. The administration of water to babies 
has already been mentioned. 



MEDICAL SCHOOLS 



PAKT VI. 
ECLECTIC MEDICINE. 

Name and Principle. — The name eclectic means choosing, and it re- 
fers directly to the means used for treating disease. It implies a selection 
of methods and remedies from all other systems of practice. "The great 
principle upon which eclecticism is based is : that disease, wherever met, 
and in whatever form manifested, is an impairment of vitality; that 
causes of disease are depressing and, whilst they exist, lower vital powers. 
The corollary from this is, that all agencies employed in the treatment 
of disease should act in one of two ways — removing the depressing cause, 
and increasing the vital powers for better resistance and subsequent res- 
toration of structures and function/' 

Belief — The eclectic schools of medicine believe in the curative power 
of nature. They claim that medicines can be useful only as they aid 
nature in her endeavors to cure the diseased condition. 

All the remedies known as antiphlogistic are discarded: bleeding, 
mercurials, antimony, and so forth. They avoid the use of mineral 
poisons for medical purposes. They seek to remove the cause of disease 
through the natural outlets of the body, and foster those measures which 
result in a better renewal of life. They treat the cause rather than any 
special symptoms which result from its presence. 

CONDITIONS OF HEALTH. 

1st. A general bodily expression of vigor, the face being the chief 
indicator. 

2d. !N"o painful or unpleasant sensations should be present. 

3d. The bodily heat should be 98.4 degrees Fahrenheit. 

4th. A pulse of 72 beats each minute, regular in force and time. 

5th. A good appetite and digestion, with a daily bowel movement. 

6th. The skin and kidneys should be acting normally. 

7th. Well-balanced nervous system and a clear eye. 

CONDITIONS OF DISEASE. 

Any deviation from the condition just described would constitute dis- 
ease, but we do not usually speak of a condition as disease until it has 
been in existence long enough, or become strong enough, to make its 

1545 



1546 ECLECTIC MEDICINE. 

presence inconvenient or troublesome to the patient. The following are 
some of the conditions which indicate disease : 

1st. The face of the patient, his position and actions show signs of 
suffering. 

2d. The temperature may vary widely from the normal. It may 
fall to 95 degrees or lower, or rise to 107 degrees or more. The presence 
or absence of fever can be discovered to some degree by the hand, but 
far better with a thermometer. 

3d. The pulse may be increased or decreased in frequency; may 
become harder or softer than normal ; may be irregular in rhythm or force. 

4th. The stomach and bowels may be disturbed, and this will be 
indicated by the condition of the tongue. 

5 th. The urine and discharges from the bowels may be very much 
altered. The skin will be rough and harsh to the touch, and during fever 
hot and dry. 

6th. The nervous system may present a great variety of symptoms. 
The eye will be dull and heavy except in special diseased conditions. 

ECLECTIC DIAGNOSIS. 

A consideration of the symptoms present in a given case leads to a 
conclusion regarding its character. That is called making a diagnosis. 

Diseases are known by their features in the same way that we know 
our friends and relatives by their features. 

ECLECTIC TREATMENT. 

The medicines and methods used in caring for a sick patient are 
termed the treatment. These will be indicated in connection with each 
condition as it is described later. One thing only need be said here: 
"'Never give medicine unless you are positive that it ivill relieve present 
discomfort and shorten the duration of disease/' 

FEBRILE DISEASES. 

Fevers are of two classes: 1st. Those which have a local cause in 
one or more of the organs of the body ; 2d. Those in which no such local 
cause is found, but in which the fluids of the body are involved in disease. 

Phenomena of Fevers — The advent and course of a fever is, in gen- 
eral, as follows: 1st. A period of gradual approach called the incubation 



INTERMITTENT FEVERS. 1547 

period or onset. It is known by the feeling of weariness, dry skin, cold 
hands and feet, loss of appetite, with headache and disturbed sleep. 

The Cold Stage. — 2d. This is usually known by the chill which occurs. 
Severe headache and backache. The hands and feet become icy cold, the 
lips are blue and the face very pale. This stage may last only a few 
minutes or may be prolonged to several hours. 

The Hot Stage — 3d. At this time the pulse becomes rapid. The 
color returns to the face and is increased. The body heat rises, some- 
times very high. The skin remains hot and dry. The length of this 
period varies greatly in different fevers. Following it we have 

The Stage of Decline — 4th. This leads to recovery. The various 
symptoms become less and less severe. The skin becomes moist. The 
secretions begin again and gradually all the functions resume their nor- 
mal course. 

Fevers are divided into two classes according to their course: inter- 
mittent and continued. 

INTERMITTENT FEVERS. 

Treatment. — This class of fevers is the result of poisoning by malaria. 
In the stage of onset they may be aborted by a brisk purge, an emetic and 
a sweat. In the cold stage the patient should be treated by a hot mustard 
foot-bath and then placed in bed, well covered by blankets, with hot bottles 
or bricks to the feet and limbs, and given frequent drinks of ice water or 
very hot coffee or water. During the hot stage cold drinks should be ad- 
ministered ; the body frequently sponged with cold water, and then lightly 
covered and protected from draughts. 

Between attacks the patient should remain in bed if he is at all pros- 
trated. He should be given quinine in large enough doses to cause the 
ears to ring. It is best given in solution. The following prescription is 
a good one : 

R— Quinine 2 drachms 

Water i ounce 

Give half a teaspoonful in a glass of water every throe hours. A 
double dose should be given about two hours before the time of next ex- 
pected chill. 

When the stomach will not retain quinine it may be used in an 

ointment : 



1548 ECLECTIC MEDICINE. 

R. — Quinine I drachm 

Lard 2 ounces 

This should be rubbed into the skin, especially the parts under the 
arms and on the inside of the thighs. The amount above indicated should 
be used every day if the patient is an adult. It will be sufficient for four 
days in a child five years or under. 

When Quinine Fails — When quinine fails, or is too slow in its action, 
the following may be used : 

R. — Strychnine 2 grains 

Dilute muriatic acid 2 ounces 

Water enough to make half a pint. Give one teaspoonful every three 
hours to an adult. Another remedy is common salt: 

R. — Salt 3 ounces 

Powdered alum 3 drachms 

Boiling water % pint 

Give a teaspoonful every two hours during the absence of the fever. 

CONTINUED FEVERS. 

Febricula or Little Fever. — This may be caused by a single cold, by 
constipation (especially in children), catarrh, simple sore throat, indiges- 
tion and slight congestion of the lungs. 

Treatment. — Kelieve the bowels, if necessary, by an enema. Place 
the patient in a full warm bath, rub briskly after it, and follow with a 
hot mustard foot-bath. Place him in bed between blankets and give fre- 
quent cold drinks until he sweats. Allow him to sweat for half an hour, 
then rub dry and remove all but the lightest blanket. Allow him to go 
to sleep and he will probably wake up entirely recovered. 

TYPHOID OR ENTERIC FEVER. 

There are three conditions of this fever which have received separate 
names: 1st. Those which are so mild that they are not usually considered 
to be typhoid at all, and known as synochal fever; 2d. Those that are 
somewhat more severe, but run a shorter course than most cases of typhoid, 



ECLECTIC TREATMENT OF TYPHOID. 1549 

and are called synochoid fever. They are, however, all caused by the 
same poison and should be classed with (3d) Typhoid Fever. 

Typical Typhoid. — A typical case of typhoid fever has a stage or 
period of onset covering about one week. The usual symptoms of that 
stage will be present, but the gradual daily increase of fever will be quite 
apparent. The face will acquire a dull, spiritless aspect and the patient 
may be somewhat drowsy. About the eighth day a few fine, so-called, 
rose spots will appear upon the abdomen. Their distinguishing feature 
is that they do not disappear entirely when the skin upon which they 
rest is stretched. This fever is self-limiting, so that the treatment is 
nearly all comprised within the field of good nursing. 

Diet — Certain rules, however, must be adhered to very strictly. No 
solid food should be given at any time during the illness. Liquid food 
should be given every two or three hours, according to the needs of each 
case. At times it is necessary to awake the patient during the night to give 
nourishment. Milk, beef tea, albumin or white of egg y the entire egg 
raw, and beef extracts will be found useful. 

The Bath. — Plenty of water should be given if the patient desires it. 
A soap and water sponge bath should be given daily. As often as the 
temperature goes above 102 degrees Fahrenheit an ice-water sponge bath, 
with friction, should be given. If these do not prove sufficient to keep the 
temperature under control full tub baths should be used. The water should 
be 85 degrees Fahrenheit when the patient is placed in it. Ice is then 
added gradually until the water is only 65 degrees Fahrenheit. Rubbing 
should be employed during the entire bath, which should continue for 15 
or 20 minutes, or until the patient's teeth are beginning to chatter. He 
should be lifted out and quickly dried, then laid on the bed with a blanket 
over him until reaction follows. The blanket is then replaced by a sheet 
and the patient allowed to sleep if he desires. Usually a stimulant is 
given before each tub bath. This may be half an ounce of whiskey or 
brandy. 

Disinfection. — All urine and bowel discharges should be disinfected 
before being thrown out. Probably the best thing to use for this purpose 
is a saturated solution of Chlorinated Lime or Bleaching Powder. Use a 
tablespoonful to each pint of the discharges, mix it well and allow the 
mixture to stand for five minutes before emptying. 

The giving of medicine in this fever ought to be under a doctor's 
care, and there are so many possible complications that may arise that 
it is always wise to have a physician in charge of the case. 



1550 ECLECTIC MEDICINE. 

TYPHUS FEVER. 

Symptoms. — This is sometimes called camp fever. It is a well-recog- 
nized form of disease, running a definite course, and is due to a special 
infective poison. Its onset is shorter and more severe than that of typhoid. 
There is severe pain in the head and back, the former is often retracted 
in the same way that it is in meningitis. The skin becomes a dusky red 
and about the sixth day a distinct papular eruption appears. 

MEASLES OR RUBEOLA. 

This disease is marked at the outset by redness of the eyes and free 
flow of mucus from the nose. There is usually some sore throat and 
slight cough, but the throat trouble is not as severe as in scarlet fever. 

Treatment.— 1. When the above signs appear begin the treatment by 
bathing the feet in hot water for half an hour ; then place the patient in 
bed and give frequent doses of an infusion or tea made of lobelia and 
asclepias leaves, equal parts of each. This should be stopped as soon as 
there is produced any tendency to vomit. Such treatment favors the out- 
break of the eruption. After it is fully out continue the same medicine 
but in smaller doses to relieve cough and quiet any lung symptoms which 
may be present. Plenty of water should be given and a liquid diet. 

2. When the fever is high sponging with tepid water is very soothing 
and will often quiet a restless patient and produce sleep. 

3. For troublesome cough an infusion or tea made from the ordinary 
red clover hay will be found very useful. 

Accessory Treatment. — 1. When the chest symptoms are bad a tent 
may be made over the bed and steam passed under it from a kettle, the 
water in which has a teaspoonful of the tincture of lobelia to each pint. 
A cloth spread with carbolized vaseline may be placed on the chest to aid 
in soothing the symptoms in that region. 

2. Care should be taken to protect the patient from danger of taking 
fresh cold during at least two weeks after all the fever is gone. If care 
is not exercised in this regard chronic nasal catarrh may result. See that 
the clothing is sufficiently warm and that the feet are kept dry. 

Treatment in Severe Cases. — 1. Whenever a case of measles is appar- 
ently severe at the outset, the treatment should begin with the following: 

Tincture of belladonna 20 drops 

Tincture of aconite 15 drops 

Water 4 ounces 

Mix and give a teaspoonful every hour until the skin is relaxed and the pul*^ 
less strong. 



SCARLET FEVER, OK SCARLATINA. 1551 

2. Whenever the eruption is delayed a wet pack will usually bring it 
out. If this cannot be given an emetic of salt or mustard water will be 
found effective. 

3. For very severe cough following or even during the attack a tea- 
spoonful of the tincture of drosera in a wineglassful of water every four 
hours will afford great relief. 

SCARLET FEVER OR SCARLATINA. 

Treatment. — 1. The sooner the eruption appears the shorter the dis- 
ease; treatment therefore should first be directed toward that end. We 
accordingly begin at once with the following: 

Tincture of aconite 15 drops 

Tincture of belladonna 20 drops 

Water 4 ounces 

Mix and give a teaspoonful every hour. 

2. Bathe the body frequently in water in which a little soda has been 
dissolved. These measures will hasten the appearance of the eruption and 
can be gradually decreased as the fever subsides. 

3. For the throat conditions the fumes from vinegar and water (one 
part of the former to three of the latter) will be found useful. Also a 
flannel soaked in equal parts of vinegar and water should be bound around 
the throat and renewed every hour or half hour during the worst part of 
the attack and then gradually discontinued as the trouble subsides. 

4. In the early stages of very severe cases veratrum may be substi- 
tuted for aconite in the prescription given above. If the nervous system is 
much affected replace the belladonna by gelsemium. When the glands 
of the neck swell badly the following preparation may be painted on the 
outside every four hours : 

Tincture of lobelia 2 ounces 

Tincture of aconite % ounce 

Tincture of arnica % ounce 

Or, make a poultice of wheat-bran and a strong tea of lobelia and 
apply it to the neck. One of the best gargles for patients old enough to 
use this method is made by adding one-half a teaspoonful of permanganate 
of potassium to a pint of water. 



1552 ECLECTIC MEDICINE. 

CHICKEN-POX OR VARICELLA. 

Treatment. — 1. Give a sponge bath followed by a hot foot-bath and 
hot drinks until sweating follows. If the bowels are costive it would be 
well to give a dose of castor oil or a seidlitz powder at the very outset. 

2. If the fever is high give the following: 

Tincture of veratrum 10 drops 

Tincture of asclepias % ounce 

Water 3 ounces 

Mix and give a teaspoonful every hour to a child five or six years old. 

3. For itching of the skin bathe with the following: 

Glycerine 5 ounces 

Rose water 5 ounces 

Subnitrate of bismuth 30 grains 

DIPHTHERIA. 

Treatment. — 1. First give an emetic if the attack is severe ; if not, use 
the prescription with aconite given under the head of Measles and add 
veratrum if the fever is high. In the latter condition also we should use 
the general bath in addition to the hot foot-bath. The bath may be made 
more effective by adding salt or pepper or mustard to the water. If the 
feet become cold at any time a hot mustard foot-bath may be used. 

2. For the sore throat give every hour a teaspoonful of the fol- 



lowing : 



Potassium chlorate 3 drachms 

Water 4 ounces 



If the mouth and throat remain dry use the following: 

Dilute muriatic acid % ounce 

Simple syrup 2 ounces 

Mix and give a teaspoonful in water as a drink every two hours. 

3. When the aconite has reduced the force of the disease so that the 
skin becomes soft and moist, stop it and give quinine, one grain every hour 
until the pulse is full and strong. If the patient is old enough to gargle 
any of the following may be used : Chlorate of potash ten grains to the 
ounce of water; infusion of baptisia ; infusion of witch hazel; dilute tinc- 
ture of phytolacca ; or the solution of permanganate of potash thirty grains 



TONSILLITIS. 1553 

to the pint of water. The last can be used as a spray or on cotton swabs. 
Use vinegar and water compresses to the outside of the neck constantly. 

POISONOUS BITES AND STINGS. 

Treatment. — Give aromatic spirits of ammonia in two-dracbm doses in 
water every hour until reaction follows the shock. Strong coffee is also 
useful for the same purpose. Slices of raw onion may be bound on the 
point of injury or sting. Another very good external application is the 
permanganate of potash solution two drachms to the pint of water. 

A COLD OR CORYZA. 

Treatment. — Whenever a cold is suspected it may be broken up by 
giving a half drachm of the tincture of gelsemium and allowing the patient 
to sleep for a couple of hours. If this cannot be done give a hot mustard 
foot-bath, place the patient in bed and give hot drinks until a good sweat 
is secured. If more rapid means are desired give an emetic. Another good 
method is a wet sheet pack. Give a brisk purge in nearly all cases. 

INFLUENZA. 

Treatment. — Usually the plan just given for treating a cold will be 
found equally useful for influenza. If there is fever, or further treatment 
is needed, give teaspoonful doses of compound tincture of Virginia snake- 
root every two hours until the patient is well. 

TONSILLITIS. 

Treatment. — Use the following spray to the part during five minutes 
every four hours : 

R. — Aconite tincture i drachm 

Water % pint 

This will usually cut short the attack. Do not allow the patient to 
swallow the spray. If an atomizer cannot be had apply the medicine on 
cotton. Equal parts of vinegar and water may be used in place of the 
above. Apply on the outside flannels moistened with stillingia liniment. 
If the aconite spray does not cure in two days stop it and paint the tonsils 
with fluid extract of witch hazel. 



1554 ECLECTIC MEDICINE. 

ACUTE LARYNGITIS OR CROUP. 

Treatment — This may be the same as that just outlined for tonsillitis, 
but usually more active measures are needed. The hot foot-bath, steam 
inhalations and frequent small doses of tincture of lobelia or sanguinaria 
in simple syrup should be given until free sweating and flow of mucus 
occur. Prompt relief will then follow. Dry cups on the outside will be 
necessary in severe cases. A good free purge should always be secured 
early in the treatment. 

ACUTE BRONCHITIS. 

Treatment. — 1. Begin the treatment by an emetic of lobelia or mus- 
tard water; after it acts give a purgative — the compound jalap powder or 
compound cathartic pill ; follow that with a hot foot-bath and warm drinks 
until the patient sweats freely, then dry quickly and place in bed. If the 
attack is not completely averted by this treatment give the following until 
recovery is complete : 

R. — Tincture of gelsemium i ounce 

Acetate of potash Vi ounce 

Water up to 4 ounces 

Mix and give a teaspoonful every two hours. 

2. If a stronger expectorant or cough mixture is needed the following 
may answer : 

R. — Syrup of lobelia 2 ounces 

Syrup of senega 2 ounces 

Syrup of althea 2 ounces 

Tincture of hyocyamus % ounce 

Mix and give a teaspoonful every two hours. (It is well to give quinine and 
iron as a tonic during convalescence.) 

CHRONIC BRONCHITIS. 

Treatment. — 1. This is often the result of neglect in the course of an 
acute attack. Its treatment is therefore the same as that used in later 
stages of acute bronchitis. Cough is usually the most troublesome symp- 
tom, and the following mixtures have been found useful in combating it : 

R. — Balsam of fir 1 ounce 

Balsam of tolu 1 ounce 

Balsam of peru 1 ounce 



ASTHMA AND WHOOPING-COUGH. 1555 

Oil of anise % drachm 

Tincture of opium I drachm 

Honey 2 ounces 

Jamaica rum, to make one pint. 
Mix, and take 1 or 2 teaspoonfuls every three or four hours. Shake well 
before using. 

2. Or, 

R. — Balsam of copaiba 1 ounce 

Balsam of fir V2 ounce 

Sweet spirits of nitre V2 ounce 

Honey % ounce 

Mucilage of acacia, to make 4 ounces. 
Mix, and take a teaspoonful every four hours. 

Inhalations of creosote are also useful — a drachm in a pint of boiling water 
three times a day. 

ASTHMA. 
Treatment. — 1. Chronic cases have been cured by the following: 

R. — Sulphur % ounce 

Bruised anise seed 2V2 drachms 

Confection of senna 6 drachms 

Syrup of tolu 6 drachms 

Mix, and take freely every day; or, one or two teaspoonfuls three times a 
day, or sufficient to keep the bowels moving easily. 

2. Or, 

R. — Sulphur V'2 ounce 

Anise seed % ounce 

Senna 1 ounce 

Cream of tartar 1 ounce 

Mix, and give a teaspoonful every night, or oftener if required. 

Bathing and hygiene should be very carefully attended to. 

WHOOPING-COUGH OR PERTUSSIS. 

Treatment. — 1. Begin with the following medicine as soon as the 
diagnosis is made : 

R. — Fluid extract of belladonna 10 drops 

Alum 1 drachm 

Simple syrup 4 ounces 

Mix, and give a teaspoonful every three hours to a child two years old. 

The amount of belladonna in the prescription should be increased five drops for 
every added year of age in the patient. 
98 



1556 ECLECTIC MEDICINE. 

2. Another good mixture is : 

R. — Clover hay 2 ounces 

Boiling water V2 pint 

Mix and let stand for hall an hour, then strain and add 1 ounce of sugar. 
Give 2 teaspoonfuls every three hours. 

INTESTINAL WORMS. 

Treatment — To drive out stomach worms give five and a half grains 
of santonate of soda on two succeeding nights; follow on the second 
morning with sufficient compound jalap powder to give a free purge. Give 
tonics afterward and keep the bowels regular. 

Pin Worms. — Keep the bowels regular and the person clean, also take 
daily injections of cold salt water in the strength of a tablespoonful of salt 
to the pint of water. 

Tape Worms. — 1. For tape worms give the following: 

R. — Oil of turpentine % ounce 

Castor oil 1 ounce 

Honey 1 ounce 

Yolks of 3 eggs. 
Beat the ingredients together and take it all, in divided doses during an 
hour, before retiring at night. 

2. The ethereal oil of male fern is also an efficient remedy. The dose 
is from a half to one and a half drachms according to the age of the 
patient, given in milk or mucilage at night and followed in the morning by 
a purgative of compound jalap powder. 

DYSENTERY. 

Treatment. — Give the sulphate of magnesia in teaspoonful doses in as 
little water as will melt it every hour until the blood is stopped. Follow 
that by an astringent, or opium if there is pain. The subnitrate of bis- 
muth will rapidly check the succeeding diarrhoea; give half a drachm 
every two hours until the bowels are checked. The patient should go with- 
out food for a day and then begin very cautiously with liquid diet and 
gradually increase until full diet is again reached. 



MEDICAL SCHOOLS 



PART VII. 



JAPANESE CHARACTERISTICS AND THEIR VARIOUS 
DISEASES AND TREATMENTS. 

THE SKIN. 

The skin of the Japanese is of light yellow, which on the one hand 
transits into an European white, while on the other hand it goes down into 
deep yellow or light brown. Exceptionally, it is light bronze colored as 
if they came from Ceylon. 

Skin of Upper Classes.— The people of the upper class are mostly 
lighter in color than those of the lower stratum. Some Japanese are not 
distinguishable from Caucasians in color, and apparently lighter than 
many of the Spaniards or Italians. The northern Japanese people are 
lighter in color than those of southern Japan, where they resemble some- 
what the Malayans in color. Differences between sex is very slight. It is 
caused by the difference of the mode of life. Japanese men are more 
exposed to weather and sunshine than the women, half of whose lives are 
lived inside of the house. 

Skin of Children. — Children are not lighter than the adults, and 
toward their teeth-changing age they become somewhat flushed with red 
color. 

Babies. — A new-born baby is called akambo in Japanese, which means 
"red baby." It is remarkably red compared with that of the white race, 
but the redness does not continue longer than a few days after birth. 
Babies of higher class people are also lighter in color than the lower, while 
in other respects infants coming from robust mothers are frequently 
lightly rose-colored in the cheek, and are not as beautiful as the lighter 
child for European eyes. 

1557 



1558 



JAPANESE TREATMENT OF DISEASE. 



THE CAUSE OF COLOR. 

Skin Pigments. — The yellow color of the skin of Oriental people de- 
pends upon the presence of pigment particles within the skin stratum. 
So we find yellow or brown pig- 
ments in these people while it is 
black in the negro. But by careful 
examination of the lighter-colored 
skin of the Japanese there is a very 
small amount of pigment, though it 
may be larger in amount according 
to the intensity of the color. Of 
course the amount of the pigment 
found in Japanese differs only quan- 
tatively, not qualitatively. In chil- 
dren just born/ or in foetus, the dis- 
tribution is very uneven and the 
amount is also scarce. 

Mixed Breeds.— Mix breeds of 
European and Japanese are mostly 





Japanese Lady— fMiddle Class ) 

must be gently rose-color before marriage. 



Japanese Ladies— (Upper Class.) 

very beautiful, their skin resembling 
north Europeans, or sometimes the 
inhabitants along Mediterranean Sea. 

Skin of the Abdomen. — Local 
pigmentation is not without interest. 
The pigmentation of the middle line of 
the abdomen is oftentimes noticed in yet 
young maids who have no relation to 
pregnancy at all, whereas European 
women have it only during their preg- 
nancy. Tn rare cases we meet with 
pigmentation of male subjects. 

Nipples. — tipples of unmarried 
girls are darker than those of the blonde 
European women, which in the latter 



JAPANESE TREATMENT OF DISEASE. 1559 

Lips. — Lips and eve-balls are generally about the same as Europeans 
are, but sometimes tbere are some who have circumscribed blueish-grey 
coloration along the conjunction of external skin and mucous membrane. 

Tatooing. — Beside these congenital characteristics, Japanese did 
tattooing in greater extent. But tattooing on the skin is not accepted by 
the higher class or educated people, it is controlled exclusively by the 
lower layer of the people, such as coolies or the same. Under the law 
these barbarous customs were already forbidden and now we see them 
very seldom among the old coolies. 

CARE OF THE SKIN AMONG JAPANESE. 

Japanese Cleanliness. — Japanese are strict lovers of individual cleanli- 
ness. Every family has a bathroom, whether in the city or the village 
cottage, from the wealthy to the poorer classes. Those who have no 
bathrooms of their own may find everywhere public baths, which are 
scattered throughout the cities or towns. These public baths stand under 
inspection of the sanitary police. 

Daily Baths. — Above the middle-class people, Japanese take baths 
every day; even the laborers never omit baths over three days at longest. 

Change of Clothing. — Underwear, stockings or other clothes are sent 
once a week to laundries, while well-to-do families take more frequent 
care of the clothing. Japanese women are more careful than the men, 
so if any woman omits a bath over two days she is spoken of as dirty by 
the others. 

Bath Temperatures. — The temperature of the bath is generally very 
high in the city, while it is about the same as in other lands in the country. 

THE HAIR. 
Types of Hair. — Speaking generally, Japanese have the same features 
of hair as the other folks of the Malayo-Mongolian race. There are, how- 
ever, at least two kinds of Japanese distinguishable by their hair, one 
is of the thin hair type, with long face ; another is of the thick hair type, 
which reminds us of resemblance of the Albino race. In this latter type 
we observe pretty coarse hair on various parts of the body. 

THE HAIR OF THE HEAD. 
Color of Hair. — Development of hair of Japanese is thick and strong. 
The color of the hair is seemingly dark, but absolute black is very seldom 
seen. If we examine the hair carefully it is darkish-brown, or frequently 
red-brown ; true blonde hair being seen rarely in the Japanese, it being 
somewhat abnormal, as the hair of the Albino is among Europeans. 



1560 JAPANESE TREATMENT OF DISEASE. 

Hair of Children. — The hair of children is far lighter in color than 
that of adults. Under four years the children rarely have dark hair. 

Women's Hair. — The hair of women appears a more brilliant black 
than that of the men. The length of the hair is preserved pretty long, 
for aesthetic purposes, and some reaches to the heel, when they untie 
their pompadours. Japanese women's hair is generally straight. Curling 
is seldom seen. Japanese women detest curled hair, and unmarried girls 
are quite unhappy when they have curled hair. 

THE BEARD. 

The beard of the Japanese is very thin and scarce. It makes its 
appearance comparatively later in life than with the Europeans. The 
color is generally dark-brown to red-brown, and sometimes lighter brown. 

CARE OF THE HAIR. 

Pompadours. — No woman in the world, from admirable society ladies 
to the negresses in a wild part of Africa; from ancient Egyptians to the 
present Hottentots, have failed to take care of their precious hair. So 
it is also the case with Japanese women. As you read and see, the 
Japanese women form very peculiar pompadours with great earnestness 
and skill. 

Perfumes. — They use some perfuming oily materials to make the 
hair fragrant and brilliant. 

Hats. — The European hat is never used by Japanese women. They 
use an oblong square piece of various cloth. In a short walk they use no 
cover except a handy parasol. On the other hand, most of the laboring 
class women use cloth covers over their heads. 

NOSE AND EYES. 

Nose Peculiarities. — One glance is enough to judge what nationality 
is in question, when anybody notices the nose and eyes of the Japanese. 
The difference of the nose of Japanese from Caucasian lies in the anatomi- 
cal difference as to the attaching point of the root of the nose to the frontal 
bone. Where the Caucasian's stretches out directly from the same plain 
in front the Japanese nose starts from far deeper portion of the frontal 
bone. This peculiarity gives a further characteristic appearance to the 
face of disagreeable flatness. Exceptions to this common character are 
frequently seen. 



JAPANESE TREATMENT OF DISEASE. 1561 

The Eyes. — Japanese eyes are very different from those of the Euro- 
pean, as the latter have the depression between the orbital arch and lid- 
rim, while the former lack this depression and have folds in the lid-rim 
and inner-angle of the eyes. The opening also is narrower in Japanese. 
All these differences depend upon the position of the eye-balls. The 
European has eye-balls situated more forward. 

Color of the Eyes. — Japanese have dark eyes; among one hundred, 
ninety-five being brown, five black. But in Japan true black eyes are 
rarer than in Southern Europe. New-born infants have bluish-black to 
greenish-black colored eyes, which after several months become gradually 
a brown color. 

Eyebrows generally grow very thick and broad and of black color. 

Ears — Ears are not built shapely in many cases as we notice in 
Europeans. 

Cheek. — The cheek is also pretty prominent, which represents an 
Asiatic characteristic. This is only remarkable in one type of Japanese; 
while in another the long-faced type is not much noticeable. 

MOUTH AND TEETH. 

The mouth of fine type is usually small, and the lips fasten shapely ; 
while the lower type has a comparatively wider opening, which is dis- 
agreeable to look at. Teeth are of good quality when grown normally. 
In the lower class, however, there is a more prognatic mouth, owing ap- 
parently to the ignorance about the proper care of the children during 
their second dentition. Dental diseases seem to be rarer than in this 
country. Oral hygiene is regarded as important by the Japanese, and 
children are taught to get a regular habit of cleaning the mouth at home 
as well as at school. 

INFECTIOUS DISEASES. 

Measles (Mashin or Hashika). — Preventive measures are taken 
strictly. Isolation of the sick children from healthy. When one of a 
family falls a victim, all dejecta of the sick child is mixed with antiseptica, 
such as Hve per cent, carbolic acid, or one one-thousandth corrosive subli- 
mate lotion, and so forth. For the disease itself, baths, packs — especially 
carbol ointment, milk, eggs, expectorants and sometimes antipyretics. 

Scarlet Fever (Shiokownetz) . — Preventive measures are the same in 
all infectious cases. Baths, douches, packs, gargles, lemonade, stimulants 
and symptomatics. In Japan no epidemic of this disease has been experi- 



1562 JAPANESE TREATMENT OF DISEASE. 

enced, and I have treated only one case. Some authors believe that 
Japanese are immune to scarlatina. 

Small-Pox (Howsow) — Before the introduction of Jenner's vaccina- 
tion, small-pox was regarded as if a life-tax which everybody born in 
Japan must pay once in a lifetime. 

Vaccination — Since vaccination has been imported people believe in 
it unanimously, and thirty years ago the government put forth vaccination 
laws. It is compulsory every three or seven years. The treatment is by 
baths, symptomatics, stimulants, prophylactics. 

Chicken-Pow (Futow) . — Children suffer only slightly, and unless com- 
plications follow the physician is not usually called in. But medical 
officers of health notify the case. 

Mumps (Zikasenin) — Generally mercuric ointment rubbing is enough. 
If the case is grave, the leech, purgatives, light diet and incision are 
resorted to. 

Whooping-Cough (Hiakunichigai) — Isolation of children from pa- 
tient. Change of air; much out-of-door life; moist packs; cold ablution. 
Each fit attended with vomiting should be followed immediately by the 
administration of nourishment (milk, egg, broth, and so forth). Bromo- 
form from three to ten drops, sometimes beneficial. Internally, some 
narcotics, such as bromide or belladonna. There are many children who 
become true patients from imitating their comrade-patients. Parents lack 
care when such a comic accident occurs. 

Cholera Nostra (Kakuran). — This is much dreaded by parents, and 
also in adults in the summer months. 

Treatment. — Opium, calomel, bismuth, astringent wine, soup, poul- 
tices, stimulants. 

Dysentery (Sekiri). — Japan was losing her inhabitants at a dreadful 
rate annually, and the cause was discovered by Dr. Shiga, who started his 
serum-therapy treatment about three years ago in behalf of the govern- 
ment. The result of this special treatment decidedly diminished the 
mortality. Dr. Flexner, professor in University of Pennsylvania, dis- 
covered the same cause in his expedition to the Philippines. 

General Treatment. — Besides this special treatment, castor-oil, calo- 
mel, opium, suppositories, saline infusions, mucilaginous enemata, con- 
centrated liquid diet, stimulants, hot packs, isolation, notification, disin- 
fection, and so forth. 

Canine Rabies (Kiokenbio) — Preventive inoculation, or commonly 



JAPANESE TREATMENT OF DISEASE. 1563 

spoken of as Pasteur's treatment. Cauterization of wound, narcotics 
(chloral, morphine), stimulants. 

The Plague (Pest or Kokushibio) — The recent invasion of plague gave 
Japan a severe blow, and government as well as people were in utmost 
alarm, and every effort was made to subdue this obstinate disease. At 
present no case in Japan. The preventive measure is very strict ; burning 
down infected places, ships and trains quarantined, house-hunting and 
arrests in suspicious cases. 

Special Treatment. — For special treatment, Yersin's healing and pre- 
ventive inoculation ; Kitasato's serum therapy ; Oiher's symptomatic treat- 
ments. 

Yellow Fever (Ohnetz) — ]STo cases in Japan. 

The Rheumatic Diseases (Riumatisu) — Salicylic acid and its salts, 
salophen, salol, colchicum. Wet packs, baths (iodine, bog-mud), massage, 
and so forth. 

Croupous Pneumonia (Haiin). — Ice-bag, cold drinks; diet with milk 
and eggs ; cold packs, mustard-plaster, digitalis and stimulants. 

Epidemic Cerebro-Spinal Meningitis (Riu-kow-sei Now-sekizuimaku-in) . 
— Occurs seldom in Japan. 

Treatment. — Best, cold pack, ice-bag, blood-letting from mastoid 
region, calomel, cantharoidal blister to the nape of the neck, mercurial 
inunction, antipyretica and narcotica. 

Erysipelas (Tandoku). — Serum therapy in first place, and then or- 
dinary symptomatic treatments, such as poultices, sustained nourishment, 
cold baths, stimulants, injection of 3 per cent, carbolic acid to surrounding 
inflammation. 

Relapsing Fever (Kaikinetz). — Quinine or other antipyretica stimu- 
lants and tonics. This disease was introduced by soldiers at the end of 
China-Japanese war, but no cases at present. 

Malarial Fever (Kwanketsunetz) . — Quinine sulphate in various doses 
before the expected attack — usually six hours. In protracted cases, ar- 
senic and iron administered, and baths directed. 

TUBERCULOUS DISEASES (Kekkaku-bio). 

Pulmonary Tuberculosis (Hai-kekkaku) . — Digestible diet (milk chiefly 
recommended, eggs, solf -boiled rice, cod-liver oil, young poultry), cool 
rubbing of skin, open-air life, country residence, treatment in sanatorium ; 
arsenic, creosote, guayocole, myrtol, solveol, and so forth ; mineral waters. 



1564: JAPANESE TREATMENT OF DISEASE. 

t 

Expectorants (pectoral tea, senega, apomorphine, chloride, and so forth). 
For cough — codeine, opium, belladonna, morphine. For night-sweats — 
atropine, agaricine, and so forth. For hemorrhages — rest, ergotine, mor- 
phine, ice-bag, lead acetate. For marasmic fever — antipyretics. Indi- 
vidual spittoon, disinfection of linens, encouragement of the patient. 

Sanatorium Treatment. — Beside these ordinary treatments in Japan a 
special serum therapy is in popular favor, or new-tuberculin injection in 
sanatorium, where patients are provided with free air, sports in various 
styles and medical attendance. 

Glandular Tuberculosis (Rui reki). — Cod-liver oil with lime, iron, 
iodide, arsenic, nutrition; sometimes surgical operation. Japanese be- 
lieve that glandular tuberculosis is a forerunner of pulmonal tuberculosis, 
and they come to get it extirpated by surgeon. 

Intestinal Tuberculosis (Cho kekkaku) — Opium, poultices, bismuth, 
astringents, mucilaginous drinks, decoction of salep or Colombo. 

Tuberculous Peritonitis (Fukumaku-kekkaku) . — Beside symptomatic 
treatments, laparotomy undertaken with brilliant results. 

Typhoid Fever (Chotyphus). — Serum therapy is used as a special 
remedy with good results. Diet : milk, broth, eggs, beef juice or chicken. 
Calomel at onset. Cold baths at 20 degrees Centigrade, and antipyretica 
in febrile stage. Later, digitalis and stimulants. Prevent bed-sores by 
alcoholic applications or air bed. 

Diphtheria and Croup (Dixteria Croopu) — Serum therapy in every 
case. As other methods for preventing complications, gargle or inhala- 
tion of dilute solution of carbolic acid (rarely used), iced milk, stimulants. 
In suffocating stakes, emetics, intubation or tracheotomy. In such grave 
cases combination of antitoxin serum and surgical operation are pre- 
ferred. 

Grippe (Riu kow sei Kanbo). — Isolation and disinfection of the pa- 
tients, but in widespread epidemic these preventive measures are 
scarcely to be carried out. For patient, rest in bed, good ventilation, light- 
ly digestible food and medicaments. Among medicines, chinine is very ef- 
fective, or antipyrine and salicylic acid are recommended for fever. Ex- 
pectorants, gargles and stimulants according to the condition of the 
patient. 

Asiatic Cholera (Kolera). — Strict quarantine and disinfection. 
Cholera cadavers always cremated. 

Serum therapy against cholera was and is used by government insti- 
tute, but we have not many cases to determine its real value. Calomel, 



JAPANESE TREATMENT OF DISEASE. 1565 

opium, ice-pills, hot-packs, stimulants, infusion of saline solution are 
symptomatic medicines. 

Leprosy (Rai-bio) — Preventive measure is the most important, inas- 
much as we have no special treatment. In a plain, near Mountain Fuji, 
there is one lepra village under government expense, where any patient 
who desires to spend his poor life apart from the community is allowed 
to live, furnished with necessary staffs. 

Among medicaments for leprosy, natrium salicylicum has good rep- 
utation and ointments of ichthyol, aristol and hydroxylamin are recom- 
mended. 

Gonorrhea (Rinbio). — As preventive measure, strict inspection of 
public girls thrice a month by sanitary inspectors. Some use condoms 
and wash local part with 2 per cent, carbolic acid, after intercourse. 

Medicinal Treatment. — Among medicines, sulphate of zinc followed 
by iodoform is most used; garbolmol came in general use quite recently. 
Internally, balsamum copaivse (0.6 in gelatine capsule, five to ten times a 
day), balsamum peruvianum, balsamum tolutanum, oleum terbenthinse, 
fructus cubebae, and so forth. Dietary care is very important, as light 
coffee, milk, tea, avoiding strong coffee, tea or spices. Patient must be 
confined to bed, no speaking, no pictures which may cause sexual excite- 
ment; against erection and pollution; early supper, many hours before 
sleep, and a pulver consisting of bromide potash, lupulin and camphor. 

For annoying urination (repeated in short time) suppositories of 
opium or morphine used (but not belladonna). 

For chronic gonorrhea we decline to meet urethral strictures, which 
want bougie treatment or surgical operation. 

Tetanus (Hashofu). — Serum therapy used in general. Beside thor- 
ough incision and washing of the infected wound, if discovered. Among 
symptomatic remedies narcotics are the only medicines to lessen patient's 
trouble. 

Chancre (Nansei-gekan) . — When ulcers appear many abortive treat- 
ments offered, such as washing with concentrated nitrate silver, sulphate 
zinc, caustic potash, caustic paste or galvanic cauterization. 

After these methods, application of thin layer of iodoform, aristol, 
calomel, bismuth, dermatol or europhine, and covered with fat-free cotton 
moistened with carbol vaseline. Liquors avoided as well as sexual inter- 
course. For complications, often surgical treatment wanted. 

Syphilis (Baidoku) or Acquired Syphilis (Kowten baidoku). — Prophy- 
laxis, being the same as gonorrhea. When syphilitic patients may marry. 



1566 JAPANESE TREATMENT OF DISEASE. 

It is considered as harmless if they marry after three years from their 
first infection. But this, of course, depends upon the patients, whether 
they had taken proper antisyphilitic treatment during that period or not. 
After marriage, they should consult physicians every two or three weeks 
for first six months whether any sign of return appears or not. 

Syphilitic Stages.— If a man is infected with syphilis, the first symp- 
tom is hard chancre, which wants mercury treatment. From this primary 
stage to secondary period mercury cure is the chief treatment. The 
patient is forbidden to indulge in baccho et venere during this treat- 
ment. Cold is harmful for the patient taking inunction cure, so cold 
baths or douches not allowed. Dietary care is also important. Some 
physicians recommend combination of inunction and internal administra- 
tion of iodide potash. For the broad condylomata on the external skin, 
washing with saline solution and calomel pulverization proves beneficial. 
When recidicive occurs, sometimes condylomatous eruptions appear in 
mouth. In such case internal use of mercuric preparation is prescribed. 

Third Stage of Syphilis. — When syphilis proceeds to the third stage, 
iodide of potash is prescribed as a special remedy. By this treatment, 
if patient be persevering enough to maintain full effect, almost all of the 
syphilitic symptoms disappear. 

Iodo preparations combined with iron serve as an effective remedy 
against subsequent cachexia and amyloid degeneration. Mineral baths 
(sulphur) are recommended also. Sometimes subcutaneous injections of 
mercuric preparations are directed. 

If gummata affects various parts they are treated surgically. 

Nose Syphilis. — When syphilis is located at nose, mercuric plaster 
is used for ulcerative part of skin. For the destruction of internal part 
of nose, we treat it with nose-douche, washing with carbolic acid (2 per 
cent.), corrosive sublimate or thymol, followed by snuffing of calomel or 
iodoform. After the destructive process ceases to progress, the deforma- 
tion is repaired by a plastic operation. 

Other Syphilitic Forms. — Other forms of syphilis are treated under 
general antisyphilitic remedies and special methods according to the lo- 
cation. 

For syphilitic affection of nervous system, electricity or massages 
are recommended sometimes beside general antisyphilitic cure. 

Hereditary Syphilis (Senten baidoku). — Prophylactic measures are 
most important, so nobody should marry within the course of three years 
after infected with syphilis. If a woman becomes infected with syphilis 



JAPANESE TREATMENT OF DISEASE. 



1567 



during her pregnancy, a strict antisyphilitic remedy must be taken. If 
it was in the course of the latter half of pregnancy, the baby is expected 
to be born healthy. But in such a case, the baby is to be nourished with 
cow-milk or by a wet-nurse exclusively. But if syphilis had rooted deep 
in the parent before pregnancy, the baby also inherits the formidable 
virus with its life, and then the baby is preferably nourished with its 
mother's milk. But the mother is treated with iodide potash in order 
that the specific medicine may be secreted through mammalian glands into 
the milk. For the disease itself, use mercuric pills in favorable forms for 
the stomach. 

Treatment of Mothers. — During treatment the mother should take 
care of cleaning oral cavity every day. Bath containing corrosive sub- 
limate (3.0), 28 degrees Reaumur, is directed every day. In my country 
the bathtub is made of wood generally, and it suits for the use of mercury 
bath. 

DISEASES OF RESPIRATORY ORGANS. 

Laryngeal Catarrh (Kowtow katarrh) — Priesneitz's pack around neck, 
hot milk, codeine for acute. Inhalation of saline water, tannin-alum solu- 
tion; painting with nitrate silver (3-10 per cent.) for chronic. Baths are 
not recommended much. 

Bronchitis (Kikwanshi katarrh). — For acute form, mineral water, 
milk and tea, wet packing, warm baths, codeine, expectorants. For chronic 
form, marine life or warm southern climate, wet packs, rubbing skin, 
expectorants. Inhalation of mineral water is especially recommended. 

Asthma (Zensoku) — Treatment of eventual nose diseases, marine 
life. In paroxymata, iodide potash, morphine, inhalation of pyridin 
vapor, and so forth. 

Pulmonal Emphysemata (Haikishi). — About same as asthma or bron- 
chial catarrh. Iodide potash or digitalis, gymnastics of lungs, pneumatic 
chamber, compression of thorax, and so forth. 

Pleurisy (Kiomaku-irr) . — If the quantity of exudate reaches up to 
second intercostal space soon, it is drawn by puncture. But there must 
be several pauses during the whole operation, as it will cause cerebral 
anemia from sudden loss of blood-pressure. Before and after treatment 
of the operation must be strictly aseptical. Besides, contra-irritation, wet 
pack, ice-bag, diuretics, anti-rheumatics and morphine. 



1568 JAPANESE TREATMENT OF DISEASE. 



DISEASES OF CIRCULATORY ORGANS. 

Endocarditis (Shinzonaimakuin) — Best, ice-bag, salicylic preparation 
or eventually digitalis, strophantus. 

Cardiac Insufficiency (Shinzo-benmaku-heisafuzen) . — Digitalis infusion 
(0.8 — 1.2/00) is the chief remedy in meeting the disturbance. Other 
auxiliary medicaments are diuretics, stimulants, morphine. 

For the hydropsy from heart disease: Calomel combined with digi- 
talis, taking care of stomatitis at the same time. Then the diuretics such 
as acetate potash, diuretics, scilla, tartarus boraxatus, and so forth. 

Treatment by Massage — Massage, high position and enveloping of the 
swollen parts is recommended. Puncture for strong hydropsy is rare. 
During compensated stage care is directed not to use strong body moving 
or alcoholic beverages, while patient should take nourishing, assimilable 
food. Bath-cure (cold baths) is also advisable. 

Nervous Palpitation (Shinkeisei Shinki-kowshin) First affair is to 

improve patient's general condition; iron, quinine or strengthening diet 
for anemic subjects, while bitter waters or bath-cure prescribed for the 
full-blooded. Among internal remedies nervines or sometimes narcotics 
are used. Cold compression and ice-bags often act beneficially. 

Angina Pectoris (Kyoshinsho) — Irritation of skin (mustard), applica- 
tion of hot or cold compression, morphine injection and other narcotics 
such as chloralamid, nitro-glycerine, and so forth. 

Pericarditis (Shinnow-in) . — Quiet, rest, digitalis, strophantus, ice 
bag or mustard-paste. In large exudate, puncture with aspirator ; in pus 
accumulation, surgical operation. 

Aneurism of Aorta (Daidowmyakuriu) — Iodide of potassium, ergo- 
tine, compression, electric cauterization, and so forth. But no remedy 
proves effective. 

DISEASES OF DIGESTIVE ORGANS. 

Inflammation of the Mouth (Konai-iu) — Including various forms of 
stomatitis. Cleanliness, care of gums; gargle with tannin, alum, borax, 
and so forth, according to the condition, antiseptics also used such as 
hypermanganate of potassium (0.1 per cent.), chloro-potash (2 per cent), 
hydrogen dioxide solution (2 per cent.), tincture myrrh, tincture ratani, 
or lapis cauterization in grave cases. 

Acute and Chronic Gastric Catarrh (Kuisei and Mansei-I-katarrh) . — 
Treatment of the acute same as here. For chronic forms it depends upon 



JAPANESE TREATMENT OF DISEASE. 1569 

the nature of the causal diseases. At first, treatment of causal diseases ; 
regular dietary, avoiding fatty indigestible foods. Sometimes cold rubbing 
upon the stomach region, massage over stomach, regular evacuation (using 
oil or glycerine enema), sea-water baths, hot spring cures. 

Gastric Ulcer (I-kwaiyo) — Bed-rest, warm poultice applied inter- 
mittently, fluid diet (milk, eggs, soups). Internally, administer sodium 
bicarbonate with bismuth, the latter used alone in large doses in some 
cases. 

Cancer of the Stomach (I-gan) . — Internally, only symptomatics, some- 
times hydrochloric acid and extract of condurango used with good results. 
Eventually, when the cancer is located near the pylorus it is removed by 
surgical operation. 

Dilatation of the Stomach (I-kakucho) — Regular washing of the 
stomach in evening daily ; massages, electricity ; cold rubbing over gastric 
region. Fluid diet, regular evacuation with purgatives or enema, mor- 
phine, chloral hydrate, and so forth. Surgically, early extirpation of 
the tumor. 

Nervous Dyspepsia (Shinkeisei-shokaf urio) . — Cold rubbing, strength- 
ening diet, massage, electricity, baths and mental therapy. 

Intestinal Catarrh (Chokatarrh). — Dietary regulation, opium and 
tannin, tannigen, and so forth. For acute form, artificial Carlsbad salt, 
packs, massage, digestible food and regular evacuation. Alcoholic liquors 
forbidden. 

PARASITES OF THE INTESTINES (CHOKISEICHIU). 

1. Tape-Worm. — Extract filic maris 2.0 in capsules (in 5-6 pieces) 
taken in one-half hour. Three hours later one spoonful of castor oil 
given. Sometimes we use thymol, one-half grain, instead of extract 
filic, as the latter may eventually cause amourosis. Chloroform is also 
used with success. 

2. Ascarides (Round Worm) — Santonin, one grain several times a 
day. 

3. Oxyuris (Seat Worm). — Naphthalin, 4x0.15 — 0.4; castor oil or 
calomel. 

Ascites (Fukusui). — Treatment of causal diseases, digitalis, diuretics, 
calomel, puncture. 

Jaundice (Oudan) Artificial Carlsbad; dietary direction; no fat 

stuffs. 



1570 JAPANESE TREATMEXT OE DISEASE. 

Biliary Calculi (Tanaeki). — For paroxysm apply cataplasm, narcotics 
internally or hypodermic ally. Carlsbad-cure, salicyclic and bicarbonate 
sodium given later. 

SOME HINTS FROM JAPANESE TREATMENT 

Taking the Pulse. — The little finger can be used in taking a delicate 
pulse when it would be impossible to readily recognize it with the fingers 
ordinarily used. 

Curing Convulsions. — Convulsions may be frequently cut short like 
magic by turning the patient on his left side. 

Increasing Warmth. — When chilly from exposure breathe very deeply 
and rapidly, and the increase in bodily warmth will be surprising. 

A Cure for Burns. — Crude petroleum poured upon a burned surface 
and covered loosely with cotton will subdue the pain almost at once. 

Poisonous Wounds. — Strong spirits of ammonia applied to the wounds 
of snake bites or rabid animals is better than caustic. It neutralizes the 
poison. - 

Carbolic Acid Poisoning. — Carbolic acid poisoning can be quickly 
cured by giving cider vinegar diluted with equal parts of water in half 
tumblerful doses every &ve or ten minutes for a few times. 

Morphine Poison — Permanganate of potash is an efficient antidote 
if taken while morphine is in the stomach. Grain for grain will com- 
pletely decompose it. 

Infantile Colic. — A towel dipped in boiling water, wrung out rapidly, 
folded to proper size and applied to the abdomen, with a dry flannel over 
the hot towel, acts like magic in infantile colic. 

Pregnancy Nausea. — Vomiting and nausea of pregnancy, a 20 per 
cent, solution of menthol in sweet oil ; use ten drops on sugar when nausea 
appears. 

Rheumatic Joints. — Wrap a swollen rheumatic joint in cloths wrung 
out of ice water and the pain will almost instantly cease. 

Snake Bites. — Saltpetre is a specific for snake bites. The dose is a 
teaspoonful for a child and a tablespoonful for an adult in a glass of cold 
water, applying it also to the bite. 

Cure of Opium Habit. — The most effective treatment and cure of the 
opium habit consists of the administration of bromide of soda. The drug 
is given one drachm every two hours for the first two days and one-half 
drachm on the third day. Two ounces seldom fail to effect a cure. Soc 
index. 



MEDICAL SCHOOLS 



PART VIII. 

GERMAN HOME MEDICAL TREATMENT. 

The Kneipp Cure. — Natural healing has been developed in Germany 
mainly by Priessnitz, Schroth, Kneipp, Kuhne, Bilz and others, a feature 
common to all their cures being the extended application of water. Espe- 
cially the Kneipp cure has found in recent years a great many friends. 

Principles of the Kneipp Cure. — The principal remedy is cold water. 
Regarding its judicious application the following general rules may be 
given : 

1. The shorter the bath or the application of water, the better the 
result. 

2. The colder the water, the shorter must be the bath and the quicker 
results the wholesome reaction in the body. Weak persons ought to begin, 
however, with mild temperatures, say, first 60 degrees (Fahrenheit), later 
55 to 50 degrees and finally cold water. 

3. Before the application of the cold water is made the body should 
be as warm as possible ; otherwise one must begin with a warm water treat- 
ment. 

4. When the application of the water has been made, do not dry the 
body, but dress yourself quickly and make first quick movements and 
then slower ones, in order to produce the reaction in the body. Should 
the reaction not set in and the patient be very weak, he should go to bed 
to get warm. 

5. Hardening the body is the best means against all diseases. 
Nothing is better for this purpose than cold water. 

Kneipp Knee Shower-bath. — With a hose sprinkle cold water on the 
leg of the patient, from the foot to the knee. Begin with the front of the 
leg ; start with the right foot ; go up to the knee and then back to the right 
foot ; go then over to the left foot, up to left knee and back ; do this until 
the legs become red. Then turn the patient and treat in the same way 
the back part of the legs. 

The knee shower is applied mainly against rush of blood to the head ; 
to make the blood circulate from the head to the lower parts of the body. 
99 (1571) 



1572 GEBMAN HOME MEDICAL TREATMENT. 

The Kneipp Head Shower-bath — The whole head is uniformly 
sprinkled over with water by means of a sprinkling can; one sprinkling 
can full of water is sufficient. For weak persons take the can only one-half 
full. The head shower-bath is applied with success, especially against 
diseases of the eyes, ears, nose and head. Take care to dry the hair care- 
fully after the bath. 

Walk Barefoot in the Damp Grass. — Besides the regular baths of the 
whole body or of parts of the body, this is the most simple and natural 
means of hardening the body. Persons who suffer with rush of blood to 
the head or with diseases of eyes, ears, throat and nose, ought to walk 
daily barefoot in the damp grass for ten to twenty minutes with excellent 
success if the weather is not too cold. 

Natural Healing in Special Diseases. — Special applications of the 
Kneipp cure in different cases will be found in the following articles on 
special diseases, in which also the methods of treatment of other German 
representatives of natural healing are considered. 

CHICKEN-POX. 

Treatment. — Keep the body warm, take good care of the skin by 
taking daily a full or three-quarter full bed steam bath (see the description 
below). After the bed steam bath take a bath of 86 degrees Fahrenheit, or 
rub the whole body with water of 72 degrees. The inflamed portions of 
the skin may be powdered now and then with rice-flour. Avoid stimu- 
lating food, go much into the fresh air, and if necessary use a syringe when 
bowels are constipated. 

The Bed Steam Bath. — This bath may be taken in two forms : either 
as a full bath or as a three-quarter bath. In the full bath the body is 
wrapped up to the chin, in the three-quarter bath the arms are free. The 
method of wrapping up the body is the same in both cases. The wraps are 
a woolen blanket, and a damp linen cloth, which has been put into water 
between 64 and 77 degrees and has then been wrung out. The woolen 
blanket must be larger than the damp linen cloth. Put the woolen blanket 
first into the bed on the mattress, put the damp linen cloth above the 
blanket, put the entirely nude patient above that and then wrap him up. 
The patient must be covered entirely by the damp linen cloth, and this 
must be again wrapped up in the woolen blanket, so that at the outside 
there is nothing but the woolen blanket. Hot water bags may often be 
used to advantage in connection with this bath ; four bags may be applied : 



BRIGHT 7 S DISEASE. 1573 

one at the bend of the knee, the second at the soles of the feet, and the 
other two at both sides of the legs, outside of the wrapping. Sometimes 
the two bags alone are sufficient. 

These baths are not only good against chicken-pox, but may be ap- 
plied also in other diseases, as will be noticed in the following articles. 

WORMS. 

Treatment. — Avoid irritating food. The best food is bruised wheat- 
bread, pumpernickel, fruits, figs and carrots. Place every night, or every 
second night, a bandage around the abdomen at 77 degrees (see the de- 
scription below), and rub the whole body in the morning with water of 
55 degrees. If necessary, use a small syringe twi$e daily to make the 
bowels move; use water of 77 degrees. r '^*(8P 

Kneipp's Worm Remedy — Kneipp recommends' the following remedy 
against worms : Mix wermuth with twenty-five ground seeds of pumpkins, 
and drink this tea for several weeks, and the worms, which cannot stand 
the bitter tea, will soon disappear. 

The Bandage Around the Abdomen. — This bandage is not only useful 
for the above purpose, but is somewhat like a universal remedy; it acts 
often in an admirable manner; it renders very good service against cold 
in the head, headache, toothache, loss of appetite, dizziness, etc. ; it is 
especially useful against female ailments. 

How to Apply the Bandage — There are required for this bandage 
some woolen cloth or a long woolen shawl or a piece of flannel of sufficient 
length and width to make a bandage twice around the abdomen. There 
are further required two towels of coarse linen, which are put into water 
between 66 and 75 degrees, and are then thoroughly wrung out. These 
towels are placed upon the flannel or woolen bandages, which are spread 
out ready for use. The flannel or woolen bandages must be larger than 
the towels, so that the flannel or wool have to show from either side the 
width of two or three fingers. The bandage, fixed in this way, is then 
placed around the abdomen of the patient. 

BRIGHT'S DISEASE. 

Treatment of Acute Form. — Take daily a bed steam bath (see the 
description in the article on chicken-pox), with extra bandages at the back 
in the neighborhood of the kidneys, also extra bandages on the heart, 



1574 GERMAN HOME MEDICAL TREATMENT. 

until perspiration takes place freely; after that take a bath of 88 to 90 
degrees, and a shower-bath with the water of 81 to 84 degrees, and rub the 
skin thoroughly. If necessary, extra bandages of shorter duration may 
be made on the kidneys, around the legs, and so forth, also during the 
night. Patients who do not stand well the bed steam baths should be 
treated by mildly washing and rubbing the whole body several times 
daily. A^oid irritating food ; don't drink much. The best to drink is milk 
which is not too cold; strictly avoid all alcoholic drinks. Take care that 
the bowels move regularly; if necessary use a syringe; go much into the 
fresh air. Improvement can be obtained by this treatment in one or two 
weeks, but sometimes it takes several months, until the urine becomes 
clearer and lighter and begins to flow in greater quantities. 

Treatment o jJS^^ g Form — The chronic form develops itself from 
the acute form; ^Bj^SBr patient is not aware of the development itself 
until the disease is in a critical state: Take daily a bed-steam-bath, after 
that a bath of 88 degrees or warmer, say 61 to 63 degrees, for eight to 
ten minutes. Bandages may also be applied during the night. Avoid 
irritating food ; take much sweet milk. Drink water in moderate quanti- 
ties, take care that the bowels move regularly. Above all, rest in the bed. 

Kneipp's Cure. — Against Bright's disease Kneipp warmly recom- 
mends lemon juice. According to Dr. Siebert one patient ate in three 
months three hundred lemons, daily three or four, and the urine was free 
of glair. The patient was dismissed as cured. Kneipp's baths must be 
of course also applied in connection with the treatment. 

ITCH. 

Treatment. — Separate the sick person from the healthy people, be- 
cause this disease is contagious. Give the patient a steam-bath of 15 
to 25 minutes, and after that let him take a bath in a bathtub at 97 to 104 
degrees, for ten to fifteen minutes; rub the body thoroughly with soft 
soap, to which may be added some sand in order to scratch the itchy spots 
open. After the bath, rub soft soap thoroughly in the itchy spots (without 
sand) and give the patient a "dry-wrapping" (see description below) for 
three-quarters of an hour to an hour. Finally let the patient take a 
cleansing bath at 88 degrees. Repeat this treatment daily for four to 
five days. Let the patient change the underwear every day. One may 
also leave out the steam-bath and begin at once with the warm bath. One 
may also rub the itchy spots with kerosene before retiring in the evening ; 



Cancer. 1575 

■vvken rising in the morning let him take a bath and clean the body with 
soap. Repeat this treatment for three or four days. 

Description of the Dry-Wrapping — Place on the mattress a large 
woolen cloth and above that a large linen bed-spread, put the patient on 
these cloths and wrap the same around him, first the linen bed-spread 
and around that the woolen cloth; wrap the bed-covers (the blankets) 
around and tuck them in all about so that no air can come through, and 
the heat which is developed inside cannot escape. The patient will soon 
begin to perspire. 

The dry-wrapping is of great value for the most chronical diseases, 
but may in single cases be of advantage. One should always observe 
whether a patient stands better a dry-wrapping or a bed-steam-bath (see 
the description of the latter in the above article on chicken-pox) and one 
should choose what is more advantageous to him. 

CANCER. 

Treatment. — The prospect of a thorough recovery of the patient is 
not very great. To produce relief, give the patient daily a warm bath of 
59 to 61 degrees, and sprinkle softly the sick portions of the body; further 
avoid all irritating food, use a diet without any meat (among the original 
inhabitants of the East Indies, who are vegetarians, and live on vegetables 
and fruits, the disease of cancer is entirely unknown) ; finally let the 
patient go much into the fresh air and let him sleep at open windows. 

The cancerous spots of the body should often be cleansed by rinsing 
them with clean water or with decoctions of camomile; also soothing or 
exciting bandages (see the descriptions below) should be applied. During 
the first period of the disease let the patient take weekly three or four 
full steam-baths following with full-wrapping baths and baths in the bath- 
tub with shower-baths ; or, instead of that full bed-steam baths (see the 
description in the above article on chicken-pox) with following bath. 
Sometimes it is of advantage to apply daily warm compresses on the sick 
spots, which are afterward sprinkled softly with water of 81 to 86 degrees 
and are then covered with a compress, moistened with water of the same 
temperature. 

Description of Soothing and Exciting Bandages. — Both bandages are 
applied only at special sick portions of the body, that is on the cancerous 
spots. An "exciting" bandage heats the sick portion of the body and dis- 
solves and diverts the disease. It is applied in the following manner. 



1576 



GERMAN HOME MEDICAL TREATMENT. 



Dip a piece of linen into cold water of 64 to 73 degrees, wring it out and 
place it in two, four, six or more layers on the sick spot ; place above it a 
thick dry woolen patch which must be larger on all sides than the moist 
linen. This compress must be tight and well fixed so that the heat formed 
below it cannot escape ; the compress must be larger than the sick spot on 
all sides by several inches. This compress is left on the sick spot for two, 
three or four hours, or for the whole night; in general as long as the 
patient does not want it removed; it should not annoy the patient. 
After the compress has been removed sprinkle the sick spot with cold 
water. 

The Soothing Bandage. — A "soothing" bandage is applied for relieving 
the pain. A piece of rough linen, folded up in four to eight layers, is 
dipped into water of 77 to 86 degrees, slightly wrung out, placed on the 
sick portion of the body and covered with a woolen patch. This compress 
is mostly applied for 30 to 45 minutes and in general as long as they pro- 
duce agreeable feelings to the patient. 

CATARRH. 

Treatment. — The first point to aim at must be to remove the special 
causes to which the increased separation of phlegm is due. Avoid irritat- 
ing food, rub the whole body daily with water of 73 to 77 degrees, or 
take a bath of 88 to 91 degrees, after which the body must be thoroughly 
rubbed until it is dry. During the night a bandage around the abdomen 
(see description in the above article on worms) is to be applied. Further 
different forms of wrappings, bandages and bed-steam-baths are often 
advantageous. Keep quiet and rest. When the organs of breathing are 
affected, keep the body uniformly warm, and breathe mild, clean air 
which is not too dry. Take care that the bowels move daily. As the 
different forms of catarrh are produced by different causes, they must be 
also treated in a different way, and the treatment should always be of such 
a kind that it suits the special patient. The above remarks give the 
general rules. 

CHOLERA MORBUS. 

Prevention of Cholera Morbus. — In case of epidemic cholera morbus in 
a town, everybody must take great care to keep his body in such a con- 
dition that it cannot be affected by the disease. The best means of accom- 
plishing this are as follows: 



CHOLERA MORBUS. 1577 

The Blood — Take care that your blood is good and healthy. For this 
purpose breathe good, clean air. Everybody who can afford it should be 
daily in the fresh air for some time ; in the fresh air take repeatedly deep 
breaths. Air thoroughly the rooms where you live and sleep. If one is 
confined to the house and must breathe bad air, breathe through the nose 
and rinse afterward mouth and nose with fresh water and strengthen the 
lungs in the best air which is at disposal. 

Diet — Avoid irritating food, don't eat meat, don't drink alcoholic 
drinks, avoid spiced and sour dishes. When one does not want to avoid 
meat entirely (which would be the best), one should take care at least that 
meat does not amount to more than one-fifth of the meals, while four-fifths 
are vegetables, rice, noodles, barley, Indian meal, farina, legumen, and 
everything in the way of potatoes. A sudden and thorough change in 
the custom of eating and drinking may, however, have disadvantageous 
consequences, hence be cautious during the change. Drink good water. 

The Skin. — Before all other things take good care of the skin. Rub 
the whole body daily with water by means of a rough linen towel, dry the 
body, rub it thoroughly with a dry towel until the body is dry ; begin with 
the legs and arms and proceed then to neck, head, chest, abdomen and the 
back. The clothing should not be too thick but comfortable. 

The Gargle. — To strengthen the pituitary membranes, gargle daily 
with cold water and rinse the nose, afterward take a few drinks of water. 

While eating, chew well the meals ; "well chewed is half digested," is 
of great importance in this case. Keep the house and the rooms very 
clean. 

The Bandage. — The life should be very regular. Keep the abdomen 
warm. He who thinks that he needs a woolen bandage around the abdo- 
men should wear it not below but above the linen or cotton shirt. 

The Bowels. — Take care that the bowels move regularly every day. 
In cases of diarrhoea, as well as of consumption, take a clyster with a 
syringe containing about one-fourth pine (i. e., one gill) of water at 50 to 
66 degrees; also apply during the night a bandage around the abdomen 
(see the description in the above article on worms), the water used for 
this purpose having a temperature of 72 degrees. (While most people and 
even physicians think that a clyster — injection — is only good to make the 
bowels move, it is a fact that one may also cure diarrhoea with it.) 

Who lives according to these rules may be sure that he does the very 
best to prevent cholera morbus and should not be afraid. To be afraid 
is disadvantageous. 



1578 GERMAN HOME MEDICAL TREATMENT. 

Treatment of Cholera Morbus — 1. Cholera morbus never attacks a 
healthy person unexpectedly; there are always before symptoms of the 
developing disease. If the symptom is a light diarrhoea, sometimes with 
an unpleasant feeling in the abdomen, rub the whole body at once thor- 
oughly with water of 66 to 73 degrees (one part of the body after the 
other, while the body is warm), place a bandage around the abdomen 
(see the description in the above article on Worms), and put a hot-water 
bag at the feet; keep the bandage on for about an hour; but if it should 
become hot quicker, replace it repeatedly. As soon as the feet get warm, 
wash them with cool water and repeat this four or five times during this 
hour. When the bandage has been taken from the abdomen, rub again 
the body with water and apply a small injection with the syringe, the 
water having a temperature of 68 degrees. These injections should be 
given especially after the bowels have moved. If this treatment does not 
help apply a steam-bath in a suitable form, following with cooling bath, 
shower-bath or rubbing of the whole body. After that massage of the 
body and exercises or a good walk. 

2. When the symptom of the developing disease consists in constipa- 
tion apply injections with the syringe, about half a pint or one-fourth 
pint, with water of 73 to 90 degrees ; repeat the same every hour or every 
second hour if the bowels do not move ; and if this is not successful give 
the patient a "sitz-bath" (see the description below) at 68 to 86 degrees for 
five to ten minutes, while the body is kept warm and a hot-water bag is 
placed at the feet. Don't apply this bath when the patient feels cold, nor 
when he has a disease of the heart or the lungs, nor when he is nervous. 
Avoid any irritating meals. 

Description of the Sitz-Bath — The sitz-bath may be taken in the bath- 
tub or any large vessel. The water may reach up to the navel. This sitz- 
bath is not only good in the case of cholera morbus, but may also be ap- 
plied against indigestion, rush of blood to the head, diseases of the 
abdomen, hemorrhoids and female diseases. These baths are often very 
important and their success becomes often apparent after a short time 
only. According to the disease and to the condition of the patient, the 
temperature of the water may be 66 to 73 or 82 or even more ; it should 
be taken for Hve to fifteen minutes and in special rare cases for twenty-five 
to thirty minutes. Kneading, rubbing and massage of the abdomen 
during the sitz-bath are often advantageous. 



ague. 1579 



GONORRHEA. 



Treatment. — Keep quiet and avoid irritating meals, eat dishes sea- 
soned very mild only, avoid all alcoholic drinks, avoid meat, drink much 
fresh water and enjoy the fresh air; avoid all opportunities which would 
cause an excitation of the genitals. 

Take daily a half -steam-bath or a half -bed-steam-bath (this is a bed- 
steam-bath as described in the article on chicken-pox, but reaching up to 
the navel only, three hot-water bags, wrapped up in damp cloths, being 
placed at the feet), put a special damp compress, moistened with water 
of 73 degrees, on the genitals. Take afterward a bath of 88 degrees. 

Take daily two or three sitz-baths in water of 77 degrees for fifteen 
to twenty minutes. During the night place a bandage around the ab- 
domen (see the description in the article on Worms). In case of consti- 
pation make injections with the syringe. Instead of the sitz-baths, three or 
four partial baths of the genitals in water of 82 to 86 degrees may be 
taken, each for ten to twenty minutes; perhaps also repeated washing of 
the genitals with water of 77 degrees. Drink much water in order to 
dilute the urine. If one wants to inject water of 82 degrees into the 
urethra, this must be done very softly by means of a small syringe with 
rounded (not sharp) mouth; such injections may be made several times 
daily, especially after having made water. In the meanwhile also soothing 
or exciting bandages (see the description in the article on Cancer) may be 
made on the genitals, with water of 73 to 77 degrees, the compress being 
all wrapped up in a woolen cloth. To prevent inflammation of the 
scrotum, or when it has become inflamed, protect it by a suspensory, which 
is to be buckled on in a careful and suitable manner. 



AGUE. 

Treatment. — For cases of ague or fever-shivering, rub the patient 
thoroughly (dry or wet) and then give him a dry-wrapping or a bed-steam- 
bath (see the descriptions in the articles on Itch and on Chicken-pox). 
When he perspires, let him take later a bath of 86 to 89 degrees. Should 
this treatment cause prickly-heat on the body, looking like measles or 
small-pox, and so forth, this should be regarded as a good sign, because in 
this way the morbid matter is removed from the body. To remove it 
thoroughly the patient should take some more bed-steam-baths, or exciting 



1580 GERMAN HOME MEDICAL TREATMENT. 

bandages, as described in the article on Cancer, should be applied, in order 
to make him perspire moderately. A bath has to follow. 

BOILS. 

Treatment. — In all cases which have been caused by bad blood a 
"restorative cure" should be used (see the description below). Further 
put soothing or exciting bandages (as described in the article on Cancer) 
on the sick portions of the body, the wet linen being folded up in six to 
twelve layers and moistened with water of 72 to 100 degrees, according to 
the nature of the boil. This compress must be well covered with a woolen 
patch much larger than the boil; when the compress begins to get dry it 
is to be renewed. These compresses cool, dissolve the boil and suck out 
the morbid matter. It is further important to clean each boil thoroughly 
by washing and dipping out with lukewarm water. 

The Restorative Cure. — This cure is not only good in the treatment of 
boils but should be applied generally in all chronical diseases, as the body 
needs to be first strengthened in general. This cure will always give good 
results whatever the special disease may be. A natural, not irritating diet 
is required : bread, vegetables, milk, anything made of milk and of eggs, 
oatmeal, fruits, now and then a soft-boiled egg is allowed. Meat should 
not be eaten in too large quantities; strong coffee, all alcoholic drinks, 
tobacco, spiced dishes, and so forth, are entirely forbidden. Drink mainly 
water, drink it often, especially before taking a walk, and before retiring 
at night a drink of water is to be recommended; lemonade, cocoa, malt- 
coffee are also allowed. The diet should be moderate; when the patient 
begins to feel better he should not stuff at once his stomach. The patient 
should enjoy the fresh air as much as possible and should take good care of 
the skin by daily washing or rubbing once or twice the whole body with 
water of 82 to 95 degrees ; the applications described in the article on the 
Kneipp Cure are also to be recommended. 

CONSUMPTION. 

Treatment. — The principal object to aim at is the production of a 
healthier and purer blood ; this requires a simple, digestible, nourishing 
and not irritating diet and plenty of pure and fresh air. The patient 
should sleep at open windows and exercise the lungs by uniform and 
slow breathing in and out in good fresh air. The patient should not 
work as a tailor, seamstress or in an office, in general not in such a pro- 



COLD AXD DIPHTHEEIA. 1581 

fession or trade where lie must sit continually. As long as the disease is 
still in the beginning period, light work in the garden, done cautiously, 
renders excellent service. In cases in which the disease has already made 
more progress the patient should begin with washing the upper part of 
the body with water of 86 degrees. When he has accustomed himself to 
these washings he should begin to wash also the lower part of the body; 
for this purpose he should use water of 73 to 77 degrees. Two points are 
to be kept in mind: first the patient must be comfortably warm while he 
is washed, and should afterward take care to dress himself quick and get 
warm by means of motions ; second, while the patient is washed he should 
sit still, the washing and later the drying should be done by an attendant. 
Who has no attendant at his disposition should not do these washings at 
all. When the patient feels cool and uncomfortable, or when the weather 
is cool and rainy the washings should not be performed. As long as the 
patient is strong enough he should take walks in pure and sunny air as 
much as possible. 

COLD. 

Treatment. — Any disease which might arise from a cold is best pre- 
vented by a cure producing a strong perspiration so that the interrupted 
activity of the pores of the skin is restored. Take a bed-steam-bath (as 
described in the article on Chicken-pox) ; a rubbing of the whole body or 
a bath follows. See also the remarks in the articles on the Kneipp Cure 
and on Ague. 

DIPHTHERIA. 

Treatment. — The patient is to be separated from the healthy people. 
The windows of the room where he rests should be open. He should be 
covered with one or two woolen blankets which must be aired several times 
daily, if possible, in the sun. The floor of the room is to be cleaned daily. 
The following special treatment is very successful: A full bed-steam-bath 
(as described in the article on Chicken-pox), combined with a cool bandage 
around the neck, which is applied as follows : Put a towel into water of 54 
to 56 degrees, wring it out moderately and place it around the neck of the 
patient so that it reaches up to the ears. The upper half of the bandage 
is now covered with a woolen cloth. The duration of the bed-steam-bath is 
45 minutes to an hour. Should the patient become uneasy the wrapping is 
to be removed earlier. If necessary this packing is to be repeated twice or 
three times during twenty-four hours. Afterward the body is to be washed 



15 S2 GERMAN HOME MEDICAL TREATMENT. 

with water of 73 to 86 degrees. Further, the mouth is to be cleaned re- 
peatedly by gargling ; one-fifth of a lemon per glass of water. Only when 
the patient wants to eat give him buttermilk, apple-marmalade, fruits, oat- 
meal, and so forth. 

DYSPEPSIA. 

Treatment. — The patient should take only small quantities of easily 
digestible food. After any meal his body and mind should rest. Anything 
that is eaten should be well chewed. The best food is rice, fruits, stale 
rolls, and now and then a drink of water ; begin first with very small quan- 
tities of water, so that the stomach can warm it, and drink gradually more 
and more water. Eub daily the whole body with water or take a bath, also 
rub repeatedly the abdomen; the sitz-bath (described in the article on 
Cholera Morbus) is a very good remedy in all cases of indigestion and 
dyspepsia. 

CROUP. 

Treatment. — As soon as the suspicious cough makes its appearance the 
patient gets a full wrapping or three-quarter wrapping (as described in the 
article on Chicken-pox) ; the linen cloth in which he is wrapped must con- 
tain much moisture; the temperature of the water used is 82 degrees; a 
hot-water bag, which is covered with a wet cloth, is placed at the feet ; the 
duration of the wrapping is one and one-half hours. After that a bath of 
91 degrees, while at the same time the neck is poured over with water of 
59 to 73 degrees. This treatment is repeated after five or six hours. 
Should the condition of the patient become worse the treatment is to be 
repeated at once. Besides this bandages around the abdomen every two 
hours with a water temperature of 82 degrees, the bandages around the 
calves with water of 73 degrees, also every half hour soothing bandages 
around the neck with water of 73 degrees (as described in the article on 
Cancer) are to be recommended. Enjoy the fresh air by opening the win- 
dows, drink fresh water, avoid irritating food, and in case of constipation 
use the syringe to make the bowels move. 



TELON. 

Treatment. — Take often a "hand steam-bath" by holding the hand 
for some time over a pot filled with boiling water, the hand and pot being 
wrapped up in such a way that the steam cannot escape. After that, 



SYPHILIS AND GOUT. 1583 

bathe the hand in lukewarm water. During the night exciting bandages 
around the hand (as described in the article on Cancer), with separate 
compresses on the sick fingers, are to be applied. Every other day, and 
later every third or fourth day, let the patient take a bed steam-bath 
(as described in the article on Chicken-pox), also with separate compresses 
on the sick fingers. The sick fingers should be thoroughly kept clean 
and care should be taken to protect them from cold. 

SYPHILIS. 

» 
Treatment — Before all other things the food for the patient should 

not be spicy, nor should he eat meat; further he should enjoy the fresh 
air as much as possible and should sleep at open windows. The patient 
should daily take a steam-bath of about fifteen to twenty minutes, after 
that he should be wrapped up, and should later take a bath of 88 degrees. 
Instead of that daily, a full steam-bath or a three-quarter steam-bath (as 
described in the article on Chicken-pox), with following bath of 86 to 88 
degrees can be applied. Bad cases have been cured by this treatment, 
combined with a strict diet, as mentioned above. Further, let the patient 
take, if possible, daily, two or three sitz-baths at 73 degrees (as described 
in the article on Cholera Morbus), each bath for fifteen to twenty minutes. 
When the genitals are inflamed, separate compresses are to be applied. 
In case the scrotum is inflamed, a suspensory is necessary. Points which 
discharge matter must be covered with wet linen, and above that a woolen 
patch is placed. The moist compresses are to be renewed, when neces- 
sary, day and night. The sick portions of the body get a bath twice or 
three times a day and must be carefully washed and kept clean ; cleanli- 
ness is of the utmost importance. To strengthen the body, the rules 
of the restorative cure should be applied, as described in the article on 
Boils. 

GOUT. 

Treatment — -Avoid any irritating food, the best is that the patient 
accustoms himself gradually to a vegetarian diet. He ought to drink 
plenty of fresh water; also the juice of lemons dissolved in water. He 
should enjoy the fresh air as much as possible and sleep at open windows. 
He should take care that the bowels move regularly every day; otherwise 
he should use the syringe. When a painful attack of gout occurs, sooth- 
ing bandages which contain much moisture (as described in the article on 



1584: GERMAN HOME MEDICAL TREATMENT. 

Cancer) are placed around the aggrieved bones ; when the bandages have 
been removed, wash the skin lightly with bare hands, afterward massage, 
first in a soft manner and gradually in a more and more effective way, 
then again soothing bandages. When the pain is great, the bandages 
should be made rather moist, so that they may be left on the skin for a 
longer time in order not to trouble the patient too much. During the 
free pauses, the patient should be brought daily to perspiration by means 
of a bed steam-bath of one and one-half to two hours (as described in the 
article on Chicken-pox), afterward a bath in water of 88 degrees, or in- 
stead of the bath, the whole body is rubbed off with water of 73 degrees. 
During and after the bath massage of the painful portions of the body 
is to be recommended. Sun-baths have also been applied to good advan- 
tage against gout. 

Description of a Sun-Bath — This bath has a very good influence in 
many diseases ; when the patient is nervous, it should, however, be applied 
only with much caution. One form of a sun-bath is as follows: On a 
warm summer day the patient is laid upon a mattress upon which the 
sun shines, but at a place where there is no breeze or air, he is covered 
with a light cloth only and his head is protected by a parasol. He will 
soon begin to perspire ; he lies first on the back and then on the stomach. 
After he has perspired, he is sprinkled with lukewarm water on the 
hind part of the head, the shoulders, the breast, the back and the legs ; or 
the whole body is rubbed off with water. For some patients it may be 
of advantage to use cold instead of lukewarm water. 



JAUNDICE. 

Treatment. — Avoid any irritating food; the best is that the patient 
should live for some time on a strictly vegetarian diet, vegetables, fruits, 
bread ; no meat, fat or eggs. Much fresh air, the windows of the sleeping- 
room being kept open; daily two to four bandages around the abdomen, 
with water of 73 to 83 degrees (as described in the article on Worms), each 
bandage for about two or three hours. Further, the whole body should 
be rubbed off once or twice daily with water of 73 degrees, or instead of 
that a bath in water of 01 degrees. One may also apply for some time 
bed steam-baths (about three per week) with following bath of 91 degrees 
or rubbing off of the body with water of 73 degrees. In more serious 
cases the rules of the restorative cure (see the article on Boils) should be 
considered. In case that gall-stones are present the patient must drink 



MUMPS AND RHEUMATISM. 1585 

plenty of water. Further, when there are symptoms of inflammations, 
compresses should be placed near the liver, the temperature of the water 
being 78 to 82 degrees. These compresses are to be replaced or removed 
according to the wishes of the patient. 

MUMPS. 

Treatment. — When the swelling of the glands is due to bad blood the 
principle of the cure must be to help nature in bettering the blood. 
Just the glands are used by nature for purifying the blood and removing 
morbid matter. Therefore, the activity of the glands should be supported 
by steam-baths, baths in the tub, wrapping, washing, and so forth ; further 
the circulation of the blood should be regulated by suitable massage; 
finally the quality of the blood should be bettered by good and healt&y, 
but not irritating food, and by fresh air at day and night. 

For acute mumps the following rules of cure may be given : Daily a 
bed steam-bath (as described in the article on Chicken-pox), with separate 
compresses around the neck, for one hour or for an hour and a half, and 
besides extra compresses around the neck with water of 68 to 73 degrees, 
well covered with woolen cloth. When they become hot so that the patient 
feels uncomfortable (about every thirty or forty-five minutes), they are 
to be replaced. Afterward the whole body is rubbed off with water of 
73 degrees. A vegetarian diet is to be recommended. 

RHEUMATISM. 

Treatment of Acute Rheumatism — Daily a bed steam-bath (as de- 
scribed in the article on Chicken-pox) for one hour or an hour and a half. 
Before this bed steam-bath massage first of the sound, then of the sick 
portions of the body with warm hands, moistened with fresh water. After 
the bed steam-bath the whole body is rubbed off with water of QQ degrees, 
with massage of the sick portions. The latter also receive often soothing- 
bandages (as described in the article on Cancer) ; when they are removed 
cold rubbing and massage of the sick portions with bare hands. Take care 
that the bowels move regularly. Apply during the night a bandage around 
the abdomen (as described in the article on Worms). In case the inflam- 
mation and the pain are very great it is better not to use massage in the 
first time. 

Avoid irritating food, strictly vegetarian diet is to be most recom- 



1.586 GEEMAX HOME MEDICAL TREATMENT. 

mended. Avoid all exciting drinks, such as coffee and alcoholic drinks. 
Breathe fresh air in the house and outside ; sleep at open windows. Drink 
often water and lemonade in large quantities. 

SCARLET FEVER. 

Treatment. — Separate the patient from the healthy people. Take care 
that the formation of the scurf on the skin goes on regularly so that the 
body is supported by the treatment in removing the morbid matter. 
Bandages around the middle part of the body and around the legs with 
water of 73 degrees (as described in the article on Cancer). When the 
patient has a high fever, wrap up the body (as described in the article on 
Chicken-pox) and put a moist towel around the neck (as in the case of 
diphtheria) ; also a bath of 86 to 91 degrees. To support the body in 
removing the morbid matter, apply bed steam-baths with following luke- 
warm baths (as described in the article on Chicken-pox). Avoid irritating 
food, eat much fruit, drink much fresh water, take great care not to 
catch cold, especially during the time the scabs fall off ; but fresh air is to 
be brought continually to the room by opening the window. In case of 
constipation, apply the syringe to make the bowels move. Be careful for 
some time after the patient has recovered in order to prevent a relapse. 

SMALL-POX. 

Treatment. — Separate the patient from the healthy people. Take 
care to have fresh air in the room where the patient lies. Greatest cleanli- 
ness, frequent change of the underwear, daily washing of the whole body. 
Avoid any irritating food. Drink often fresh water, also lemonades of 
fruit juices. Further three-quarter or full packing (as described in the 
article on Chicken-pox) , the water used for this purpose has a temperature 
of 68 to 86 degrees. Further an extra compress around the middle part 
of the body. This packing is made up as follows : On a mattress is placed 
a large woolen cloth, above that a large linen cloth which had been put 
into water of 68 to 86 degrees, and had been well wrung out. These two 
cloths are for the three-quarter or full packing. On the large linen cloth, 
where the middle part of the body will lie, place a large towel which has 
been moistened in the same water and is used as extra compress. 

Put above this the patient. Wrap the towel around the middle part 
of his body, then the large moist linen cloth around his body, and wrap 
him finally up in the large woolen cloth. The duration of this packing is 






WHOOPING-COUGH. 1587 

one hour or an hour and a half or even more, in general as long as it 
is comfortable to the patient. Afterward a mild washing of the whole 
body or a bath of 86 to 91 degrees with a following shower-bath. After 
this the patient is dried and brought to bed, or he is not dried, but, wet 
as he is, he is covered by a dry linen cloth, brought to bed and well 
covered with the blankets. As soon as the fever has again increased, this 
treatment is to be repeated. To prevent as much as possible the forma- 
tion of scabs in the face, put continually compresses of 66 to 73 degrees 
on head and face. 

WHOOPING-COUGH. 

Treatment. — Separate the patient from the healthy people, as the 
whooping-cough is contagious. Daily one to two lukewarm (82 to 93 
degrees) three-quarter bed steam-baths (as described in the article on 
Chicken-pox), with an exciting bandage around the shoulders (as described 
in the article on Cancer), of a duration of one and a quarter to one and 
a half hours; afterward a bath of 88 to 91 degrees is given or the whole 
body is rubbed off with water of 73 degrees. During the night a bandage 
around the abdomen (as described in the article on Worms) is applied ; the 
water used for this purpose has a temperature of 82 degrees ; the bandage 
must be very well covered with a woolen cloth. It is also to be recom- 
mended to take a small drink of moderately cold water after every attack 
of cough. Fresh air day and night; the windows of the sleeping-room 
should be open. Vegetarian diet, in which all irritating food is avoided. 
Let the patient eat fruits and slimy food, such as water gruel, barley-water, 
and so forth; further, let him drink lemonades of fruit juices. Meat 
should be avoided. Change of air, or the removal of the sick child from 
the town where there is an epidemic of whooping-cough, is also to be 
recommended. 



100 



MEDICAL SCHOOLS 



PART IX. 
ELECTRICITY IN MEDICINE. 

Application — At first electricity was thought to be useful for only 
that class of diseases due to the nerves and it was generally applied by 
means of the galvanic battery, which was made in various forms for home 
use. But the treatment has grown to embrace a variety of diseases. 

Dyspepsia. — Electricity is found to be an excellent treatment for dys- 
pepsia on account of the relief it affords to both the physical and mental 
conditions that accompany the disease. It gives tone to the appetite, cures 
sleeplessness, removes distress after eating, strengthening the powers of 
(digestion and drives away despondency and gloom. 

Fits, Epilepsy, Falling Sickness. — These diseases being nervous in char- 
acter yield satisfactorily to the electric treatment. Any nervous disease 
is more readily reached by electricity than by other remedies and some 
remarkable cures have been placed to its credit. 

Anemia. — This means want of blood and the patient becomes pale 
and weak. The disease is a general condition, and as a cure electricity is 
found efficacious. It stimulates the same as oxygen, produces more red 
corpuscles in the blood, imparts increased vital energy to the blood cur- 
rents and does away with languidness and depression. 

Consumption. — When this disease is traceable to catarrhal inflamma- 
tions, faulty secretions and impaired nutrition, electricity is found bene- 
ficial as a purifier of the blood, a quickener of circulation and a preventive 
of the tuberculous deposits in the lungs. It is even claimed that by its 
stimulating effects on nutritive functions it builds up that part of the 
system which has gone to decay. 

Catarrh. — Those skilled in electric-healing claim that electricity is 
almost a specific for the cure of this disease and they have placed many 
cures to its credit. The grip and hay-fever, being catarrhal in their nature, 
are also treated effectively by electricity. 

Nervous Debility. — This is produced by a constant drain upon the 
nervous forces and fluids of the system. Its symptoms are loss of mem- 
ory, dimness of sight, constipation, gloominess, impoverished blood, and 

1588 




X-Ray plate showing fracture of the forearm. 





■. .... «..._.. 


[■ 


■3ft \ 

\W 1.1 


L ; 


: 


L 






THE X-RAY. 1589 

so forth. The modern electro-therapeutic treatment is applied with great 
success in this distressing disease and many permanent cures are claimed. 

Neuralgia — This painful nervous disease yields to but few treatments, 
but it is claimed that the electric treatment can be relied on in all cases, 
acute or chronic, to give almost instant relief and effect a cure. 

Sciatica. — This is only another form of neuralgia and is also amen- 
able to treatment by electricity. 

Rheumatism. — In modern electro-therapeutics it is found that rheu- 
matism yields readily to the electric treatment, the claim being that the 
disease is due to a storing of waste material in the body which can only be 
removed through the circulation, a process which electricity effects when 
skilfully applied. 

Diabetes. — In this terrible and baffling disease the electrical treatment 
has been found efficacious, not only arresting the disease but producing 
cures. The claim is that it stimulates the system and so fortifies nature 
that the disease is finally overcome. 

Kidney Diseases. — In diseases of the urinary tract producing weak- 
ness of the organs, extreme nervousness, milky or cloudy urine, pain in the 
back, frequent, scanty or painful urination, the electric treatment is found 
to have a powerful tonic effect on the organs, enabling them to reassert 
their functions and in the end eradicate disease. 

Paralysis or Palsy. — This disease, due to an overworked or debilitated 
nervous system, is amenable to the electric treatment, and it has been 
found that such treatment is about the most effective that can be used. 

Conclusions. — It will be seen that while many of the diseases .curable 
by electricity are outside of the strictly nervous class, yet all are more or 
less associated with that .class, so that after all, the merits of the electric 
treatment may be said to rest largely on its stimulus to and power over the 
nervous system. 

THE X-RAY 

An astounding electrical revelation came during the last years of 
the nineteenth century through the discovery of the X, or unknown, or 
Eoentgen, rays. In 1894 Hertz showed that the cathode rays of the 
Geissler tubes would penetrate thin sheets of metal placed within the 
tubes. Subsequently Paul Lenard showed that the cathodic ray could be 
investigated as well outside of the tube as within it, and secured some 
photographic effects. Professor Eoentgen took up the subject, and, in 
1896, fairly set the scientific world aflame with the announcement that 
the cathodic, or X, ray would not only penetrate solid substances, but 



15U0 ELECTRICITY IN MEDICINE. 

deposit solid substances within or behind those other substances. He 
invented a photographic instrument to take advantage of his discovery, 
and by means of it, electricity was turned to the account of photography, 
pictures being possible of the interior of the human body, and of any 
foreign substance therein. 

The discovery and application of the X-ray has proved of immense 
value to medicine and surgery. By its means the physician is enabled to 
carry on far-reaching diagnoses, and to ascertain with certainty the whole 
internal structure of the human body. Fractures, dislocations, deformities 
and diseases of the bones may be located, and their character and treatment 
decided upon. In dentistry the teeth may be photographed by means of 
the X-ray, even before they come to the surface, and broken fangs and 
hidden fillings may be located. Foreign objects in the body, as bullets, 
needles, calculi in the bladder, etc., may be located, and the surgery for 
their safe removal greatly simplified. The beating of the heart, move- 
ment of the ribs in respiration, and outline of the liver and other organs 
may be exhibited to the eye. It has even been suggested that the X-ray 
may become an agency for destroying the bacilli which produces disease 
in the human body. Verily the X-ray opens the field for the grandest of 
electrical possibilities. 



MEDICAL SCHOOLS 



PABT X. 
MENTAL HEALING 



No medical work is complete that deals only with drugs. Many 
theories of healing deal with the mind alone. The mind, which tells us 
of all our sufferings, is the path along which relief and recovery often 
travel. 

Mesmerism. — This is a peculiar nervous condition in which the body 
and mind of an individual are supposed to be influenced by a mysterious 
force emanating from another person. 

Hypnotism. — This is a condition artificially produced in which the 
person is apparently asleep and yet acts in obedience to the will of the 
operator as regards both motion and sensation. 

Mind Cure. — -This is the cure of disease by means of the mind alone. 

Christian Science — This teaches that those who really follow Jesus 
should follow Him in healing, which can be done through the mind. 

Telepathy. — This is a power of mental vision or of mental hearing, 
or of a mental production of other sensations, by which the individual 
becomes aware of events happening in another part of the world from 
where he is, or can tell of the existence of objects which could not affect 
at any time any of his bodily senses. 

HISTORY OF MENTAL HEALING. 

It is natural that the apparent power of influencing the bodies and 
minds of others should attract much attention and be eagerly sought after 
for purposes of gain, or from love of the wonderful and supernatural, or 
for the cure of diseases. So, while many have studied mental healing in 
a scientific spirit, more have done so as quacks and charlatans for the mere 
purpose of making money. 

Modern Study of Mental Healing'. — Kecently, however, physicians and 
other scientists have set about investigating the subject and giving it 

1591 



1592 MENTAL HEALING. 

much study and attention. The result has been that animal magnetism, 
as this power is sometimes called, has been put on a level with other 
sciences and has helped in relieving the sufferings of humanity. 

Ancient Mental Healing. — In all ages there have been certain persons 
who could cure disease by a touch of the hand and who could communicate 
a healing virtue to the sufferer. Among the Chaldeans, the Babylonians, 
the Persians, the Hindus, the Egyptians, the Greeks and the Romans 
many of the priests effected cures or threw people into deep sleeps in the 
shades of the temples. During these sleeps the sleeper sometimes had 
prophetic dreams. Ofttimes they could produce effects like those now re- 
ferred to animal magnetism. 

Supernatural Influence. — Such influences were held to be super- 
natural, and they added greatly to the power of the priests. In the middle 
of the seventeenth century there appeared in England several persons who 
said they had the power of curing diseases by a stroke of the hand. 

King's Evil Cure — Valentine Greatrakes, in the County of Water- 
ford, Ireland, attracted great attention by his power of curing the king's 
evil or scrofula. Thousands of sufferers crowded to him from all parts 
of the kingdom. About the middle of the eighteenth century John Joseph 
Gassner, a Roman Catholic priest in Swabia, claimed that the majority 
of diseases arose from demoniacal possession, and could only be cured by 
exorcism. He believed his power to be altogether supernatural and con- 
nected with religion. 

MESMERISM. 

The Name. — Mesmerism was named in honor of one of its early 
investigators. Eriedrich Anton Mesmer was born at Weil, on the Rhine, 
on May 23, 1733. He studied medicine at Vienna, took his degree and 
commenced to practice. 

Mesmer's Belief. — He was always very much interested in astrology, 
and he believed that the stars exerted an influence on beings living on the 
earth. At first he thought this supposed force was the same as elec- 
tricity. Afterward he believed it to be identical with magnetism. Erom 
tins he deduced the theory that stroking diseased bodies with magnets 
might bring about a cure. He published his first book in 1766. Ten 
years later, while in Switzerland, with Gassner, he observed that the priest 
effected cures by manipulation alone, without the use of magnets. 

Cure by Touch. — This led Mesmer to discard the magnets and to try 



MESMERISM. 1593 

to cure without them. He found he could relieve suffering by the mere 
touch of his fingers. He therefore supposed that some kind of occult force 
resided in himself by which he could influence others. He held that this 
force permeated the universe and more especially effected the nervous 
systems of men. 

Marvelous Cures. — In 1778 he moved to Paris, and in a short time 
the whole city was thrown into a state of great excitement by the mar- 
velous effects of mesmerism. Mesmer made many converts. 

Paris Inflamed — Many controversies arose, however. The whole 
medical faculty of Paris rose in indignation and stigmatized him as a 
charlatan. But still the people crowded to him. He was offered 20,000 
francs by the French Government for the disclosure of his secret, but he 
deliberately refused the offer. He received private rewards of large sums 
of money. 

Mesmer's Office — Everything about- his office was enveloped in mys- 
tery. His consulting apartments were dimly lighted and hung with mir- 
rors. All was quiet and still, save for the soft strains of music that occa- 
sionally were heard. All sorts of odors were wafted through the room. 

Mesmeric Methods. — The patients sat around a kind of vat, in which 
various chemical ingredients were concocted or simmered over a fire. 
Holding each other's hands, or joined by cords, the patients sat in ex- 
pectancy. Then Mesmer, clothed in the dress of a magician, glided 
amongst them, affecting one by a touch, another by a look, while he made 
passes with his hand at a third. The effects of this differed greatly, but 
all were benefited. Xervous ladies became hysterical or fainted. Some 
men were seized with convulsions and palpitation of the heart. 

Franklin's Investigation. — The French Government appointed a com- 
mission of physicians and members of the Academy of Sciences to in- 
vestigate these phenomena. Benjamin Franklin, the great American 
philosopher, diplomat and scientist, was a member of this commission. 
Franklin and his fellow commissioners drew up an elaborate report. They 
admitted many of the facts, but they contested Mesmer's theory that there 
was an agent called animal magnetism. They believed the effects were 
due to physiological causes. 

Mesmer's Fate. — While Mesmer himself was honest in his belief, he 
had many imitators who brought the science into disrepute. They were 
a lot of impostors who fooled the people for the sake of Grain. Fven Mes- 
mer himself was denounced as an impostor and a fraud. He finally had 



1594 MENTAL HEALING. 

to leave Paris, and died at Meersburg in Switzerland, on the 5th of March, 
1815. 

The New School of Mesmerism. — Mesmer left many disciples who 
investigated the subject in a scientific spirit. Chief among these was the 
Marquis de Puysegur. This nobleman revolutionized the art of mesmer- 
ism. He showed that many of the phenomena might be produced by 
gentle manipulation, causing sleep, and without the mysterious surround- 
ings that Mesmer, himself, employed. 

Spread of Mesmerism — Since that time mesmerism has been studied 
by many. Each year more and more is known of it and greater use made 
of this knowledge. The power of mesmerism is no longer confined to 
France and Switzerland, nor is it exercised only by Mesmer's fol- 
lowers. There is scarcely a town in this country that does not contain 
at least one inhabitant who can heal by the stroke of the hand. Few, 
indeed, are those who have not seen or heard of one possessing this 
peculiar power. 

The Mesmeric Power. — All who exercise this influence do not have 
power in the same degree. Some, of course, are noted for their mag- 
netism and travel from city to city curing hundreds by their touch. Many, 
however, are not known outside their native village, where their gentle 
stroking is eagerly sought for by those suffering from terrific headaches, 
which nothing else can relieve. Not a few possess this power in a small 
measure without recognizing it as mesmerism. Many a throbbing, fevered 
brow has been soothed by a gentle mother's hand. How often has the 
touch of magnetic fingers done more than all the medicines the doctor has 
ordered. 

Mesmerism in the Household — Those who find that they possess this 
soothing property of animal magnetism, in ever so slight a degree, should 
endeavor to cultivate and increase that power by proper exercise. When 
one discovers that a light touch of the hand will cause an electric thrill 
which seems to drive away pain and suffering, that person must try again 
and again and find what strokings will bring about the best results. 

Electricity in the System. — Some are born with more electricity in 
their system than is possessed by the average mortal. This can be seen 
by combing one's hair in the dark, when bright sparks will fly. Often 
nibbing the ends of the fingers together will bring a spark large enough 
to light a gas burner. Tf this electricity or magnetism is developed in the 
proper channels it will make its possessor one of the most sought after of 
mortals. 



HYPNOTISM. 1595 

Mesmerism in Disease — There are many diseases that medicines can- 
not cure. Some to whom medicines give no relief can be cured by the 
current from the electric battery. But many sufferers are turned away 
with the terrible verdict that nothing can be done for them. In not a few 
of these cases animal magnetism or mesmerism has effected a cure. 

Mesmeric Cure of Headache. — In those cases of sick headache where 
drugs have only increased the agony, a few light touches of a magnetic 
hand have caused the pain to disappear, and sweet, refreshing sleep to 
take its place. 

HYPNOTISM. 

Name and Principle — In the year 1841, a surgeon in Manchester, 
England, James Braid, began the study of what he called the pretensions 
of animal magnetism or mesmerism. He started without believing in it 
at all, calling himself "a complete skeptic" regarding all its phenomena. 
While investigating this subject he discovered that by a fixed and ab- 
stracted attention of the mind and sight en one object he could artificially 
produce a peculiar condition of the nervous system. To this condition he 
gave the name of neuro-hypnotism or nerve sleep ; from the Greek £evpov, 
nerve and vnrjo^ sleep. Later the part neuro was dropped and the term 
hypnotism came into general use. 

Hypnotism Explained. — At a meeting of the British Association in 
Manchester, on June 29, 1842, he read an essay on the cure of disease by 
hypnotism. In the following year his book came out, in which he reported 
a great number of cases in which he had successfully applied hypnotism 
in the relief and cure of disease. 

Hypnotism a Science. — Since Braid started his investigation scien- 
tists in every country have studied the subject until now hypnotism is 
considered one of the national sciences. 

Generally Taught — In every college of the land hypnotism is taught 
and in every large city that art is practiced. It is not astonishing that this 
subject has caused such study among the scientists and has excited such 
wonder among all who have witnessed its workings. 

Phenomena. — To think that by holding up a bright object or by 
waving a hand one person can put another so completely in his power 
that the victim not only acts but even thinks as the operator desires. If 
the operator tells his patient to walk across the room the patient shrieks 
in terror at what he believes is a wild beast. 



1596 MENTAL HEALING. 



HOW HYPNOTISM IS PRODUCED. 



Manner of Hypnotizing. — The usual method of inducing the hypnotic 
state is to cause the person operated on to stare fixedly at a bright object, 
such as a glittering piece of glass, or a polished watch charm, or the 
shining steel of a penknife. This object is held at from eight to fifteen 
inches from the eyes in such a position above the forehead as will strain 
the eyes and eyelids. 

Effect on Eyes. — The operator may stand in front of, to one side of or 
behind the patient. As the patient strains to see an object so near it will 
be noticed that the pupils, the little round dots in the middle of everyone's 
eyes, are at first very small. You can see this whenever a person tries to 
look at a near object. 

Enlargement of Pupils. — In a short time, however, the pupils will 
begin to grow larger. It is then that the operator makes a few passes over 
the face without touching it. The eyelids then close. Or the operator may 
gently close them with the tips of the fingers, at the same time very 
gently stroking the cheeks. Often a twitching of the eyelids may be 
observed when they are closed. The eyes may afterward become widely 
opened. 

The Hypnotic State. — The patient is now in a sleep-like condition. 
The limbs often remain in almost any position in which the operator may 
place them. At the same time the patient may now be caused to make 
movements in obedience to the commands of the operator. He must also 
act according to the ideas suggested to him. 

Hypnotic Illusions — Thus, he may eat a raw potato with relish, appar- 
ently under the impression that it is an apple. He may make wry faces on 
drinking a glass of water when told that what he is taking is castor oil. 
He may ride on a chair or stool as in a horse race. He may fight with 
imaginary enemies or show tolerance of affection to imaginary friends. 
In short, all kinds of actions, even of a ridiculous and degrading character, 
may be done by the patient at the command of the operator. 

Effects on Muscles. — Another class of phenomena consists in the pro- 
duction of stiffness or rigidity of certain muscles or groups of muscles, or 
even of the whole body. For example, on stroking the forearm it may be 
rigid while bent or stretched out. The knee may be strongly bent with the 
muscles stiff, hard and immovable. The muscles of- the trunk may become 
as rigid as to allow the body to rest like a log witli the head and heels on 
two chairs. In this position it is so stiff and rigid that it can bear the 



HYPNOTISM. 1597 

weight of the operator sitting upon it. The patient may be made to hear 
sounds that don't exist and to see colors and feel various sensations which 
exist only in thevpatient's mind. 

Waking Up. — The patient may remain in this condition for an hour 
or more. He may then be roused by holding him for a few minutes and 
blowing gently into the eyes ; sprinkling water, making upward passes or 
simply saying "wake up" are other methods employed for awakening. 

After the State. — Usually the patient has a vague recollection, like 
that of a disturbed dream. Sometimes, however, the patient distinctly re- 
members all that has happened and even feels ashamed at having been 
compelled to do ridiculous actions. 

Who May Be Hypnotized. — Certain persons are more readily hypno- 
tized than others. It has also been observed that, once the condition has 
been successfully brought about, it can be more easily induced a second 
time, a third time more easily than a second, and so on. Finally the pa- 
tient may be so under the will of the operator that a fixed look, or a wave 
of the hand, may throw him at once into the condition. M. Liegeois has 
hypnotized some of his subjects by telephone. Children under three or 
four, on the other hand, and insane persons, especially idiots, are unusually 
hard to hypnotize. 

THE SYMPTOMS OF THE TRANCE. 

Loss of Memory. — In the earlier stages of hypnotism the patient re- 
members what has happened, but with successive sittings he sinks into a 
deeper condition, which is commonly followed by complete loss of memory. 
On waking he can recall nothing at all. 

Return of Memory. — But just as we may be reminded of a dream by 
meeting persons or objects that figured therein, so on being prompted the 
hypnotic subject will often remember what happened in his trance. One 
can often make them remember by merely telling them during the trance 
that they shall remember. 

Suggestibility. — The patient believes everything his hypnotizer tells 
him and does everything the latter commands. The patient may do things 
over which the will has normally no control. He will redden, turn pale, 
sneeze, become hot or cold, and so forth. 

Effects on Motion. — Tell the patient that he cannot open his eyes or 
mouth, cannot unclasp his hands or lower his raised arm, and he will be 
immediately powerless to do so. Say his arm is paralyzed and it will fall 
limp at his side. 



1598 MENTAL HEALING. 

Hallucinations and Delusions. — You can make your subject think he is 
freezing or burning, itching or covered with dirt, or wet. He can be made 
to drink a cup of vinegar for a glass of champagne and may become drunk 
in consequence. A chair will be a lion, a broomstick a beautiful woman. 
The subject can be made to believe that his personality is changed into that 
of a baby, of a street boy or of Napoleon. He may even be transformed 
into a beast or an inanimate thing like a chair or a carpet. 

Sensation Abolished — Legs and breasts may be amputated, children 
born, teeth extracted and the most dangerous operations undergone without 
the patient feeling any pain. In the same way neuralgias, toothaches and 
headaches may be cured. In one case the sensation of hunger was abol- 
ished and the patient took no nourishment for fourteen days. A subject 
may be made blind to a certain person, and to everything pertaining to 
him. What he says is not heard and his contact is not felt. 

Acuteness of the Senses. — The sense of touch is so delicate that a 
subject after simply poising on her finger tips a blank card drawn from a 
pack of similar ones can pick it out from the pack by its weight. A coin 
from the operator's pocket has been repeatedly picked out by the subject 
from a heap of twenty others by its greater weight. A subject may be 
made to hear a watch tick or his operator speak in a distant room. 

Changes in the Tissues. — In certain subjects a congestion, a burn, a 
blister, a pimple or a bleeding from the nose or skin may be caused by a 
mere suggestion. 

After-Hypnotic Suggestions. — These are given to the patient during 
the trance to take effect after waking. They succeed with a certain num- 
ber of patients, even though the act is to be performed months or even a 
year after the command is given. In this way one can make the patient 
feel a pain or be paralyzed, or be hungry or thirsty, or do something ridic- 
ulous after coming out of his trance. In these cases he forgets that the 
suggestion was given him in a previous trance. He thinks he is acting of 
his own free will. 

MIND-CURE. 

The Mind and Disease. — It is well known that the mind has a great in- 
fluence on matter. Physical changes have been wrought by mental states. 
Diseases have been caused and have been cured by the influence of the 
mind. Many instances can be quoted illustrating this fact. Persons have 
been shot dead with blank cartridges. An Edinburgh criminal died from 



HYPNOTISM. 



1599 



a supposed loss of blood when it was only warm water that was made to 
trickle over his arm after it was badly pricked by the surgeons. 

A Case in Point. — Dr. Moore mentions the case of a lady who died 
with every symptom of hydrophobia under the mistaken notion that she 
had been bitten by a rabid dog when it was demonstrable that the animal 
had only torn her dress. 

Another Illustration. — One of the most instructive and satisfactory 
experiments on record showing the influence of the mind in the generation 
of fatal diseases is that tried upon four Eussian criminals who had been 
condemned to death for political offenses. The cholera was raging at the 
time in Kussia, and the criminals, while ignorant of the fact, were made to 
occupy beds on which patients had recently died with the disease. Al- 
though thus exposed to the contagion not one of them exhibited the least 
symptom of the malady. 

The Second Experiment. — After this they were told that they must sleep 
on beds that had been occupied by persons who had been sick with the 
cholera. But in fact the beds were entirely new and had never been used 
by anyone. Their fear proved to be a more powerful influence than 
the contagion, for three out of the four took the disease in its most fatal 
form and died in four hours after the attack. 

Effect of Faith — The influence of faith in the cure of disease is well 
illustrated by a fact mentioned in Paris's Life of Sir Humphrey Davy. 
In the early period of his scientific career, Davy was assisting Dr. Beddoes 
in his experiments on the inhalation of nitrous oxide. Dr. Beddoes, think- 
ing the oxide must be a specific for paralysis, a patient was selected for 
trial and placed under the care of Sir Humphrey. Before administering 
the gas, wishing to ascertain the temperature of the palsied man's blood, a 
small thermometer was inserted under his tongue. The paralytic, wholly 
ignorant of the process to which he was to be subjected, but deeply im- 
pressed by Dr. Beddoes with the certainty of its success, no sooner felt the 
thermometer between his teeth than he concluded that the talismanic in- 
fluence was at work, and in a burst of enthusiasm declared he felt its 
healing power through his whole body. 

Carrying on the Experiment. — Here was an opportunity to test the in- 
fluence of the mind in the cure of palsy that was not to be lost. The gas 
was not used, but on the following day the thermometer was again em- 
ployed with equally marked effects, and at the end of two weeks the 
patient was discharged cured, no remedy of any kind having ever been 



1600 MENTAL HEALING. 

used except the thermometer. His faith made him whole, not by accident, 
nor by a miracle, but by an invariable law of our being. 

The Power of Faith. — Faith is a spiritual force that has accomplished 
wonders. It is an actual psychological or spiritual force. To believe that 
we can do a thing, especially if that faith is the result of an understanding 
of nature's laws, empowers us to do it. To believe that we are well, or that 
we are becoming so, excites a spiritual force within us, that goes far to- 
ward making us so. 

Faith in Remedies — If we firmly believe that a certain remedy will 
cure us of a diseased condition, though it has no chemical adaptation to the 
removal of the disorder, we shall be benefited by it. Disease has often 
been cured by faith alone in the patients. 

The Bible Instance. — The familiar case of the woman mentioned in the 
Gospel history, who had suffered for twelve years from a dangerous 
uterine hemorrhage, baffling the skill of various physicians, is known to all. 

Requisites in Mind-Cure. — There are two things in a patient necessary 
to the mind-cure. One is a desire to get well. The other is a faith in the 
efficiency of the remedial agency. 

How Mind-Cure Acts. — Through the grand system of sympathetic 
nerves each organ in the body is connected with every other, and the whole 
with the mind. There is no part or function which cannot be affected 
just as certainly, though perhaps not so sensibly, by the will-force, as the 
muscles of the arm. 

The Nerve Conductor. — The pneumo-gastric nerve, according to Evans, 
which is distributed to all the organs within the cavity of the trunk, is the 
appointed conductor through which the mental force is communicated to 
them and influences their action. We have only to concentrate the mind's 
force upon any of the internal organs, as the stomach, liver or intestinal 
canal, and through the pneumo-gastric nerve its workings will be influ- 
enced. 

Mind-Cure in Indigestion. — If the stomach has become exhausted of its 
nerve force so that it fails to do its work and the food in it is a motionless 
and fermenting mass, according to Evans, it can be made to obey the com- 
mand of the sovereign mind. Concentrating the mind upon it, bringing 
our spiritual force to a focus, we may calmly and powerfully will it to pro- 
ceed to business and attend to its proper work, and it will obey us as readily 
and as promptly as a good servant yields to the order of his employer. 
The same effect may be produced upon the action of the intestinal canal. 

Mind-Cure for Cold Extremities. — Mental-curists claim that if the 



TELEPATHY. 1601 

blood and vital heat do not circulate through the extremities, which feel 
a deadly coldness, it is because the spiritual life does not permeate the 
tissues. We may send the spiritual principle there, by the will force, to 
distribute to the negative parts their share of the vital name. 

Every Man His Own Physician. — A little practice, according to Evan, 
will render the mind-cure easy and natural, and we can become our own 
physician and healer without the use of actual medicine. 

TELEPATHY. 

Mind-Sight. — T\ T e know that the somnambulist or sleep walker, in the 
darkness of the night, with his eyes closed, can climb dizzy heights and 
walk along dangerous precipices with ease and apparent safety. This power 
thus exhibited, according to Prof. Barnes, is evidence that there is a 
medium adapted to the sight of the mind which enables it to see things 
beyond the sense of ordinary sight. Many instances have occurred where 
persons in a natural state have discovered that they possess the power to 
divine the thoughts of others. 

Division of Telepathy. — Telepathy or clairvoyance may be considered 
under two heads, namely, sympathetic and independent. 

Sympathetic Telepathy. — A sympathetic clairvoyant takes on the feel- 
ings of the one with whom he is in sympathy. He very often feels, sees, 
hears, tastes and smells that which the other party does. 

Telepathy in Disease — He is sometimes able to locate pain and dis- 
ease immediately through this wonderful faculty. Barnes gives the fol- 
lowing examples of sympathetic telepathy: "I blindfolded a gentleman, 
placed my hands in contact with his, while the third party pricked me at 
various points with a sharp instrument. The subject would feel the pain 
immediately at the point upon his own body corresponding to the exact 
location where the instrument was being used upon me. . . 

"I know a dentist in Western ISew York who is so sympathetic that 
he suffers whenever his wife does. He has the same feelings and never 
improves until she begins to recover. A pupil of mine, a contractor, who 
is exceptionally strong, told me that the above condition existed between 
himself and wife, and that the distance made no difference, as he was 
hundreds and sometimes thousands of miles away from home." 

Independent Telepathy. — Independent clairvoyants are able to get 
information independently of any sympathetic relation, apparently. They 
are able to separate the soul from the body, as it were, and to travel to 



1602 MENTAL HEALING. 

foreign countries. Time and distance seem to cut no figure with them. 
Prof. Barnes recites many startling instances of this kind of telepathy. 

Practical Application of Telepathy — The usefulness of telepathy lies 
in the knowledge of its practical application. Understood and applied, it 
is a most valuable and valued instrument in the hands of the learned 
physician or in any of the walks of life. 

CHRISTIAN SCIENCE. 

Mortal and Divine Mind. — In Christian Science a great distinction is 
drawn between mortal mind and the Divine mind. Mortal mind is part of 
our material being, it belongs to matter, and it gives us our feelings of 
pain, sickness, error and sin. The Divine mind is spiritual. It is part of 
that Divine Spirit that fills the universe. It is God. Inasmuch as the 
Divine mind is God and fills the universe, it is good and truth. There can 
be no sin or sickness in divinity. 

Nature of Sickness. — Sickness is merely a false impression conveyed 
by erring mortal mind. The- way to cure both sin and sickness is by sub- 
stituting the Divine mind for mortal mind. This can be accomplished by 
a proper realization of the Scriptures in their true meaning, according to 
Christian Science, until the seeker after truth separates the material from 
the spiritual, and thereafter is ruled by the Divine mind. 

Principles of Christian Science. — The fundamental propositions of 
Christian Science as laid down by Mrs. Eddy in book "Science and 
Health," are summarized in the four following, to me, self-evident propo- 
sitions. Even if read backward, these propositions will be found to agree 
in statement and proof: 

1. God is all. 

2. God is good. Good is mind. 

3. God, Spirit, being all, nothing is matter. 

4. Life, God, omnipotent good, deny death, evil, sin, disease. 
Disease, sin, evil, death, deny good, omnipotent God, life. 

The evidence of the physical senses often reverses the real science of 
being and so creates a reign of discord, assigning seeming power to sin, 
sickness and death ; but the great facts of life, rightly understood, defeat 
this trend of errors, contradict their false witnesses and reveal the King- 
dom of Heaven, the actual reign of harmony on earth. The material 
senses' reversal of the science of soul was practically exposed by the 
demonstrations of Jesus nineteen hundred years ago, yet this so-called 



CHEISTIAN SCIENCE. 1603 

sense still makes mortal mind tributary to mortal body, and ordains cer- 
tain sections of matter, such as brain and nerves, as the seats of pain and 
pleasure, whence matter reports to this mind its status of happiness or 
misery. 

Revelation of Christian Science. — The revelation of Christian Science 
consists of twG parts : 

1. The rediscovery of the Divine science of mind-healing, through a 
spiritual sense of the Scriptures and through the teachings of the Com- 
forter, as promised by the Master. 

2. The proof, by present demonstration, that the so-called miracles 
of Jesus did not specially belong to a dispensation now ended, but that 
they illustrate an ever-operative Divine principle. 

Prayer and Healing. — "The prayer of faith shall save the sick," says 
the Scripture. What is this healing prayer ? A mere request that God 
will heal the sick has no power to gain more of the Divine presence than 
is always at hand. The only beneficial effect of such prayer for the sick 
is on the human mind, making it all more powerful on the body through 
a blind faith in God. 

Right Prayer. — In order to pray aright we must enter into the closet 
and shut the door. We must close the lips and silence the material senses. 
In the quiet sanctuary of earnest longings we must deny sin and plead 
God's allness. We must resolve to take up the cross and go forth with 
honest hearts to work and watch for wisdom, truth and love. We must 
"pray without ceasing." Such prayer is answered, inasmuch as we put 
our desires into practice. The Master's injunction is that we pray in 
secret and let our lives attest our sincerity. 

Method of Treatment. — Mrs. Eddy advises the following mode of 
treatment : 

"Always begin your treatment by allaying the fear of patients. 
Silently reassure the patient as to his exemption from disease and danger. 
Watch the result of this simple rule of Christian Science and you will find 
that it alleviates the symptoms of every disease. If you succeed in wholly 
removing the fear your patient is healed." 

Winning the Battle. — The great fact that God wisely governs all, 
never punishing aught but sin, is your standpoint, whence to advance and 
destroy the human fear of sickness. Plead the cause for science and in 
truth, mentally and silently. You may vary the argument to meet the 
peculiar or general symptoms of the case you treat; but be thoroughly 
persuaded in your own mind and you will finally be the winner. 

101 



MEDICAL SCHOOLS 



PAET XI. 

HUMAN SCIENCE 



PHRENOLOGY, PHYSIOGNOMY AND PALMISTRY. 

"If any science, art or work has for its beginning, its object and its 
end the improvement of humanity and the advancement of the race, then 
that work, art or science deserves the encouragement and recognition 
that is its due." — Cheira. There is more in this science than may at first 
sight appear. 

Phrenology. — We know that certain bumps upon the head indicate 
certain characteristics of human nature. 

Physiognomy. — The color of the hair and eyes, the form of the mouth, 
of the chin and nose, the shape of the ears, afford certain and infallible 
indications of temperament. 

Palmistry. — The shape of the hand and fingers relates to the heredi- 
tary influence of character and disposition ; the lines and markings of the 
palm to the event of past, present and future. 

OBJECT OF HUMAN SCIENCE. 

"Know thyself" was the grand motto of the ancients. 

It is still the watchword of a modern and progressive world. 

By the knowledge of self we may master self, and by the improve- 
ment of self we may also improve mankind. 

Mentality. — Mentality is the ultimate aim and goal of men and of 
all things on earth. Mental science, therefore, constitutes the embodied 
summary of all science. 

Uses of the Science — It is the purpose of this article to give the latest 
results of the researches of scientists in the subjects of phrenology, 
physiognomy and palmistry. Only by the study of these great subjects 

1G04 



OBJECT OF HUMAN SCIENCE. 1605 

can we thoroughly know ourselves. Without it we can never understand 
the natures of our children. Ignorance of it means ignorance of mankind. 

Opponents of Human Science. — Ignorance is the father of opposition. 
!No new discoveries were ever made that did not meet with opposition, 
and this opposition was strongest in those that knew the least about the 
new discovery. Columbus was bitterly persecuted for daring to suggest 
that the earth was round. Galileo took his opponents to the famous 
tower of Pisa and let fall at the same moment from its top two weights, 
a small and a large. Although these men saw both weights reach the 
ground at the same instant they refused to believe their eyes, and held fast 
to the old Aristotleian theory that the heaviest of two bodies would always 
drop to the ground first. 

Opposition Without Weight. — The men who are the first to oppose a 
new science are those who are learned in another science, and because 
they are known to be wise, their opinion has great weight, although they 
may have devoted no study at all to the new science. Physicians, espe- 
cially, are treated in this unreasonable way by the ordinary populace. 

Readings of Character — A man sees, perhaps, a strange experiment 
in hypnotism or he may have his character accurately read from his head, 
his face or his hand. He goes to his physician, and because that physician, 
who probably has never devoted ^Ye minutes' study to any of these sub- 
jects, pronounces such things impossible, the patient also refuses to 
believe in them. So he goes away and tells his acquaintances to pooh-pooh 
the idea, because Dr. So-and-so does not believe in it. 

Human Mysteries. — It is recognized by all physicians that there are 
hundreds of mysteries in medicine as yet unfathomed. How much more 
is this so in regard to the mysteries of life and nature, which few have 
penetrated ? 

Growth of Hypnotism. — Not a great many years since almost every 
physician declared that hypnotism was impossible. To-day the medical 
profession recognizes hypnotism as one of its most important studies. 

Importance of Palmistry. — For years doctors ridiculed palmistry. 
To-day they admit that diseases are indicated in a marvelous manner 
by the hand. Almost all medical men admit now that the different for- 
mations of nails indicate different diseases, and that it is possible from 
the nails alone to predict that the subject will suffer from heart disease, 
paralysis, consumption, and so on. So it is with physiognomy. 

Detecting Ailment. — A disease often has what physicians call its 



1606 HUMAN SCIENCE AND HEALTH. 

facies, an expression by which the trained eye can detect the character 
of the ailment. 

Cheira says : "I respect doctors as a body of educated men ; but I do 
not respect the idea that they should be the appointed judges of such 
matters as telepathy, mesmerism, clairvoyance, and so on, without any 
other qualification but that of having M. D. to their names." 

What Doctors Can Tell — How a doctor treats his patient and the way 
a phrenologist or palmist treats his client. 

In the first place a doctor has a recognized science to go by. He has 
the experience of thousands of years back of him. Scientific instruments 
of precision and the most modern improvements are at his command. 
Yet how many can tell the patient what he is suffering from, unless the 
patient first tells the doctor all about himself and his symptoms ? Even 
then the physician must often listen and feel and pound before he will 
express an opinion. And after all that, how often can the doctor arrive 
at a correct diagnosis ? If the doctor makes a mistake, not much is thought 
of it, as we are all human and no man is infallible and no science is perfect. 

What Phrenologists and Palmists Can Tell. — In the case of a phrenolo- 
gist or palmist, however, the client, without giving his name, without 
telling his occupation, or whether married or single, simply exhibits his 
head or holds out his hands. The phrenologist or palmist then has to tell 
the past events in his life, present surroundings, health, past and present. 
Having, by accuracy only, gained the client's confidence, he proceeds to 
read the future from the same materials that he has told the past. 

Now, if the palmist or phrenologist should make one mistake he is 
immediately considered by his client to be a charlatan and a fraud, and 
the science of mentality is regarded as a delusion and a snare. 

Having, we hope, convinced our readers that it will be to their ad- 
vantage to consider the subject of descriptive mentality we will now take 
up in detail each of its departments. 

PHRENOLOGY 

Organ of Love of Young. — Let Vtie reader feel along the middle line, 
at the back part of the head, toward the base of the skull, and he will 
recognize a small bony projection. Below this point lies the organ of 
amativeness. Immediately above it, and on each side of the middle line of 
the head, lies the organ of the love of young, forming, generally, a single 
protuberance occupying both sides of the line. When very large it gives 
to the back of the head a dropping, overhanging appearance. 



READING THE HEAD. 1607 

Development of the Organ. — Some people are very fond of children 
and others cannot abide them. Some abhor even their good-natured prat- 
tle, while others show toward them the utmost forbearance, and soothe 
their fretfulness with admirable patience and gentleness. Now, in all 
these cases, the strong manifestation of the feeling is accompanied by a 
large development of the organ, and a feeble manifestation of the faculty 
by a small development of the organ, the manifestation and the develop- 
ment being proportional. 

Principles of Phrenology. — Gall established the following principles : 

1. That the mental faculties are innate. 

2. That the brain is the organ of mind. 

3. That the form and size of the brain are distinguishable by the 
form and size of the head or skull. 

4. That the mind possesses distinct faculties, and that the brain is 
composed of distinct organs, and that each mental faculty is manifested 
through a distinct organ of the brain. 

5. That the size of each organ can be estimated during life ; and that 
size, other things being equal, is the measure of power. 

6. That each organ, when predominantly active, impresses the body 
with certain uniform attitudes and movements, called its natural language. 

Grouping of the Organs. — The first division of the faculties of the 
mind and the organs of the brain is into three grand classes : 

1. The propensities of animal organs; 

2. The intellectual faculties, and 

3. The moral or spiritual sentiments. 

Location of the Groups. — These groups are so placed that the location 
of each indicates its work in the graded scale of functions. 

Propensities. — The propensities are placed next to the spinal column, 
in the base of the brain and in close connection with the body. 

Intellect. — Rising above these we come to the region of intellect. 

Morality. — Above that, in the very top of the head, are the moral or 
spiritual sentiments, through which we are brought into relation with God. 

Function of the Propensities. — The propensities give force and effi- 
ciency in all our actions, adapt ns to our fellows, and lead us to take care 
of ourselves. 

Function of the Intellectual Faculties. — The intellectual faculties en- 
able us to obtain knowledge of men and things; to compare and arrange 
facts ; and to invent and construct what we need for the practical applica- 
tion of our knowledge. 



1608 HUMAN SCIENCE AND HEALTH. 

Function of the Moral Sentiments. — The moral or spiritual sentiments 
are meant to control all the rest by subjecting them to the tribunals of 
kindness, justice and the Divine Law. 

Classes Divided Into Groups. — The grand classes of faculties and or- 
gans are divided into groups as follows: 

Propensities — 1. The social group. 2. The selfish group. 

Intellectual Faculties — 1. Group of the external senses. 2. The 
perceptive group. 3. The reflective group. 4. The literary group. 

Moral Sentiments. — 1. The selfish group. 2. The semi-intellectual 
group. 3. The religious group. 

Social Group. — The social group has for its collective function the 
manifestation of those affections which connect us with country and home, 
and attach us to relatives, conjugal companions, family and friends. 

Selfish Group.— The office of the selfish group is to make proper pro- 
vision for the animal wants, and to secure the preservation of life, the 
defense of the person and the accumulation and protection of property. 

The External Senses. — The external senses have for their appropriate 
work the conveying to the brain of intelligence concerning the world of 
material things outside of the brain itself, acting, therefore, in direct 
co-operation with the perceptive faculties. 

The Perceptive Group. — The perceptive group, through the senses, 
brings man into direct communication with the physical universe, gives a 
correct judgment of the properties of things, and leads to the practical 
application of the knowledge obtained. 

The Reflective Group. — The function of the reflective group is to 
analyze, compare and classify the facts collected by the perceptives and to 
philosophize, contrive, invent and originate ideas. 

The Literary Group. — The literary group imparts memory, and the 
ability to communicate ideas and feelings by means of written or spoken 
words. 

The Group of Selfish Sentiments. — The group of selfish sentiments gives 
regard for character, love of distinction, self-reliance, independence, sta- 
bility and perseverance. They have an aspiring and governing tendency. 

The Semi-Intellectual Group. — The semi-intellectual group has for its 
function self -improvement, and the love and production of whatever is 
beautiful. It is elevating and chastening in its influences, and acts in 
co-operation with the strictly religions group, to which it is closely allied. 

The Religious Group. — The religious group has the highest office of 
all, and tends to elevate man into fellowship with angels, and beget aspira- 



READING THE HEAD. 1609 

tions after holiness and heaven, while making him at the same time meek 
and humble — even as a little child — toward God. When large and active, 
and holding the leading place which belongs to it, all the other groups are 
sanctified through its action. 

Division Into Organs — Each of these groups is again divided into 
organs, designated by name and location on the head, and each indicative 
of some characteristic of the man or woman. Space will not permit a full 
classification and description of each organ as thus subdivided, but the 
general principles of phrenological science may be learned from a consid- 
eration of the organs of a single group ; say, The Social Group. 

Organs in the Social Group. — 1. Amativeness. 2. Philoprogenitive- 
ness (love of young). 3. Adhesiveness. 4. Inhabitiveness. 5. Con- 
tinuity. 

Amativeness. — "Be fruitful, and multiply, and replenish the earth, 
and subdue it." 

Definition. — Love between the sexes ; desire to marry. 

Location. — Feel on the middle line toward the base of the skull, at 
the back part of the head, and you will feel a small, bony projection called 
the occipital process. Below this point and between two similar pro- 
tuberances (the mastoid processes) behind the bottom of the ears lies the 
organ. Its size is indicated by the extension of the occipital swellings 
backward and inward of the mastoid processes, and downward from the 
occipital process. 

Function. — The function or use of amativeness is to manifest sexual 
feeling, and give the desire to love and be loved and to marry. 

Philoprogenitiveness. — "Can a woman forget her suckling child ?" 

Definition. — Kegard for offspring, pets, and so forth. 

Location. — About an inch above the occipital protuberance. When 
large it gives fullness to the back-head above amativeness. 

Function — To impart love for the young, and particularly for one's 
own children. It also leads to a fondness for pets generally. It gives a 
softness of manner in treating the feeble and the delicate, even in advanced 
life. 

Friendship. — "The soul of Jonathan was knit with the soul of David, 
and Jonathan loved him as his own soul." 

Definition. — Adhesiveness; sociability; love of society. 

Location. — At the posterior edge of the parietal bone just above the 
lambdoidal suture. It projects at the posterior and lateral part of the head, 



1610 HTJMA]^ SCIENCE AND HEALTH. 

cn each side of inhabitiveness, and a little higher than philoprogenitive- 
ness, and when very large produces two annular protuberances there. 

Function. — This organ gives the instinctive tendency to attachment 
and delight in the return of affection. It causes one to seek company, love 
society and indulge friendly feelings. Those in whom it is strong feel an 
involuntary impulse to embrace and cling to any object which is capable 
of experiencing fondness. It gives ardor and a firm grasp to the shake 
with the hand. 

Inhabitiveness — "The Lord forbid it me, that I should give the in- 
heritance of my fathers unto thee." 

Definition — Love of home and country. 

Location. — Between parental love and continuity, on the back part 
of the head. Where it is very large and continuity moderate, an angle is 
formed near the union of the lambdoidal sutures, between which and the 
occipital bone there will be considerable distance. 

Function. — To give love of home and country, a desire to have a 
permanent abode, and attachment to any place where one was born or has 
lived. 

Continuity. — "Let every man abide in the same calling wherein he 
was called." 

Definition. — One thing at a time; consecutiveness. 

Location. — ISText above inhabitiveness and below self-esteem. When 
large it gives a general fullness to the region ; and when moderate or small, 
a marked depression will be perceptible. 

Function. — To give connectedness to thought and feeling, and thor- 
oughness in elaboration of ideas or the working out of the details of any 
plan. Concentration. 

Other Organs. — Among the other organs located and functionally de- 
scribed, and whose location, description and function go to make up the 
complete system of phrenology, are combativeness, destructiveness, ac- 
quisitiveness, approbation, self-esteem, firmness, hope, spirituality, benevo- 
lence, ideality, imitation, mirthfulness, individuality, form, size, weight, 
order, calculation, locality, time, and so forth. 

PHYSIOGNOMY. 

The real science begins with Camper. He discovered the famous 
facial angle which, to our own time, has served as a criterion and a measure 
to determine the rank of che human face. Many scientists since Camper 



READING THE FACE. 1011 

have devoted great study of physiognomy. Darwin, Mantegazza and many 
others have written famous works on the subject of expression. 

Racial Expression — It is interesting to note how the expression varies 
in different races and even in the same races. In the same races pastoral 
and agricultural people are less expansive in their expression; while the 
warlike, seafaring or trading nations have more mobile and expressive 
facial muscles because their life is less simple and less contemplative. 

The Different Types — Everyone knows the tranquil expression of the 
Oriental people, who await everything from God, and do not know the 
feverish activity of the Europeans. 

The expression of the Erenchman is concentric, rapid and gay. 

That of the Englishman haughty and stern. 

That of the German heavy, benevolent and always ungraceful. 

The Spaniard and Portuguese gesticulate little ; their faces remain 
impassive. 

Many Kussian and Hungarian people do not look one steadily in the 
face, and have a very false expression. 

The expression of the Scandinavian is hard and without grace. 

Professional Expression. — Often on seeing a stranger we exclaim to 
ourselves, "This man must be a pharmacist ! I bet that this is a priest or a 
disguised soldier ! This other can only be a carpenter !" Many times these 
hazarded suppositions have been correct. The profession has a modifying 
influence on the expression of the face, and even on the character, on the 
health and many other inner and outer things. 

The professions which most profoundly modify expression are those 
which daily exert a particular mode of muscular movement or of brain 
work. It is because of this that I recognize the druggist, the doctor, the 
carpenter, the priest and the soldier more readily than other members of 
society. 

Judgments on the Face — After looking at a human face we can nearly 
always formulate certain judgments relating to one of the five great 
problems which a human face presents. 

1. . Condition of health or of sickness. 

2. Degree of beauty or ugliness. 

3. Moral worth. 

4. Intellectual worth. 

5. Race. 

The Healthy Look. — The healthy look is not difficult to detect. We 
all take great satisfaction at the sight of a picture of perfect health. 



1612 hitman science and health. 

The Unhealthy Look — The unhealthy look, on the other hand, may 
appear in a great variety of forms. Many times the outer aspect of the 
invalid, and especially of his face, suffice to make the nature of the evil 
guessed, and to put us on the way to a good diagnosis. 

Special Functions. — There are some special functions where the par- 
ticular nature of the sufferings is so faithfully inscribed on the face that it 
at once suggests to the observant doctor the diagnosis before any examina- 
tion of the patient. The tuberculous, the asthmatic, the hypochondrical, 
the cancerous have a characteristic physiognomy and expression which 
everyone can recognize. 

The Good Face. — The two most certain signs of a good face are the 
permanent expression of benevolence and the absolute absence of all 
hypocrisy. 

Never to express either hatred, or cruelty, or passion, or rancor, or 
envy, or luxury, or debauchery — this is enough that a face may indicate 
a great fund of benevolence. 

The good man is happy, and he expresses his serenity, his content in 
loving and being loved by a perpetual smile. 

Another almost constant character of the physiognomy of goodness is 
to be frank, open to every emotion, incapable of hiding anything. 

The good man, in fact, never distrusts others; he does not feel the 
need of withdrawing himself from an inquisitive observation. 

The Evil Face — The habit of hatred and of all vices which debase man 
and reduce him to the beast, impress sadness on the face, discontent, which 
reveals continual displeasure and a perpetual state of war against self and 
against others. 

The contempt, the antipathy which the wicked excite, increases in 
them the rancor, the secret and incessant desire for vengeance which gives 
to the features of their face a sad expression. 

A wicked face is always false. The cheat avoids the looks of others 
in his invincible fear that they may read within him. 

The Intelligent Face. — Large head, beautifully oval. Wide, high and 
prominent forehead. Eyes large rather than small. Ears small or medium 
and beautiful. Eace small and not very muscular. 'Not very prominent 
jaws. Large and prominent chin. 

The Stupid Face. — Small head or very irregular. Narrow, retreating, 
smooth forehead. Eyes rather small. Large and ugly ears. Large and 
very muscular face. Prominent jaws. "Retreating and small chin. 

The Amative Face. — A prominent if not massive chhv; a full neck; 



READING THE FACE. 1613 

breadth and fullness of the lips. Redness of the lips indicates present 
activity of the function. Absence of color indicates inactivity. 

Face of Friendship. — Friendship (adhesiveness) holds fast, clings, ad- 
heres and is represented by the round muscle which surrounds the mouth 
and draws together or closes the lips. When this muscle is large and 
strong it produces slightly converging wrinkles in the red part of the lips, 
sometimes extending slightly into the white part. 

Small perpendicular wrinkles in the red part of the lips indicate a 
smaller degree of friendship, but not a deficiency. 

The Combative Face. — There is generally a marked enlargement of 
the neck below the back of the side-head. Prominence of the ridge of the 
nose is another sign. 

The Acquisitive Face. — Persons noted for their love of gain and ability 
to acquire property are observed to have, as a general rule, massive noses, 
and it is believed that thickness of the nose above the wing is the true facial 
sign of acquisitiveness. 

Face of Firmness. — The facial sign is the perpendicular straightness 
or convexity and stiffness of the centre of the upper lip. 

This faculty has also one of its most striking indications in the size 
and strength of the bones of the neck and in the perpendicularity of the 
neck itself. 

Face of Hope — Hope elevates the centre of the eyebrow, opens the 
eyes wide and turns them upward. It gives an open and pleasant expres- 
sion to the whole countenance. 

The Spiritual Face. — Large and active spirituality gives a singularly 
elevated expression of countenance. 

The Face of Benevolence — The inner extremities of the brows are 
elevated, sometimes causing, when strong, short horizontal wrinkles in the 
centre of the forehead. 

Face of Mirthfulness. — Mirthfulness shows itself on the face in a 
graceful turning upward of the corners of the mouth. 

Language Face. — A large development of language is indicated by 
prominent eyes. Sometimes the eyes not only project but are also de- 
pressed, when the under eyelid presents a sort of sack or roll or appears 
swollen. 

PALMISTRY, OR LANGUAGE OF THE HAND. 

Divisions. — Palmistry should really mean the study of the hand in 
its entirety. It is, however, divided into two sections : the twin sciences 
of chirognomy and chiromancy. 



1611 HUMAN SCIENCE AND HEALTH. 

The first deals with the shape of the hand and fingers and relates to 
the hereditary influence of character and disposition. 

The second deals with the lines and markings of the palm and relates 
to the events of past, present and future. 

Chirognomy. — There are seven types of hands, each of which may 
again be subdivided into seven varieties. The seven types are : 

1. The elementary or the lowest type. 

2. The square or the useful hand. 

3. The spatulate or the nervous active type. 

4. The philosophic or the knotty hand. 

5. The comic or the artistic type. 

6. The psychic or the idealistic hand. 

7. The mixed hand. 

Elementary Hand. — This hand naturally belongs to the lowest type 
of mentality. 

Description. — In appearance it is coarse and clumsy with large, thick, 
heavy palm, short fingers and short nails. There are also very few lines to 
be seen on the palm. 

Interpretation. — The people possessing such a type have very little 
mental capacity, and what they do possess leans more to the order of the 
brute. They have little or no control over their passions. Love of form, 
color and beauty does not appeal to them. 

Thumb. — The thumb of such hands is short and thick with the upper 
part of nail phalanx heavy, full and generally square. Such people are 
violent in temper, passionate but not courageous. They possess a certain 
low cunning, but the cunning of instinct, not reason. These people are 
without aspirations ; they but eat, drink, sleep and die. 

The Square Hand. — The square hand means the palm square at the 
wrist, square at the base of the fingers, and the fingers themselves square. 
Such a type is called the useful hand because it is found in so many walks 
of life. With this type the nails as well are generally short and square. 

Interpretation. — People with the square hand are orderly, punctual 
and precise in manner, not, however, from any innate grace of nature, but 
more from conformity to custom and habit. 

They respect authority, they love discipline. They have a place for 
everything and everything is kept in its place, not only in their household 
but in their brains. 

In work they have great application, force of character and strength 



READING THE HAND. 1615 

of will. They are sincere and true in promise, staunch in friendship, 
strong in principle and honest in business. 

The Spatulate Hand. — The spatulate hand is so-called not only be- 
cause the tip of each finger resembles the spatula that chemists use in 
mortars, but also because the palm, instead of having the squareness of the 
preceding type, is unusually broad either at the wrist or at the base of the 
fingers. When the greater breadth of formation is at the wrist the palm 
of the hand becomes pointed toward the fingers. When, on the contrary, 
the greatest breadth is found at the base of the fingers the shape of the 
hand slopes back toward the wrist. 

Significance. — When hard and firm the spatulate hand indicates a 
nature restless and excitable but full of energy of purpose and enthusiasm. 
When soft and flabby it denotes the restless but irritable spirit. Such a 
person works in fits and starts but cannot stick to anything long. The 
peculiar attribute that the spatulate hand has is its intense love of action, 
energy and independence. 

As a rule it is a large hand with fairly long, well-developed fingers. 
The most striking characteristic of all is the singular independence of 
spirit that characterizes individuals possessing such a development. 

No matter in what grade or position in life these spatulate hands 
find themselves they always in some form strike out for themselves and 
assert their right to possess a marked individuality of their own. It is 
from this hand that we get not only our great discoverers and engineers, 
but also the whole army of men and women we are pleased to call cranks, 
simply because they will not follow the rut made by the centuries of 
sheep that have gone before them. They will break all rules of precedent, 
not by any means for the sake of eccentricity, but simply because they 
have an original way of looking at things, and their sense of independence 
inclines them to resent suiting their brain to other people's ideas. 

The Philosophic Hand. — This shape of hand is generally long and 
angular with bony fingers, developed joints and long nails. People with 
such a type are, as a rule, students, but of peculiar subjects. They study 
mankind. They like to be distinct from other people and they will go 
through all kinds of privation to attain this end. Such people love mys- 
tery in all things. In character they are silent and secretive. They are 
deep thinkers, careful over little matters, even in the use of little words. 
They are proud with the pride of being different from others. They 
rarely forget an injury but they are patient with the patience of power. 
They wait for opportunities and so opportunities serve them. Such hands 



1616 HUMAN SCIENCE AND HEALTH. 

are usually egotistical, which is in keeping with the life they lead. When 
in any excess of development, they are more or less fanatical in religion 
or mysticism. With these hands it must be borne in mind that the devel- 
oped joints are the peculiar characteristic of thoughtful people, while the 
smooth, pointed fingers are the reverse. 

The Conic Hand. — The conic hand is medium-sized, the palm slightly 
tapering and the fingers full at the base, and conic, or slightly pointed, at 
the tip or nail phalanx. 

The main characteristics of the conic hand are impulse and instinct. 
There is a great variety in connection with this type but it is more usually 
found as a full, soft hand with pointed fingers and rather long nails. 

Such a formation denotes an artistic, impulsive nature, but one in 
which love of luxury and indolence predominate. 

The Psychic Hand — The most beautiful but the most unfortunate of 
the seven is what is known as the psychic hand. It is in formation long, 
narrow and fragile looking, with slender, tapering fingers and long, 
almond-shaped nails. Individuals with the psychic hand have the purely 
visionary, idealistic nature. They appreciate the beautiful in every shape 
and form. They are gentle in manner, quiet in temper. They are con- 
fiding and they instinctively trust anyone who is kind to them. 

They have no idea of how to be practical, business-like or logical. 
They have no conception of order, punctuality or discipline. They are 
easily influenced by others. 

Color appeals to this nature in the highest possible way. 

This type is unconsciously a religious one. It feels what is true but 
has not the power to seek truth. 

These individuals have the intuitive faculties highly developed. 

The Mixed Hand — The mixed hand is so-called because the hand 
cannot be classed as square or spatulate, and so forth ; the fingers also be- 
long to different types. 

The mixed hand is the hand of ideas, of versatility and generally of 
changeability of purpose. A man with such a hand is adaptable to bot 1 ! ♦ 
people and circumstances, clever but erratic in the application of his 
talents. 

He will be brilliant in conversation, be the subject science, art or 
gossip. He may play some instrument fairly well, may paint a little, and 
so on. But rarely will he be great. 

When, however, a strong line of head rules the hand, he will, of all 



READING THE HAND. 



1617 



his talents, choose the best and add to it the brilliancy and versatility of 
the others. 

Such hands find their greatest scope in work requiring diplomacy and 
tact. 



LINE MEANINGS. 
i. (Rare.) Sudden death. 

2. Long life. 

3. Character of mind- 

4. Capacity for love. 

5. (Rare.) Attractiveness to 

opposite sex. 

6. Fate line — success accord- 

ing to its length. 

7. (Rare.) Unusual suecess 

or fame. 

8. Health line— good in in" 

verse ratio to its length 
and depth. 

9. The number of lines at 9 

indicate the number of 
marriages. 




CHARACTER LINES OF THE HAND. 



They are so versatile that they have no difficulty in getting on with 
the different dispositions with which they come in contact. 



1618 HUMAN SCIENCE AND HEALTH. 

Their most striking peculiarity is their adaptability to circumstances. 
They never feel the ups and downs of fortune like others. Almost all 
classes of work are easy to them. 

They are generally inventive, particularly if they can thereby relieve 
themselves of labor. They are restless and do not remain long in any town 
or place. As they are always changing and unstable as water, they rarely 
succeed. 

The Thumb. — The long, well-formed thumb denotes strength of intel- 
lectual will. The short, thick thumb brute force and obstinacy. The 
small, weak thumb, weakness of will and want of energy. 

The Fingers. — Long fingers give love of detail in everything. Short 
fingers are quick and impulsive. They cannot be troubled about tittle 
things. They take everything en masse. They generally jump at con- 
clusions too hastily. They do not care so much about appearances or for 
the conventionalities of society. They are quick in thought and hasty 
and outspoken in speech. Fingers thick and clumsy as well as short are 
more or less cruel and selfish. 

When the fingers are stiff and curved inward, or naturally contracted, 
they denote an excess of caution and reserve and very often indicate a 
cowardly spirit. 

When they are very supple and bend back like an arch they tell of a 
nature charming in company, affable and clever, but curious and in- 
quisitive. 

The Palm. — A thin, hard, dry palm indicates timidity and a nervous, 
worrying, troubled nature. 

A very thick palm, full and soft, shows sensuality of disposition. 

When the palm is firm and elastic and in proportion to the fingers 
it indicates evenness of mind, energy and quickness of intellect. 

When not very thick, but soft and flabby, it denotes indolence, love 
of luxury and a tendency toward sensuality. 

Lines of the Hand. — There are seven important lines on the hand 
and seven lesser lines. The important lines are : 

The Line of Life, which embraces the Mount of Venus. 

The Line of Head, which crosses the centre of the hand. 

The Line of Heart, which runs parallel to the above, at the base of 
the fingers. 

The Girdle of Venus, found above the line of heart and generally 
encircling the Mounts of Saturn and the Sun. 



READING OF THE HAND. 1619 

The Line of Health, which runs from the Mount of Mercury down the 
hand. 

The Line of Sun, which rises generally on the Plain of Mars and 
ascends the hand to the Mount of the Sun. 

The Line of Fate, which occupies the centre of the hand from the 
wrist to the Mount of Saturn. 

The seven lesser lines are: 

The Line of Mars, which rises on the Mount of Mars and runs within 
the Line of Life. 

The Via Lascina, which lies parallel to and outside of the Line of 
Health. 

The Line of Intuition, which extends like a semi-circle from Mercury 
to Luna. 

The Line of Marriage, the horizontal line on the Mount of Mercury. 

The three bracelets found on the wrist. 
102 



BOOK XVI 

Treats of Beauty Culture and Self Care for Women, 
and gives formulas for a number of good cosmetics. 



Air and Sun 1633 

Beauty, Cultivation of 1623 

Beauty and Health 1623 

Beautiful Features 1624 

Beauty and Youth 1625 

Birth-Marks 1637 

Blackheads 1631 

Body, Contour of 1626 

Brittle, Hair 1639 

Brush, Flesh 1633 

Brushing the Teeth 1640 

Care of the Complexion 1628 

of the Ears 1643 

of the Feet 1646 

of the Hands 1644 

of the Nails 1645 

Chapped Hands 1644 

Skin 1633 

Cold Cream 1633 

Complexion, Care of 1628 

Contour of Face and Body 1626 

Cosmetics ". 1635 

Barley, Honey and Egg 1636 

Cucumber Lotion 1636 

Ice 1630 

Lemon Juice 1636 

Milk 1635 

Oatmeal Water 1637 

Strawberry Lotion 1636 

Salt 1635 

Tomato Bleach 1636 

Watermelon 1636 

Cutting the Hair 1639 

Dandruff 1638 

Diet and the Teeth 1639 

Dry Skin 1632 

Ears, Care of 1643 

Enlarged Pores 1632 

Exercise for the Eyes 1643 

Facial. .» 1627 



Exercise for the Hands 1646 

Eyes, Exercise for 1643 

Massage for 1643 

Salt Water Baths for 1642 

Strong and Beautiful 1641 

Eyelashes, The 1643 

Face, Pale 1634 

Red 1634 

Washing of 1629 

Facial Contour 1626 

Exercise 1627 

Massage 1626 

Falling Hair 1638 

Features, Beautiful 1624 

Feet, Care of 1646 

Flesh Brushes 1633 

Freckles 1634 

Fruit Juices for Cleansing the 

Teeth 1641 

Hair, Brittle 1639 

Care of 1637 

Cutting 1639 

Falling 1638 

Gray 1639 

Health and 1637 

Superfluous 1637 

Washing of 1638 

Hands, Care of 1644 

Chapped 1644 

Exercise for 1646 

Perspiring 1645 

Red 1645 

Health in Relation to Beauty 1623 

Ice as a Cosmetic 1630 

Itching Skin 1633 

Lotion, Cucumber 163^ 

Strawberry 1636 

Massage for the Eyes 1643 

Facial 1626 

Moles 1637 



1621 



1622 



INDEX TO BOOK XVI. 



Nails, Care of 1645 

Nose, Red 1634 

Oatmeal Water 1645 

Oily Skin 1630 

Pale Face 1634 

Perspiring Hands 1645 

Pimples 1631 

Pores, Enlarged 1632 

Powders 1635 

Red Face 1634 

Hands 1645 

Nose 1634 

Salt Water Eye Baths = 1642 

Self Care for Women 1623 

Skin, Chapped 1633 

Dry 1632 

Improving the 1628 



Itching 1633 

Oily 1630 

Sleep 1628 

Strong Eyes 1641 

Sun and Air 1633 

Sunburn 1635 

Superfluous Hair 1637 

Teeth, Brushing 1640 

Care of * 1639 

Diet in Relation to 1639 

Fruit Juices for 1641 

Warts 1637 

Washing the Face 1629 

the Hair 1638 

Wrinkles 1634 

Youth and Beauty 1625 



ILLUSTRATIONS 



Bandage for Mouth Breathing 1643 

Bandage for Outstanding Ears 1643 

Brushing the Hair 1643 

Brushing the Teeth 1643 

Cold Compress 1642 

Drying the Face 1642 

Flesh Brush, The 1642 

Ice as a Cosmetic 1642 

Massage of the Body 1642 

Massage for the Bust 1643 

Massage for Double Chin 1643 

Massage of the Scalp 1643 



Massage for Wrinkles 1643 

Massaging the Eyes 1642 

Massaging the Face 1643 

Prevention of Wrinkles 1642 

Removing Blackheads 1642 

Removing Superfluous Hair 1642 

Stimulating the Hair Roots • . 1643 

Treatment of the Eye Lashes 1642 

Treatment for Moles 1642 

Using Dental Floss 1643 

Washing the Face 1642 



Book XVI 



SELF CARE FOR WOMEN 

HEALTH IN RELATION TO BEAUTY. 



The Cultivation of Beauty. — It is natural for every woman to desire 
to be beautiful and attractive. This desire should not be frowned upon 
as an indication of vanity or frivolity, for it is the expression of a sound 
and healthy instinct. It is not only right and proper that women should 
desire to be beautiful, but it should be the duty of every woman to be just 
as attractive as her physical and mental endowments will permit. 

Beauty is normally an indication of health. It means a wholesome 
state of body and mind and this in turn means fitness for wifehood and 
motherhood. It is a part of the great plan of Nature that women should 
be attractive. 

But is beauty a matter of cultivation? Can it be developed? We 
are told that poets are born and not made. Is the same true of the quality 
of beauty? Or can all women make themselves attractive and fair to 
look upon ? 

There is no question that some are more favored by nature than 
others. It would be folly to deny this. It should be said, however, that 
the differences between women in this respect should be simply a differ- 
ence in the degree of beauty rather than the difference between beauty 
and ugliness. Ugliness is entirely foreign to the nature of woman. The 
truth is that Nature intended all women to be attractive, even though 
there may be differences in the degree of comeliness. Beauty depends 
upon various factors in the way of contour, coloring, skin texture, the 
expression, the mental state and the suggestion of vitality in the features 
and body as a whole. All of these factors may be lacking in a given case, 
and may always be improved by cultivation of the right kind. In short, 

1623 



1624 SELF CARE FOR WOMEN". 

beauty is a potentiality in the case of every woman and needs only to be 
developed and realized by proper cultivation of the different factors and 
qualities upon which it depends. 

Beautiful Features — There is one factor that goes to determine the 
beauty and outlines of the face which is practically beyond our power 
to control, and that is the fundamental conformation of the skull and 
face giving us our characteristic features. There is no question that 
some are naturally gifted with greater symmetry in this respect than 
others. In one case the outlines are perhaps more harmonious than in 
another, but beyond this question of features it can hardly be said that 
any one has any important natural advantage over another in the matter 
of personal appearance. 

Furthermore, when one stops to analyze the part played by the fea- 
tures in determining facial beauty, it immediately becomes apparent that 
even this factor is greatly over-rated. 

For the features alone do not make for beauty. It is only the touch 
of health, vitality and good coloring that can make them attractive ; and 
where there is health, vitality and intelligence, all features and all faces 
are attractive or even beautiful. 

Just how little the features amount to as a means of giving one 
beauty will be seen from a study of the same face under conditions of 
health and ill-health. In the latter case the appearance may be drawn, 
haggard, hopeless and altogether unattractive, while under conditions of 
health the features will be properly filled out, smoothly modeled and well 
colored, with the expression animated in such a way as to provide that 
elusive quality which we term beauty. Consider the features in youth and 
in age. On the one hand we have the bloom and glory of youthful beauty, 
and at the other extreme we have the withered, faded and altogether ugly 
aspect of age. Note that the features remain the same. It will be seen, 
therefore, that the question of beauty depends not upon the features, but 
upon the manner in which they are ' 'dressed up" by flesh and blood. Good 
features without health and coloring signify nothing. On the other hand, 
the features of any woman that lives, when marked by the bloom of 
health, suggestive of vitality and youth and bodily vigor, and expressive 
of intelligence and personality, will become both attractive and beautiful. 

Health the Foundation of Beauty. — From what we have just said it 
will already have been made clear that the one indispensable factor in 
the cultivation of beauty is health. Men may strive for fame and for- 
tune, and may fail; but the woman who strives for beauty and follows 



SELF CAKE FOR WOMEN. 1625 

the proper natural methods for attaining health, will succeed. Beauty 
expresses internal harmony and well-being. Beauty means pure, rich 
blood, a condition of internal bodily cleanliness, active circulation, good 
nutrition as a result of faultless digestion, and perfect bodily function- 
ing. In short, beauty is a quality that necessarily follows upon a con- 
diton of strength and physical efficiency. 

The woman who would make herself attractive, therefore, in the 
very beginning cannot do better than make a careful study of the section 
on "Physical Development for Women." She should avail herself of 
every possible means of building increased vitality; she should particu- 
larly get as much sleep as she can; she should spend as much time as 
possible out-of-doors; she should keep her blood pure through whole- 
some food and the drinking of plenty of pure water; she should dress 
sensibly and healthfully; and last but not least she should maintain a 
serene state of mind. There is no question that the mind has an im- 
portant influence not only upon the health, but especially upon facial 
beauty. And particularly a woman's usual or prevailing attitude of 
mind, being an expression of personality, has everything to do with mak- 
ing her attractive or the reverse. 

Youth and Beauty. — It is a matter of common observation that youth 
is a period of beauty, and that beauty fades with advancing years. This 
only emphasizes the great truth that beauty is really a matter of health 
and vitality. The fact is that to preserve beauty it is simply necessary 
to preserve the condition of youth. Youth is a matter of condition rather 
than of years, and if one will maintain the vitality, physical energy, good 
circulation, healthy red blood and vivacity of youth, she will retain with 
it the attractiveness of youth. When a woman gazes sorrowfully into 
the mirror at a plain and unattractive face, now faded, it simply means 
that she has suffered in the way of physical deterioration. She has lost 
her youthfulness or is rapidly losing it. What she needs is not cosmetics. 
She cannot buy beauty in a bottle. She must restore the condition of 
vitality, good nutrition, active circulation and pure blood, and this is 
entirely a matter of physical culture, sleep, fresh air, sufficient rest and 
freedom from nerve-destroying influences. 

When your friend tells you that you are "looking good," she really 
means that you are truly "good looking," for the health that is manifest 
in your appearance has made you at the same time pleasing to look upon. 



1626 SELF CARE FOR WOMEN. 



CONTOUR OF FACE AND BODY. 



We have already referred to the uselessness of good features as a 
factor in beauty when they are not properly covered by healthy flesh. 
The first essential to beauty, even more important than the texture of 
the skin, is a pleasing contour. The bodily structure and the facial 
conformation must be properly filled out with good, healthy flesh. This 
means, in the case of the body, a normal, muscular development made 
smooth with a moderate covering of fatty tissue. The same thing ap- 
plies to the face. There are muscles of the face which should be healthy 
and well developed in order to give character to the face. These mus- 
cles are well developed in the case of children and healthy young peo- 
ple, and they give not only character but firmness to the flesh. These 
muscles are covered by a smooth distribution of fatty tissue, and just 
beneath the skin there is a considerable amount of connective tissue 
which helps to give the skin firmness and smoothness. It is largely 
the breaking down of this connective tissue that produces wrinkles, 
although the loss of fatty tissue in age is likewise still further con- 
ducive to the formation of "lines." All of these tissues in youth and 
health are properly built up and give the face that harmony of out- 
line and delicacy of contour which make for beauty. 

A fat face is not attractive; only a firm plumpness of the cheeks 
is desired. Well-modeled features mean a condition of vigor, good 
nutrition and good circulation, and anything that is conducive to health 
would improve one in this respect. The haggard appearance of one suffer- 
ing from the results of disease, overwork or dissipation is directly due to 
the breaking down of many cells, imperfect circulation and the weakening 
of the muscles, as a result of which there is a sagging down of the flesh. 
The characteristic of age is not so much the formation of lines, but the 
sagging down and shrinking of the structures of the face. One may have 
many fine lines and still retain the appearance of youth, so long as this 
drooping of the muscles and tissues of the face is not in evidence. Or one 
may have very few lines and yet the aspect of age is given unmistakably 
by this very sagging down of the cheeks and other parts. 

Facial Massage. — Massage is usually the first measure advised by the 
beauty specialist as a means of improving the face. Naturally, massage 
affects not only the skin itself, but the underlying structures. There is 
no question as to the value and effectiveness of massage of the body. It 
promotes the circulation and yields a form of passive exercise. It is in- 



SELF CARE TOR WOMEN. 1627 

dispensable in certain cases where exercise is impossible. But in the 
treatment of the face the value of massage is not so apparent. It may 
produce gratifying temporary results because of the improved circulation 
and momentary coloring induced. There is no question, also, that for the 
time being it tends to remove "lines" to some extent and improve the 
appearance. At the same time, facial massage is likely to be ultimately 
detrimental for the reason that it involves too much the breaking down 
of the connective tissue underneath the skin. By pulling and stretching 
the skin and the ilesh one way and another, the connective tissues are 
weakened or partially destroyed and the result will be the formation of 
more lines and a tendency toward sagging of the flesh. Therefore massage 
cannot in all cases be recommended and particularly not for those who 
have already passed the years of youth, or, if employed, massage should 
be very carefully and intelligently administered. 

The greatest mistakes in facial massage are too much stretching and 
pulling down of the tissues. There should be no downward strokes em- 
ployed upon the face, and there should be no movements which tend to 
place the skin upon stretch to any extent. The most satisfactory form 
of facial massage, accordingly, would be something in the nature of pres- 
sure applied with the finger tips or with the heel of the hand or ball of the 
thumb, especially in the form of small, circling movements. This pressure 
should be applied for a few moments only and then relieved. The relaxa- 
tion of the parts will permit a new supply of blood to flow into the tissues, 
whereupon the massage may be continued. A rotary movement of this 
kind covering a circle not larger than that of a ten-cent piece would be very 
satisfactory. In massaging the forehead, the finger tips may be used satis- 
factorily. For the cheeks, the eyes and directly underneath the eyes, an 
effective treatment would be to press the ball of the thumb upon the skin 
for a moment with a slight circling movement. Where there is already 
a tendency toward the sagging of the flesh, upward strokes may be used. 

Where there are wrinkles, massage should take the form of strokes in 
line with the wrinkles. By massaging across the wrinkles, one only tends 
to make them deeper. 

Facial Exercise. — Of greater value than massage in most cases is 
facial exercise or, in other words, the active use of the muscles of the face. 
These muscles are used in laughing, in crying and in all expressions of 
the face. A system of exercises for the face, therefore, may be devised by 
simply "making faces" at yourself in front of a looking glass, just as you 
somtimes liked to do when you were six years old. It sounds very foolish, 



1628 SELF CAKE FOR WOMEN. 

but it is the most effective means of regularly and thoroughly bringing 
into play the facial muscles. The improvement in these muscles and the 
better circulation helps greatly to beautify the face. Children whose faces 
are often wrinkled and distorted in laughing and crying have beautifully 
smooth faces. Actors and actresses whose facial muscles are continually 
employed in the expression of simulated emotions of various kinds, fre- 
quently retain their facial attractiveness and even youthful appearance far 
beyond the age at which most other men and women commence to look 
old. Clergymen and orators whose facial muscles are used in forcible ex- 
pressions are often exceptionally good-looking men. 

Once each day, therefore, it will profit one to take ^.Ye or ten minutes 
during which to concentrate on facial exercises. The muscles of every 
part of the face should be brought into action, stretching them, contracting 
them, opening the mouth wide or yawning, then pinching the lips together, 
opening the eyes wide, then squeezing them together, raising and lowering 
the eye-brows to the limits of possible motion and drawing the mouth first 
to one side, then far to the other. Thrust the tongue into the cheek on 
each side, assume laughing and crying expressions, simulate horror and 
express as great a variety of other emotions as possible. Finally, simply 
make faces at yourself in the glass, just as children do, and you will find 
when you are finished that your face partakes of a sensation of life and 
energy. If persisted in, these facial exercises will accomplish a great 
deal. 

Sleep — There is nothing in the world that will take the place of sleep 
as a beautifier, and especially sleep in the early part of the night. There 
is a good reason why the term "Beauty Sleep" has been applied to the 
hours before midnight. Pay no attention to the theorist who tells you 
that many people sleep too much. If you sleep in the fresh air, either 
outdoors or with windows wide open, and without too much covering, it 
is impossible to sleep too much. There is nothing that you can do in 
the form of beauty culture than can possibly be of value if you do not 
allow yourself sufficient sleep. 

CARE OF THE COMPLEXION. 

Improving the Skin. — A beautiful complexion depends chiefly upon 
two factors, the coloring and the texture. Fortunately in most cases the 
same measures are effective in improving the skin in relation to both 
color and texture. A perfectly healthy skin is smooth as satin and pleas- 



SELF CAKE FOE WOMEN. 1629 

ing in color. Local care of the complexion is of great value and the sug- 
gestions we are offering will be very helpful in all cases, but it must be 
understood that constitutional measures are far more important than any 
local care. In other words, a good complexion depends upon the state of 
health and of the blood* A good complexion is indicative of health and 
is seldom possible without good health. Vigorous digestion, active cir- 
culation and rich, red blood are conducive to beauty of the skin, and with- 
out these fundamental requisites one cannot accomplish much by external 
means. 

Granting, however, that the health is fairly good and the blood supply 
normal, a great deal can be done to improve the condition of the skin by 
proper care. Do not be misled into the notion that you can buy beauty at 
the drug store. Highly advertised cosmetics are of little value and in 
some cases are actually dangerous. The more simple home remedies used 
in the days of our grandmothers are far more effective and reliable than 
the innumerable highly priced and widely advertised preparations recom- 
mended by the druggist. Infinitely better results, if one wishes local ap- 
plications, can be secured by the use of buttermilk, lemon juice, fresh 
milk, mutton tallow and other articles of common household use. Cold 
water offers a cosmetic infinitely superior to anything that has ever been 
placed on the market. Paints and powders are not only injurious in many 
cases, but they fail to produce the appearance of a healthy and beautiful 
skin. No matter how skilfully applied, there is always the artificial 
aspect of the skin, and the face so treated never can compare with a 
beautiful natural complexion. 

Washing the Face. — There is nothing so good for the complexion 
as cold water. Use plenty of it. Use it several times a day. 

There is nothing worse for the complexion than hot water. Never 
use it. 

Hot water and soap, while producing a temporary effect that may 
be gratifying, will invariably be detrimental in the long run. The heat 
relaxes the blood vessels, causing them to lose tone, and especially opens 
the pores. Furthermore, heat stimulates the secretions of the oil glands 
or sebaceous glands, and in the case of an oily skin or one subject to 
blackheads and pimples, hot water is particularly detrimental. Steam- 
ing the face, a method commonly used by beauty specialists, is likewise 
detrimental for the same reason. 

Strong soaps should never be used. A pure castile soap is usually 
to be preferred, and the face should be washed with luke-warm or cool 



1630 SELF CARE FOR WOMEN. 

water, using a very small amount of the castile soap. It should, further, 
be very thoroughly rinsed with cold water, so that all traces of the soap 
will be completely removed. Do not pull and stretch the skin too much 
when washing, but use a soft cloth and wash the face gently, with mild 
friction. 

Cold compresses may be advantageously applied to the face, using a 
small towel for the purpose or a wash cloth and using water just as cold 
as possible. This is a tonic of great value. 

In drying the face, do not rub too vigorously with the towel but 
gently pat the skin until dry. The reason for this is the same as the ob- 
jection to massage, namely, that too much pulling and stretching weakens 
or loosens the connective tissue beneath the skin. 

Ice as a Cosmetic. — If cold water is valuable for improving the com- 
plexion, ice is even more effective in most cases. It has a wonderful tonic 
effect and not only closes up the pores, but improves the circulation and 
the general health of the tissues. It will pay one to take a piece oi ice and 
move it about over the face for two or three minutes, at least once each 
day. The result will be a glow which will last for hours in some cases, 
and you will enjoy a feeling of life in the skin that will be gratifying. 
If the bare ice seems a little too severe, a cloth or towel can be wrapped 
around it. Do not try it if subject to neuralgia. 

For one who lacks color, a treatment of this kind is much more 
satisfactory than an attempt at "painting." In certain "beauty parlors" 
a temporary glow of the skin has been produced by the application of a 
chemical preparation which leaves the skin red for some time afterwards. 
This, however, is only a state of inflammation accomplished by a poi- 
sonous irritant, and needless to say such methods are very destructive in 
the long run. The ice treatment will produce better results without any 
injurious after-effects. If one is particularly lacking in color, the alter- 
nate use of hot and cold water, with a final application of ice, will be 
particularly effective in this direction, but, except for an emergency, the 
hot water should not be used in this way. In many cases, however, a 
woman may thus secure a pleasing color which will endure throughout 
the entire evening at some social affair. 

Oily Skin. — Many women complain of oiliness of the skin. This is 
the result of excessive activity of the oil glands or sebaceous glands. These 
must not be confused with the sweat glands. The sebaceous glands are 
located chiefly on the face, neck, shoulders, chest and back, and it is con- 
sequently mostly on these parts that pimples and blackheads are located. 



SELF CARE FOR WOMEN. 1631 

These glands usually do not become active before puberty. Up to the age 
of twelve or fourteen the skin is smooth and clear. In the case of some 
women the sebaceous glands never become very active and they retain 
the "baby skin" through maturity. From puberty on, however, and espe- 
cially in youth, all of the glands of the body are very active, including 
the sebaceous glands, and an oily complexion is often the result. In such 
cases hot water should be avoided except to the extent that one takes a 
full warm bath once or twice a week followed with a cold sponge. Cold 
water and ice tend to check the activity of the sebaceous glands and also 
to contract their pores or ducts. 

Blackheads and Pimples — When the pores or ducts leading from the 
sebaceous glands to the skin are clogged or closed in such a way that the 
oil cannot be poured out upon the skin, the oil accumulates, forming what 
is known as a "blackhead" when the duct is clogged and blackened with 
dirt, as is frequently the case. When squeezed out, the blackhead appears 
in the form of what is often called a "flesh worm," but it is really only the 
hardened and accumulated secretion of the gland. When there is inflam- 
mation at the same time, a pimple is formed. "Acne" is the technical 
name of the so-called disease represented by a large number of pimples. 
A pimple is usually the result of a mild infection which travels down the 
duct of a sebaceous gland or sometimes down the root of a hair. 

Any treatment tending to overcome oily skin would likewise tend to 
overcome blackheads and pimples. Cleanliness is of great importance, 
especially in preventing the infection and mild inflammation which causes 
pimples. Cold water and ice are of great value, while some harmless as- 
tringent such as lemon juice, borax or benzoin is often quite helpful. 

Squeezing and pinching blackheads is not advisable because of bruis- 
ing the tissues and leading to inflammation and the formation of pimples. 
A small blackhead remover, which you can buy in a drug-store, will be 
much better, or one may use an old-fashioned watch key, pressing around 
the blackhead until it slips out with the least possible irritation. In a 
serious case of blackheads, a preliminary steaming of the face, or wash- 
ing with hot water and soap to open the pores, may be permitted, where- 
upon the blackheads can be more easily removed. Thereafter, however, 
no hot water or steam should be employed. A solution of common washing 
soda, a teaspoonful to a pint of water, will soften the blackheads for re- 
moval, but it is very irritating to the skin, and should be thoroughly 
sponged off immediately, afterward applying cold milk. A gentle fric- 
tion of the skin with the dry bare hand, improving the circulation, and a 



1632 SELF CARE FOB WOMEN. 

plentiful use of cold water for improving the skin generally, are particu- 
larly recommended in the case of pimples or acne. In opening a pimple, 
the part should always be thoroughly cleansed with an antiseptic. Per- 
oxide of hydrogen is fairly satisfactory, although listerine and other 
standard antiseptics will answer the purpose. 

Enlarged Pores. — Enlarged pores are usually found in connection 
with an oily skin and particularly require persistent treatment with cold 
water or ice. These are not the sweat-pores. Cold creams are especially 
undesirable in such cases. A good astringent to help close the pores 
would be a tablespoonful of tincture of benzoin to a quart of water. 
Lemon juice sponged upon the skin is also very effective, but should be 
washed off with cold water or sponged off with milk in two or three 
minutes. Although we have mentioned astringents, they should be used 
simply as an emergency treatment and not habitually. Their continued 
use will always prove detrimental. 

Dry Skin. — An unusually dry skin is the result of a lack of oil or in- 
activity of the sebaceous glands. When much soap is used in such cases, 
abstracting the limited amount of the natural oil, the condition becomes 
aggravated. The use of hot water with soap is highly detrimental. Those 
having a very dry skin should be extremely careful in the use of soaps, 
and even more than usually careful not to use patented preparations for 
the skin, many of which are irritating and astringent in character. The 
possessor of a dry skin should use just as little soap as she possibly can, 
and use only cold water for cleansing purposes. The use of a little 
cocoa-butter or refined olive oil might even be advantageous to supply the 
deficiency. 

It is in cases of this kind that a real "cold cream" would be unob- 
jectionable, but it is not wise to buy it in the open market because of the 
various unsatisfactory formulas used. A cold cream that is a real 
"grease" cream, and especially if it has mutton tallow as its basis, would 
be advantageous, but those containing mineral oils are detrimental and 
might cause the growth of hair. The use of the original mutton tallow, 
a good, old home-remedy, would be infinitely better than any perfumed 
cream. Many so-called "cold creams" are not cold creams at all, "but 
astringent preparations, and should be carefully avoided. This usually 
applies to so-called "peroxide" creams. The theatrical cold cream, al- 
though cheaper in price, is usually a real grease cream and probably su- 
perior to the high priced preparations sold for cosmetic purposes. The 



SELF CARE FOR WOMEN. 1633 

theatrical cold cream is used simply to protect the face from the grease 
paint and powder used in "making up." 

Cold Cream for Cleansing Purposes — Those having very dry skins 
and who cannot therefore use much soap, will find the use of a pure cold 
cream or theatrical cream advantageous for cleansing purposes. Simply 
rub the cream well over the face and then rub off thoroughly with a soft 
cloth. This will remove the dirt with the cream. Never use a rough 
cloth for the purpose. 

Chapped Skin. — Dry skins, when improperly cared for, are liable to 
become chapped, especially when too much soap is used and when the 
skin is exposed to harsh winds and cold weather. The best preventive of 
chapping is to thoroughly dry the skin after washing, before going out- 
doors. Mutton tallow is especially recommended for this condition, though 
olive oil and cocoa-butter are both excellent. A half and half mixture of 
glycerin and rose water, with a bit of benzoin added, is always an effec- 
tive treatment for chapped lips or chapped hands, to be applied before 
going to bed. 

Sun and Air. — The effect of sunshine and air upon the skin is gen- 
erally beneficial. Those who are anemic or whose complexions are pale 
should especially get a certain amount of sunshine every clear day. Sun- 
shine stimulates the formation of red blood corpuscles. Besides the effect 
of the sunshine in tanning the skin or developing pigment, it actually in- 
creases the undertone of red coloring which indicates health. 

In the case of very thin and delicate skins, however, too much wind 
and too much sunshine may be detrimental from the standpoint of the 
complexion, even though the air and sunshine may be beneficial to the 
general health. The blonde and thin-skinned man or woman too much 
exposed to the sunshine acquires a dried and wrinkled appearance of the 
face along with the heightened color. While one cannot get too much out- 
door life, yet such persons should protect their complexions from too much 
direct exposure to the summer sun in the middle of the day. 

Flesh Brushes. — One of the most beneficial treatments of the skin 
that can be suggested is the use of a soft flesh brush, by means of which 
to give the face a gentle friction. The brushes should be sufficiently soft 
to be comfortable on the face and to avoid scratching. Such friction of 
the entire body is of great health value, but when applied to the face it 
tends to develop a soft, smooth texture. 

Itching 1 Skin. — In most cases itching skin is simply an aggravated 
conditon of dry skin, and the annoyance usually follows a bath in which 



1634 SELF CARE FOR WOMEN. 

too much soap is used. It can be relieved by rubbing the skin thoroughly 
with a very little olive oil or cocoa-butter following the bath. Air baths 
and friction baths are especially valuable. The use of buttermilk is often 
advantageous. 

lied Face. — A red face, although usually accompanied by a thin- 
skinned condition, in most cases represents imperfect circulation. Where 
the circulation is properly distributed, this conditon never appears. Plenty 
of muscular exercise, improved digestion, the use of less meat, more fruit 
and the drinking of more water will usually correct this tendency. Out- 
door life is advised. Frequent washing of the face with cold water will 
be beneficial. 

Red Nose. — This conditon, like redness of the face, indicates imper- 
fect circulation. Exercise and improved general health are necessary. 
Massaging and rubbing the nose, together with application of ice, will 
be helpful. It is entirely a question of improving the circulation. 

Pale Face. — The lack of color in the face indicates an anemic condi- 
tion and calls for the building up of the general health. More sunshine 
is especially necessary, together with outdoor life in general, long walks, 
games and exercises, plenty of sleep and improved nutrition. The use 
of eggs, milk and fresh meats in the diet, balanced by a liberal use of 
fruits and green vegetables, can be recommended. 

Wrinkles. — The formation of wrinkles is due usually to the breaking 
down of connective tissue beneath the skin, although lack of nutrition 
generally and the distortion of the face through the expression of various 
mental states are important factors. Improved health and better nutrition 
cause these lines to disappear. Massage is suggested, rubbing in the 
same line as the wrinkles themselves, but never across them. The flesh 
brush may be used the same way. The improved circulation due to the 
use of cold water or ice on the face, tends to overcome these lines. A 
serene mental attitude has a great deal to do with them. 

As a local application, the most effective treatment will be to use 
strips of soft linen cloth, dipped into the raw white of an egg. These 
should be placed upon the face where the wrinkles are located, smoothed 
out carefully and allowed to remain for some time. Another suggestion 
is to mix equal parts of alcohol and the white of an egg, spreading upon 
the forehead and binding with a bandage or compress. 

Freckles. — Although sometimes undesirable, freckles are not ab- 
normal and are usually indicative of vigorous health. It is better to have 
freckles and have the good health that goes with them, than to be deprived 



Book XVII 



PHYSICAL CULTURE AND BODY BUILDING 

PAKT 1. 



EXERCISE NECESSARY TO HEALTH. 

Why Exercise is Beneficial. — There is a general impression in many 
circles that exercise or physical culture is merely a means of developing 
muscular strength. There is also a general impression that in this age 
brain is more important than brawn. Consequently, those who view the 
subject of body-building from this narrow viewpoint are not likely to take 
physical culture seriously. 

The great truth is that physical culture is not simply a means of 
building strong muscles, for it is also a means of improving health and 
building vitality. Even brain work requires energy. Physical culture 
is a means of building not only muscular vigor but functional strength, 
organic strength and nerve strength. Muscular power in many cases is 
desirable for its own sake, but for the average man and for the average 
women exercise is chiefly valuable not for the sake of strength but for the 
sake of health. Let this point be made clear, with all possible emphasis. 

The basis of every healthy life is activity. There can be no such 
thing as health without muscular action. Man is fundamentally an ani- 
mal. He is much more than this, but this he is first of all, and should be 
a perfect representative of animal life. In the days of the cave man 
the ordinary requirements of life were such as to keep one physically 
active and strong. The preservation of life depended upon strong limbs, 
a clear eye, agility and speed of movement, with perfect control of every 
muscle of the body. Men in the stone age did not need physical culture. 
They lived it all the time. But civilized man, with his sedentary occu- 
pations and limited physical activities needs special forms of exercise to 
keep him strong and vital. 

1649 



1650 PHYSIC An CULTURE. 

Brains are indispensable these days, but bodily strength is also neces- 
sary to stand the stress and nerve-strain of modern life. The man of 
to-day should represent a combination of brains and brawn, for never was 
life so trying as at present. Never was a strong constitution more neces- 
sary. 

Importance of the Muscular System — You could not speak, you could 
not open your eyes, you could not adjust or focus the sight, you could 
not breathe, your heart could not beat, you could not digest your food, 
you could not laugh or cry, you could not walk, you could not dress, you 
could not even crook a finger without muscular action. The muscles 
should be regarded as organs of the body just the same as any other organ, 
for they are organs of movement. 

Exercise is absolutely essential to health because of the physiological 
relation of the muscular system to the rest of the body. For over two- 
fifths of the bulk of a normal body is made up of muscular tissue. The 
nutrition of such a large part of the body is therefore an important matter. 
Most of the food we eat is consumed by the muscles, and most of the heat 
in the body is produced by them. It is apparent that to neglect the mus- 
cular system, therefore, means to derange the harmonious balance of all 
bodily functions. Exercise is beneficial because of its influence upon 
the appetite through the increased demand for food. It is beneficial be- 
cause of its influence in promoting a vigorous and active circulation of 
the blood. It stimulates functional activity in all the internal organs. 
It causes deep breathing, thereby promoting health of the lungs, increas- 
ing the supply of oxygen upon which all life depends, and facilitating the 
removal of carbonic acid gas. Furthermore, it stimulates the elimina- 
tion of all wastes and poisons through the kidneys and the pores of the 
skin. Muscular stagnation means stagnation in all of these functions as 
well, and under such conditons it is not possible to maintain a high degree 
of health. 

Physiological Effects of Exercise. — Muscular activity brings about in- 
creased metabolism or cell-activity. There is a breaking down or wear- 
ing out of the cell structures, resulting in the formation of waste products 
and in the subsequent rebuilding of new cells. Strength may be increased 
and the muscular structures themselves developed by daily and persistent 
exercise which involves these changes. The formation of new cells is 
stimulated by the demand for greater strength in the muscles, and it is 
because of this fact that body building becomes an easy possibility. In 
fact, the muscles represent the only tissues in the body which we can in- 



SELF CARE FOR WOMEN. 1635 

of sunshine. Chemical preparations for eradicating freckles are not only 
unreliable but injurious, and should never be used. 

The most effective treatment for freckles is lemon juice. This should 
be removed with a little milk after five minutes to relieve any irritation. 
Buttermilk is sometimes useful for the same purpose. Peroxide of hydro- 
gen may be used. A lotion consisting of one ounce of lactic acid, one 
ounce of glycerin and six ounces of rose water may be applied with cotton 
two or three times a day. 

Sunburn. — There is probably nothing better than plain olive oil to 
relieve ordinary cases of sunburn. Cocoa-butter may likewise be used. 
In extremely severe cases, probably the best treatment will be the use of 
cold wet compresses. To prevent the compresses from becoming dry, 
cold water may be sprinkled upon them frequently. 

Cosmetics and Powders. — Every woman should prefer a good natural 
complexion to an artificial complexion. The use of cosmetics of all kinds, 
even if they were temporarily effective in improving the appearance, 
which usually they are not, inevitably have the result of injuring the 
complexion. The woman with an originally good complexion will find 
in a few years that she has ruined it. 

The only excuse for anything of the kind is to be found occasionally 
in the case of an oily skin, in which instance the use of a little powder to 
overcome this condition, especially so far as the nose is concerned, is not 
objectionable. Many powders, however, contain injurious and poisonous 
ingredients. Many of them are seriously irritating. The best applica- 
tion, therefore, is pure rice-powder, and it would be well if the applica- 
tion of this were confined to the nose itself. 

Following are a few remedies of special value in the way of natural 
cosmetics : 

Milk. — Either fresh milk or sour milk may be used for washing the 
face, with the very best results. Fresh cream is infinitely superior to any 
"cold cream" ever devised. Buttermilk makes a very good skin whitener 
in many cases for either face or hands. Those who suffer from dry skin 
may frequently benefit by using fresh milk entirely for washing the face. 
A half cup of milk or less will be sufficient, when using a good face cloth 
for the purpose. 

Salt. — Salt has a wonderfully stimulating and tonic effect upon the 
skin. One may put a handful of sea-salt or of ordinary table salt in the 
bath with advantage. The washing of the face with cold salt water, then 

103 



1630 SELF CARE FOR WOMEN. 

rubbing gently with the bare bands until dry instead of using a towel, 
will have a very good effect. 

Another good plan is to take a little salt in the hands, moisten it 
only slightly and then rub the face or even the skin of the entire body with 
it. It can then be rinsed off with cold water. The effect is delightful. 

Lemon Juice. — Fresh lemon juice is one of the most valuable of 
natural beautifiers, especially in the case of oily skin, blackheads, pimples 
or rough skin. Washing the face with diluted lemon juice will bring 
surprising benefits. For the neck and shoulders one can apply the lemon 
juice undiluted. 

A good, economical household plan is to save the lemon peelings, 
after making lemonade or using the juice, and to rub the face, neck and 
shoulders with the inside of the lemon peeling, thus using up the little 
remaining juice in this way. Where the hands are badly stained from 
cutting vegetables or from other causes, lemon juice is the most effective 
means of cleansing and bleaching them. Where the hands are sore and 
rough the lemon juice may smart temporarily, but it will leave the hands 
soft and comfortable.. When using lemon juice full strength, it should 
either be sponged off with milk or rinsed off with water in a few minutes. 
For a face wash dilute it, using half a lemon to a pint of water. 

Strawberry Lotion. — Strawberries were used by the ladies of ancient 
Rome to whiten the skin. Fresh, ripe strawberries should be mashed to 
a pulp and the juice strained through a cloth. Dilute Avith an equal 
part of water and add a pinch of borax. This tends to whiten the skin 
and make it clear. 

Watermelon Rub. — Rubbing the face, neck and arms with the pulp 
of a watermelon has an excellent effect in clearing the skin. 

Tomato Bleach. — To make a yellow skin more clear, take a slice of a 
ripe tomato, rub well upon hands, neck or shoulders for five minutes and 
then rinse off with water mixed with borax, taking a teaspoonful of borax 
to a quart of water. 

Cucumber Lotion. — Good results may sometimes be secured with oily 
skins by rubbing with sliced cucumbers. The cucumber pulp also may be 
pounded in a bag, the juice strained through and applied to the skin two 
or three times a day. 

Barley, Honey and Egg. — Where the skin is coarse and the pores en- 
larged, a satisfactory remedy will be found in a mixture of ground barley, 
three ounces ; honey, one ounce ; and the white of an egg, one ounce. This 
should be spread upon the face at night, using a cheesecloth protector or 



SELF CAKE FOR WOMEN. 1637 

mask. It should be washed off in the morning with lukewarm water fol- 
lowed bj cold water. 

Oatmeal Water. — A little raw oatmeal stirred into cold water for 
washing the face is excellent for making the skin soft and smooth. 

Superflous Hair. — The electric needle is the only absolutely satisfac- 
tory treatment for the removal of superflous hair. Avoid chemical de- 
pilatories ; they injure the skin and sometimes cause increased growth of 
hair. Take no chances. The most satisfactory home treatment is to use 
small tweezers and pull out the superfluous hairs one by one. They may 
grow again a few times but with repeated extractions they will become 
discouraged and you will not be bothered with them further. 

Moles and Warts. — Moles and warts may be destroyed by the electric 
neeedle, but the most simple treatment is the use of diluted nitric acid. 
Apply this with a match stick, and simply touch the mole or wart with it 
once each day. 

Birth-Harks. — It is best not to experiment with birth-marks, inas- 
much as nothing can be done for them in most cases. 

CARE OF THE HAIR. 

Health and Beautiul Hair — The woman who desires to improve the 
condition of her hair should learn, first of all, that vigorous health and 
good blood are more important than local treatment. In poor health, the 
hair either falls out or becomes dull and dead in appearance. In vigor- 
ous health, the hair takes on the appearance of life and health, with a 
beautiful lustre. Therefore even the hair is a feature of beauty that 
reflects the general condition of the body. 

Care of the Hair. — The most important and most valuable treatment 
for the hair is plenty of brushing. Most women try to do their hair up 
as quickly as possible and have it over with. In the time of our grand- 
mothers, women would spend a half hour or more in simply brushing the 
hair. Thorough treatment of this kind made it healthy and luxurious. 
Brushing stimulates the roots of the hair and promotes active circulation 
in the scalp. A woman should spend at least twenty to thirty minutes 
each day in brushing the hair if she wishes to improve it. 

Next to brushing, massage of the scalp is of great value in directly 
stimulating the circulation in the tissues about the roots of the hair. In 
many cases the scalp tends to become tightly adhered to the skull, and in 
order to maintain good circulation the connective tissues should be 



1638 SELF CARE FOE WOMEN. 

loosened. In massaging the scalp, the finger tips shonld be placed firmly 
upon it at various successive points, so that they will not slip, and a 
rotary, or circular movement should be used so as to give the scalp as 
much elasticity and movement as possible. 

Gentle pulling of the hair, supplementing the brushing, is likewise 
of great value in strengthening the roots of Jhe hair. One should not pull 
too hard, but just enough to bring about a feeling of life in the roots of the 
hair. This should be done each night before going to bed and before doing 
up the hair in the morning. 

Washing the Hair — One great mistake is often made in the use of 
strong soaps on the hair. In most cases a plain castile soap should be 
used, lathering and rinsing very thoroughly. 

The most satisfactory method of washing the hair in most cases is 
the use of an egg shampoo. Beat up a fresh egg with a tablespoonful of 
water and rub it thoroughly into the hair and scalp or five minutes or 
more with the finger tips. After thoroughly treating in this manner, it 
may be rinsed off with lukewarm water. It will be best to use several 
changes of water to accomplish this effectively. 

The frequency of washing will depend upon the character of the 
hair. Where the hair is dull and dry, one should not wash it often and 
should never use anything but the egg shampoo. Where the hair is very 
oily or where there is dandruff, frequent washing will be required, per- 
haps once each week or every ten days. 

Dandruff — Dandruff is the result of excessive activity of the oil 
glands and should be combatted with vigorous treatment in the way of 
scalp massage, brushing and pulling of the hair in order to improve the 
local circulation. One suffering from dandruff should never use very hot 
water on the hair but can advantageously use plenty of cold water. If 
the case is unusually stubborn, it will be best to use tincture of green 
soap instead of the castile soap. This should be thoroughly rubbed into 
the scalp with a soft brush, in order to remove all the dandruff, and the 
subsequent rinsing of the hair with lukewarm water should be exceedingly 
thorough. It should be said that a certain amount of fine dandruff is 
only natural and should not occasion any concern. It is only when 
dandruff is excessive and the hair unusually oily that one should try to 
check it. 

Falling Hair. — Falling hair is practically always associated with 
dandruff, although disease of one kind or another may be responsible. Im- 
proved general health is nearly always reflected in a lessening of the loss 



SELF CARE FOR WOMEN". 1639 

of hair. The general stimulating treatment of the scalp through brush- 
ing and massage is of the greatest value. The hair and scalp should be 
exposed to the sunshine, if possible, for a certain time each day. Where 
there is falling of the hair without much dandruff, a good, stimulating 
treatment would be the alternate use of hot and cold water without soap 
two or three times each week. 

Brittle Hair. — Brittleness and splitting of the hair is simply the re- 
sult of a dried condition and is due either to the lack of activity of the oil 
glands or to the use of to much or too strong soap. In such cases a little 
olive oil may be applied to the scalp with the finger tips. Be sure to apply 
it on the scalp rather than to rub it on the hair. Singeing is of no value, 
although it was a supposed remedy of great popularity many years ago. 

Cutting the Hair. — The value of cutting the hair as a means of stimu- 
lating the growth has been greatly over-estimated. Repeated cutting robs 
the hair of its vitality. Many authorities now claim that the only reason 
why men are more subject to baldness than women is because of the hair- 
cutting habit among them. A woman's hair should never be cut short 
after the age of puberty or maturity, for in many cases it is impossible 
ever again to regain the full growth. 

Gray Hair. — When the hair turns gray, it does not mean that the 
health of the hair is in any way impaired, but simply that the tiny color 
producing glands have gone out of business. Gray hair previous to middle 
age can often be restored to its natural coloring by improved health and 
hair culture, and especially when it is the result of nervousness or poor 
health. In more advanced years, however, there is nothing that can re- 
store color after the hair turns gray or white. 

CAItE OF THE TEETH. 

Diet in Relation to the Teeth. — Good teeth really depend on good 
health and satisfactory nutrition, although good health in turn depends 
somewhat on good teeth. Thorough mastication of food is essential to 
good digestion and good health, and mastication is impossible without 
sound teeth. 

Too much attention cannot be given to cleanliness of the teeth and 
mouth as a means of avoiding conditions which lead to the decay and loss 
of the teeth. At the same time, however, there is one factor in maintain- 
ing sound and healthy teeth that is commonly overlooked, and that is the 
character of the food. The preservation of the teeth depends on good 



1640 SELF CABE FOB WOMEN. 

nourisLment just as any other part of the body depends upon securing 
suitable building material from the food consumed. If the diet is lacking 
in the elements required for building teeth and bone, the decay and loss 
of the teeth is almost inevitable. 

All foods rich in lime and organic mineral salts are of great value. 
For this reason whole wheat bread is greatly superior to white bread, and 
in the case of children especially whole wheat or graham bread, shredded 
wheat and all whole grain products will tend to build strong, healthy 
teeth. Oatmeal is a food of special value for this purpose. Milk and 
eggs are both rich in lime and are valuable to supply the material for 
building teeth and bones. Vegetables, eaten with the water in which they 
are cooked, are valuable, and fruits are particularly to be recommended. 
Fruits are not only advantageous from the standpoint of their nourishing 
elements, but because of their cleansing effect upon the teeth and mouth, 
especially when eaten without sugar. If one will eat natural foods, calling 
for exercise of the teeth, and supplying all the elements provided by 
nature, one will have healthy teeth such as he cannot possibly enjoy by 
eating white flour, polished rice, white sugar, corn syrup, and other 
foods which have been refined by manufacturers until they are of very 
limited value from the nutritive standpoint. 

At the same time mouth hygiene and the care of the teeth are none 
the less important. Every child should be trained in this way and es- 
pecially women should take care of their teeth because of the special 
tendency of childbearing to bring about the loss of the teeth where the 
diet is not entirely satisfactory. 

Brushing the Teeth. — The teeth should be brushed at least once each 
day, but it is better to brush them after each meal. This would be con- 
venient for most women living at home, although it would not be for 
many women in business. In any case it is a simple matter to brush the 
teeth on rising and retiring. 

The common practice is to brush the teeth with a lateral movement. 
This, however, is insufficient inasmuch as the brush does not in that way 
reach the crevices between the teeth. They should be brushed with a short, 
vertical movement, so that the bristles may reach the spaces between the 
teeth as perfectly as possible. It is these crevices that really most need 
the cleansing, for it is in these that the decay commences. 

The use of dental floss is a much neglected practice. If anything, 
dental floss is even more important than the tooth-brush, for it is only by 
the use of something of this kind that one can completely remove matter 



SELF CARE FOR WOMEN". 1641 

that has lodged directly between the teeth. If you have not a good dental 
floss, a little piece of white silk thread will answer the purpose very satis- 
factorily. It is well, first, to use the dental floss thoroughly in all the 
spaces between the teeth and afterwards to complete the cleansing work 
by means of thorough brushing. 

The standard tooth powders on the market at the present day are for 
the most part satisfactory. It may be said, however, that ordinary table 
salt is particularly to be recommended for the purpose. The salt, like- 
wise, has a healthy effect upon the gums, helping to harden and give them 
tone. In fact, salt water may always be used advantageously as a mouth- 
wash, rinsing with plain water afterwards. There is hardly anything 
better. It leaves one with a clean, wholesome taste in the mouth. 

The stem of the althea blossom is to be recommended for the 
whitening of the teeth. Take the stem, crush the end of it, and rub the 
teeth vigorously with the crushed and juicy part, just as you would use a 
brush. 

A good mouthwash is bicarbonate of soda. Dissolve a half teaspoou- 
ful in a cup of water. It is a good throat gargle also and is especially 
recommended for singers. 

To remove tartar from the teeth, there is nothing so good as powdered 
pumice-stone. This can be rubbed upon the teeth with a piece of orange 
stick, the same as used by manicurists, until they are thoroughly cleaned 
and then the teeth brushed thoroughly and the pumice-stone rinsed well 
out of the mouth. 

Fruit Juices for Cleansing the Teeth. — Many savage tribes have won- 
derful teeth in spite of the fact that they never clean them and do not 
know what a tooth brush is. It is largely due to their plentiful use of 
fruit, the juices having a valuable cleansing effect. In recent years, some 
famous dental authorities have advocated cleaning the teeth with fruit 
juices or food acids, such as dilute cider vinegar, instead with the usual 
alkaline tooth powders. It is claimed that fruit acids promote the in- 
creased flow of saliva and in this way bring about a greater alkaline con- 
dition of the mouth within a few minutes, inasmuch as the saliva is 
naturally alkaline. Furthermore, fruit is somewhat antiseptic and is 
always healthful. 

STRONG BEAUTIFUL EYES. 

There is no other feature that plays so prominent a part in making 
one attractive as the eyes. The eye is the window of the soul. It domi- 



1642 SELF CAEE FOR WOMEN. 

nates the face just as the face itself dominates the body. The eye is the 
most expressive feature just as it is the most important organ of sense, 
though one should apreciate the fact that the beauty of the eye is, to a 
large extent, a question of the condition of the tissues and structures sur- 
rounding it. In other -words, the eye should be appropriately "framed." 
As a matter of fact, the expression of the eye is determined not by the 
eye itself, but by the eyelids, eyebrows, and the muscles which control 
these surrounding parts. When these muscles are weakened or fatigued, 
there is a drooping and tired aspect. "When the muscles of these parts are 
contracted through pain, the eye wears the expression of agony or distress. 
When these parts are all well nourished, strong and healthy, the eye looks 
clear and strong. In other words, the eyes are a good barometer of the 
general health. They sparkle when one is full of vitality. 

However, the eyeball itself has something to do with the appearance 
of the eye. The socalled "whites" of the eye, when in perfect health, are 
a light, clear blue in all fair skinned persons. This fact has a great deal 
to do with the beauty of the eye from the standpoint of color. When the 
whites of the eyes are muddy, or when they are congested and bloodshot, 
they naturally lose their attractiveness. In this respect also the eyes re- 
flect the general health. 

Much of the eye trouble of civilized races is due entirely to eye 
strain, and, in large part, to the use of artificial light at night. Those 
having a tendency to weak eyes should go to bed early and avoid artifi- 
cial light as much as possible ; they should especially avoid sitting in 
such a way that the light shines into their faces. Sewing should particu- 
larly be avoided in the evening, though sewing and reading are not to be 
encouraged under any conditions by those whose eyes are weak. It may 
be said, however, that with the building up of the general health and im- 
proving the condition of the blood, the eyes always get stronger and par- 
take of the general improvement. A great many people have been able to 
discard glasses simply through taking up systematized physical culture. 

Headaches are very commonly due to eye strain. In all cases of per- 
sistent headaches or frequently recurring headaches, the eyes should be 
investigated. It is well in such cases to consult a competent oculist. In 
every case where there seems to be the least tendency to eye trouble, 
nervousness or headache, the eyes should be examined. Even where the 
sight seems perfect, glasses may be needed to relieve eye strain until the 
eyes are stronger. 

Salt Water Eye Baths. — Are of great value in toning up these organs. 




Water as a cosmetic, i. Plenty of cold water tones up the skin and gives it 
that "fresh" appearance. 2. Do not wash the face with hot water, but use cool 
or luke-warm water, with a little castile soap. Use the washcloth gently. 3. Cold 
wet compresses, using washcloth or small towel, will help to clear the complexion 
and improve its color. 4. A small piece of ice rubbed over the face will close the 
pores, improve the circulation, and give "life" to the face. It is the most stimu- 
lating of all means for this purpose. 5. If the face is tender the ice may be 
wrapped and held in a small cloth when applying it 



E. T. S. 




I. Moles may be touched with a weak solution of nitric acid, applied with a 
match-stick. 2. Removing superfluous hairs with small tweezers, the best home 
treatment. 3. Using a blackhead remover. Never squeeze them with the fingers. 

4. Always apply a good antiseDtic to the face after treating blackheads or pimples. 

5. Stroking under the eyes, sideways, not downwards, for puffiness or sagging un- 
der the eyes. 6. In drying the face do not rub roughly, but pat the face with the 
towel, gently, until dry. 



E. j. S. 




■1 



■ 



I. The soft flesh brush is the best of all means for making the skin smooth 
and soft, and for preventing pimples on the shoulders, chest and back. 2. Soft 
linen cloths, dipped in white of egg, may be applied to remove the lines or 
wrinkles at the sides of the mouth and upper lip. 3. The growth of the eye- 
lashes is stimulated by gently pulling them. 4. The flesh brush is of value for 
giving color to the face, and improving the texture of the skin. 5. Massage is of 
special value for the body, and may be self-applied with advantage. 

© E. J. S. 




i. Massage for the face should consist largely of gentle pressure, applied with 
a small circular movement, but no pulling and stretching of the tissues. 2. In 
smoothing out wrinkles, rub in the same direction, never across them. 3. Mas- 
sage for a double chin is of great value, stretching the head up when applying it. 
Massage for the bust is of much value, and should be applied with a circular 
movement, never with downward strokes. 



E. T. S. 




i. In brushing the teeth, use a vertical rather than a lateral action, so as to 
reach the spaces between the teeth. 2. The regular use of dental floss, thus clean- 
ing the spaces between the teeth, is if anything even more important than the use 
of a toothbrush. 3. A bandage to be worn at night to correct outstanding ears. 
4. A device to prevent mouth-breathing during sleep. A bandage applied in this 
way will hold the mouth shut so that one will breathe through the nose properly. 



E. J. S. 




I. Thorough and prolonged brushing of the hair night and morning will in- 
sure its luxuriant growth. 2. Before doing up the hair, always give it a gentle 
pulling, taking only a part of it at a time, and thus stimulating the roots. 3. Once 
each day, if possible, spend some time massaging the scalp with the finger tips, 
thus improving the circulation and giving life to the roots of the hair. 4. When 
convenient, massage of the scalp may be advantageously administered by another, 
but it is quite as satisfactory when self-applied. 



© E. J. S. 



SELF CARE FOR WOMEN". 1643 

They will sometimes cure a headache. They are more stimulating when 
used with cool or moderatly cold salt water, but they may be used warm. 
One can use a small eye cup for this purpose or immerse the face in a 
basin of salt water, opening the eyes under water and rolling them around 
so as to give the eye ball a good salt bath. Repeat this several times. 

Where there is any inflammation of the eyes, bathing with boric 
acid solution is even better than salt water. For this purpose an eye cup 
should be used, using a fresh solution for each eye. If the eyes are 
strained and sensitive, however, they should be protected from the light, 
perhaps by a bandage, and in such cases it is always well to consult a 
specialist. Sometimes complete darkness for a day or two will so rest the 
eyes as to restore their strength. 

Massage and Exercise for the eyes themselves help greatly in 
strengthening them and giving them the bright, clear appearance that 
makes for beauty. Exercises for the eyes consists simply in moving and 
stretching them as far as you can upward and downward several times, 
far over to each side several times and then around in a circle, reversing 
the circular movement after a few times. Follow this by squeezing the 
eyelids tightly shut and then opening them as wide as you can stretch 
them, shutting again, opening, and continuing this a number of times. 
This will strengthen the adjacent muscles and increase the circulation in 
the eye. 

Massage of the eyes may be administered with the heel of the hand, 
pressing gently and using a circular movement. Young children in- 
stinctively massage the eyes after crying with the backs of their little 
hands, but the base of the thumb or heel of the hand will be found more 
satisfactory as a rule. There is no question of the stimulating effect of 
such treatment. 

Remember, however, that one's entire state of mind and also the 
condition of health are accurately reflected by the eyes, and all health 
building measures are of importance in beautifying these remarkable 
organs. 

The eyelashes are important in their influence upon the beauty and 
appearance of the eye. They may be improved by the practice of gentle 
pulling, thus stimulating their growth and giving them strength. The 
same is true of the eye-brows, though rubbing olive oil or vaseline on 
the latter will also promote their growth. 

Care of the Ears — Not much attention is ordinarily required in the 
care of the ears apart from the matter of cleanliness. One mistake fre- 



1644: SELF CARE FOB WOMEN. 

quently made, however, is the attempted cleaning of the ears with hair- 
pins and other hard objects with which to remove supposed accumula- 
tions of wax. If the ears are washed thoroughly with an ordinary wash 
cloth, one need not he concerned about wax. The presence of a certain 
amount of this is natural and has a protective purpose. The finger nails 
especially should be kept out of the ears, inasmuch as scratches by the 
nails may give rise. to serious inflammation, with possibly tragic conse- 
quences. The only thing that should ever be inserted into the ear is a 
little twisted wad of clean absorbent cotton, such as mothers commonly 
use in cleaning a young baby's nose. Nothing harder than this, however, 
should ever be inserted in the ear except by a physician. 

Projecting or outstanding ears cannot in all cases be modified, al- 
though something may be done to improve them by wearing a bandage 
passing from under the chin over the ears and fastened at the top of 
the head, thus pressing the ears flat against the side of the head. Do not 
expect results in a week. This bandage must be worn over night for 
many months to get results, and the treatment will naturally be more 
effective in children than in the case of adults. 



CAttE OF THE HANDS. 

A great deal may sometimes be learned of one's character through 
scrutiny of the hands. The hand is a wonderfully perfected mechanism 
and it is a member of the body well worth taking good care of. 

Cleanliness is a matter of first importance in well kept hands. This 
does not mean, however, that soap should be used excessively, inasmuch 
as pure lemon juice is not only a more effective means of cleansing the 
hands, but it is particularly valuable for softening the skin. Furthermore, 
lemon juice will remove stains from the hands probably better than any- 
thing else in the world. At the same time, where the hands are soiled 
with grease, the use of soap will be necessary, always rinsing well after- 
wards with cold water. 

Chapped Hands. — There is good reason to believe that chapped hands 
are largely the result of dirt which has worked into the skin and thus 
produced an irritation. Therefore a thorough cleansing should be the 
first step in overcoming a chapped condition of the hands. Thorough 
washing with a mixture of warm water, castile soap and corn meal is very 
valuable, afterwards rubbing in a little olive oil, vaseline or cocoa butter. 

In order to protect the hands when any dirty work is to be performed, 



SELF CARE FOR WOMEN. 1645 

it is a good plan to rub the hands well with olive oil. This will prevent 
dirt from working its way into the skin. Or one may wear rubber gloves 
or an old pair of kid gloves. 

One of the most effective treatments for chapped hands is a half and 
half mixture of glycerin and rose water with a benzoin added. This 
should be rubbed into the hands well after washing with warm water and 
before going to bed. Where there are deep cracks as the result of chap- 
ping, hot melted tallow or shoemaker's wax may be dropped upon the 
cracks, where it will immediately harden and protect the sensitive tissues 
until they have had a chance to heal. 

Oatmeal Water is splendid for washing the hands. Oatmeal boiled 
in water may be strained, using the liquid as a wash. 

A good preparation for whitening the hands is a mixture of equal 
parts of cocoa butter, refined wax and oil of sweet almonds, first heating, 
then stirring until cool and applying to the hands before retiring. Bran 
mixed with buttermilk to make a thick paste may be rubbed upon the 
hands at night, after which put on loose gloves and let them remain until 
morning. Another satisfactory preparation for whitening the hands is a 
mixture of equal parts of glycerin, rose water and lemon juice. First 
wash the hands with oatmeal or almond meal water and then apply this 
mixture. 

Red Hands. — Redness of the hands is usually an indication of poor 
circulation. Tight gloves, tight sleeves or even tight lacing at the waist, 
by preventing the free circulation of the blood, may be the cause of red 
hands. The blood does not return freely from the extremities. Holding 
the hands upward will relieve this condition and also relieve the swollen 
condition of the veins. For permanent results, exercise, massage and 
keeping the feet warm will be effective. Washing in cold water is the 
best temporary remedy. 

For perspiring hands, there is nothing better than washing in a little 
cold water in which a lump of soda is dissolved. Dusting with a little 
starch will help. Lemon juice will also be valuable in such cases. 

Care of the Nails — If the nails are not abused in any way, they do 
not need a great deal of attention, aside from proper trimming. For 
this purpose a file should always be used rather than scissors. Cutting 
thickens the nails. In filing, the file should always be held between the 
nail and the flesh rather than at right angles. The deposit of dirt be- 
neath the nails should be removed only with an orange stick. Never use 
a sharp instrument for this purpose. 



1646 SELF CARE FOR WOMEN. 

The greatest mistake in connection with the nails is the habit of 
chewing or biting them off. It is largely a nervous habit. The best cure 
for this is careful manicuring, so that there will be no temptation to bite 
off jagged ends. Any one who takes pride in her nails and cares for them 
properly, will find it almost impossible to bite them. 

It is advisable that every woman should secure a little manicure out- 
fit and use it regularly. A chamois-skin polisher will be effective even 
without the polishing powder ordinarily used, though of course this will 
help. 

Brittle nails are the result of defective diet. 

Exercise for the Hands. — Exercise for the hands is necessary to keep 
them in good condition. Hands that are too soft or too much unused are 
never attractive. If one has no regular employment requiring active use 
of the hands, piano playing is to be recommended, together with vigor- 
ous massage. Shaking hands with yourself and squeezing or massaging 
the hands and fingers vigorously in this way will promote an active circu- 
laiton that will not only build up the muscles, but strengthen the bones, 
tendons, ligaments and other structures in the hands. 

Care of the Feet. — The most important factors in the care of the feet 
are cleanliness and proper footgear. The question of footgear has already 
been referred to. Corns and bunions are entirely the result of imperfect 
footgear and can only be permanently corrected by wearing shoes that fit. 

Tender feet should be treated with a cold salt water bath each morn- 
ing. After each washing with warm water and soap they should also be 
treated with a cold salt water bath, after this massaging and rubbing them 
vigorously with a little olive oil. This treatment will accomplish wonders. 

For perspiring feet, frequent washing is necessary and the salt water 
suggested will be valuable. The foot may also be dusted with a half and 
half mixture of starch and salicylic acid. 

For flat feet, see "Corrective Exercises" under "Physical Culture 
and Body Building." 



BOOK XVII 



Treats of Physical Culture and Body Building. 
The book is divided into three parts, describing re- 
spectively exercises for men, women and children. 



Abdomen, Strength of 1654 

Age and Exercise 1664 

Air Baths 1665 

Amount of Exercise 1683 

Athletics, Limitations of 1659 

Babies' Exercise 1685 

Back, Strength of 1654 

Baths, Air and Sun 1665 

Baths and Exercise 1664 

Baths for Women, Cold 1677 

Bodily Defects, Remedying 1651 

Body Building for Children 1679 

for Men 1649 

for Women 1667 

Body, Perfect 1658 

Brain-worker, Exercise for 1654 

Breathing, Diaphragmatic 1655 

Exercises 1655 

Bust Development 1674 

Calisthenics 1660 

Carriage 1669 

Exercise for Correct 1652 

Chest, Strength of 1654 

Children, Physical Culture for.... 1680 

Classification of Exercise 1654 

Clothing 1677 

and Sunshine 1666 

Cold Baths for Women 1677 

Competitive Games 1685 

Complete and Incomplete Move- 
ments 1661 

Constipation, Exercise in 1672 

Constitutional Exercise 1657 

Corrective Exercise 1651, 1682 

Correct Postures, Influence of ....1652 

Spinal Column in 1652 

Corsets a Non-Necessity 1670 

Why They are Worn 1670 



Development, Bust 1674 

Exercise 1658 

Diaphragmatic Breathing 1655 

Dress Reform, Extremes of 1678 

Dumb-Bells 1660 

Effects of Exercise, Physiological. 1650 

Endurance, Importance of 1658 

Exercise and Age 1664 

Amount of 1683 

For Babies 1685 

and the Bath 1664 

is Beneficial 1649 

and Bodily Weight 1663 

for the Brain-worker 1654 

Breathing 1655 

Classification of 1654 

in Constipation 1672 

Constitutional 1657 

for Correct Carriage 1652 

Corrective 1651, 1682 

Development 1658 

for Functional Strength 1657 

Housework as 1668 

Light and Heavy 1660 

Necessary to Health 1649 

Occupational 1663 

Organic 1654 

Physiological Effects of 1650 

and Play 1680 

Rapidity of 1662 

Recreational 1675 

Relaxation 1676 

Right Kind of 1668 

Stimulating 1663 

Stretching 1661 

Tensing 1660 

Versus Work 1659 

for Worry 1676 



1647 



1648 



INDEX TO BOOK XVII. 



Extremes of Dress Reform 1678 

Fatigue 1653 

Friction Rubs 1666 

Functional Strength, Exercise for. 1657 

Games, Competitive 1684 

Gymnasium Work 1662 

Health, Exercise Necessary to 1649 

Housework as Exercise 1668 

Masculine and Feminine Outlines, 1668 

Men, Physical Culture for 1649 

Muscular System, Importance of.. 1650 

Occupational Exercise 1664 

Organic Exercise 1654 

Outdoor Play 1680 

Physical Culture for Children 1680 

for Men 1649 

for Women 1667 

Play versus Exercise 1680 

Poise 1669 

Posture, Influence of 1652 

Pregnancy, Exercise in 1673 

Recreational Exercise 1675 



Relaxation and Contraction 1663 

Exercise 1676 

Slender Child, The 1685 

Spinal Column in Correct Posture. 1652 

Stimulating Exercise 1663 

Strength of Back, Chest and 

Abdomen 1654 

in Childhood 1679 

and Womanhood 1667 

Strong Muscles or Strong Organs.. 1654 

Sun Baths 1665 

Sunshine and Clothing 1666 

Tensing Exercise 1661 

Thin Woman, The 1675 

Vitality Building 1658 

Weight and Exercise 1663 

Lifting 1660 

What Children Need Exercises . . . 1681 

Women, Physical Culture of 1667 

Weaknesses of 1671 

Work versus Exercise 1659 

Worry, Exercise for 1676 



ILLUSTRATIONS 



Balancing and Stretching Exercise, 1684 

Broomstick Exercise 1685 

Example of Physical Development, 1650 
Exercise for the Abdomen . . 1672, 1673 

for Abdomen and Trunk 1673 

for Abdominal Muscles 1657 

for the Back 1656, 1672, 1673 

for the Bust 1672 

with Chair 1684 

for the Chest 1672 

for Constipation 1673 

for Female Weakness 1673 

for Grace and Agility 1672 



for the Hips 1673 

for Muscles of the Front of 

the Body 1656 

for Prolapsed Organs 1673 

for the Spine 1656 

for the Stomach and Ab- 
domen 1657 

for the Trunk of the Body ...1657 

with Two Chairs 1684 

General Exercises for Women .... 1672 

Hand Wrestling 1685 

Rooster Fight 1685 

Wrestling 1685 




A superb example of physical development. This shows a splendid combina- 
tion exercise for neck and chest. Pull the head back in this manner while resist- 
ing the movement with the arms, and repeat until slightly tired. This exercise 
will insure good chest expansion. 



J. S. 



BODY BUILDING FOR MEN. 1651 

active exercise and a cold bath, by stimulating respiration, will also 
quickly bring a sense of refreshment. 

CORRECTIVE EXERCISE. 

Remedying Bodily Defects — In two respects systematic exercise has 
a great advantage over play or athletics as a means of physical develop- 
ment. Active open air pastimes, while always recommended, do not 
necessarily mean a perfect development of all parts of the body. Exer- 
cise, however, properly designed and systematized, will bring about sym- 
metrical development, for each part of the body will be employed in such 
a way that there are no weak parts. And in the second place, special 
exercises may be used for corrective purposes where there are bodily 
defects. Many athletes may be found who are well trained in some 
specialty, but are nevertheless one-sided in development. 

Such conditons as flat chest, drooping or "round" shoulders, spinal 
curvature, a pouchy abdomen, head hanging or thrust forward, flat foot, 
"chicken breast," and other similar defects, may be either partially or 
entirely remedied by appropriate exercise. 

To a large extent, however, ordinary development exercises of the 
best type are corrective in their influence. In other words, so far as the 
trunk of the body is concerned corrective and development exercises are to 
a large extent identical. The subject should be understood, however, so 
that intelligent selection may be made of those exercises which in each 
individual case are most suited to one's requirements. All exercises which 
strengthen the back, and especially stretching and bending movements, are 
corrective of spinal curvature. All exercises which bring the shoulders 
back and improve the carriage of the head have a corrective influence upon 
the chest. In both flat-chest and "chicken breast," chest expansion exer- 
cises and chest breathing exercises are advisable, though proper posture 
in such a case is most important of all. All exercises which tend to 
strengthen the stomach and abdominal muscles, and particularly those 
which also promote improved posture, will tend to overcome a pouchy or 
sagging condition of the abdomen. All neck exercises will strengthen that 
part and improve the carriage of the head. Flat-foot or weakness of the 
ankles may be corrected by systematic exercise and especially by the 
wearing of moccasins or sandals, going barefoot, and the practice of "toe- 
ing-in" when walking. Exercises for gripping with the toes, for plac- 
ing the weight on the outside edge of the foot, for arching the foot and for 

104 



1652 PHYSICAL CULTURE. 

deep-knee-bending with the toes slightly turned in will be valuable in flat- 
foot and other foot troubles. The strengthening of any of these parts 
will naturally be corrective, but by selection of special exercises suited to 
each case wonderful results can be secured. 

Influence of Correct Posture — Where there is any occasion for the 
use of corrective exercise special study should be given to the question of 
bodily posture. This is always important;, even where there is no physical 
defect or weakness. Correct posture really means a properly balanced and 
erect condition of the spine. Everything else depends upon this funda- 
mental necessity. An erect spine naturally involves a normal position of 
the shoulders, chest and abdomen. The chest, under such conditions, is 
in an active position, well raised and expanded so as to give room for 
heart and lungs. The shoulders are fairly well back and the abdomen 
somewhat retracted. The extreme military position, with the abdomen 
far drawn in and the chest thrown far forward, is neither necessary nor 
desirable. It is essential, however, that a comfortably erect position be 
maintained. By holding the head fairly well back this position is easily 
assumed. 

The Spinal Column in Correct Posture — We have said that good pos- 
ture is chiefly a question of an erect spine. The human spine is unique 
in the animal world because man is the only animal who naturally stands 
erect. This has required a certain variation in the evolution of the spine 
peculiar to the human race. Particularly this variation involves the 
natural curves in the spine, of which there are three, the more important 
for our present consideration being the lumbar curve, which is respon- 
sible for the conspicuous arching of the back at the waist line. It is 
true that these curves help to give resiliency, but fundamentally they 
are the direct result of our erect posture. This arching of the back, there- 
fore, is an inevitable feature of an erect position. When you slump 
forward, with shoulders drooping and chest flat, the arch in the back tends 
to disappear. But when you draw yourself up to your full height, with 
chest elevated and expanded and head thrown back, the arch in the back 
becomes pronounced. When you hear reference made to a "straight back," 
the idea conveyed should be that of square shoulders and erect posture, 
inasmuch as the spine is never really straight in the strict sense when the 
body is properly carried. 

Exercises for Correct Carriage. — Therefore if you see to it that the 
back is arched in this way you can depend upon having a correct carriage. 
As a means of securing this at any time there are three extremely simple 



BODY BUILDING FOE, MEI. 1653 

fluence directly. All other structures must be improved indirectly through 
the influence of exercise and other measures in the improvement of the 
blood and the promotion of the general health. 

The first and most important effect of exercise is accelerated circu- 
lation. The breaking down of the cells brings about a demand for oxygen 
and new building material, and also the necessity for the removal of the 
carbonic acid and other waste products formed. Therefore, the heart 
is compelled to beat more rapidly, pumping the blood through the arteries 
and finally through the capillaries in such a way that the oxygen is sup- 
plied to every minute part and the waste materials are taken up by the 
blood-stream and carried to the channels of elimination. This means in- 
creased breathing, increased action of the kidneys and increased perspira- 
tion. Under conditions of physical stagnation the removal of wastes is 
sluggish and imperfect. The active and vigorous circulation induced 
by exercise, on the other hand, tends to cleanse all of the bodily struc- 
tures. A sufficient amount of exercise, therefore, means a condition of 
internal cleanliness. Exercise for those who are strong enough to take 
it is the most valuable of all blood purifying measures. 

Fatigue. — What we call fatigue is simply the result of an accumula- 
tion of the waste products resulting from metabolism. If not removed 
they will poison the body and make life impossible. When they have 
accumulated, even to a limited degree, these waste-poisons produce a 
stiffened and weakened conditon of the muscles in which the latter are 
incapable of normal action. The relief of this condition necessarily in- 
volves the removal of these fatigue-poisons. This is ordinarily accom- 
plished during sleep and rest, although it is hastened by massage, hot 
water bathing and other measures that increase the circulation and hasten 
elimination. 

These fatigue-poisons are produced not only by muscular effort but 
by brain work or the functioning of any other of the organs of the body. 
Under conditions of physical inactivity and sluggish functioning these 
wastes accumulate. Under such circumstances the first effect of exercise, 
by increasing the circulation, is to remove these poisons and thereby bring 
about a sense of refreshment. It is in this way that a moderate amount 
of active exercise is refreshing in its effects. It is possible, however, to 
carry the exercise to such a point that the muscular work itself involves 
such increased production of fatigue-poisons that the refreshing effect 
of the exercise is lost and one feels fatigued. For this reason exercise 
for constitutional purposes should not be carried too far. 



1654: PHYSICAL CULTURE. 

Exercise for the Brain Worker. — It will be seen from what has just 
been said that mental work is productive of fatigue, or the accumulation 
of waste-poisons. That is why one feels exhausted at the end of a day 
of brain work. Exercise in such a case should be taken at five or six 
o'clock in the afternoon as a means of relief and refreshment. The in- 
creased circulation will enable one to sweep these wastes out of his sys- 
tem and to clear his brain. So long as your exercise is enjoyable it is 
productive of this result,, but as soon as it becomes laborious and you lose 
the sense of pleasure you may understand that it is time to stop. 

Classification of Exercise. — While practically all exercises have cer- 
tain results in common, yet various forms of exercise are especially 
adapted for definite purposes. Certain types, for instances, are chiefly 
effective for purposes of muscular development. Other forms of exercise 
will be particularly valuable for strengthening the internal organs. ' We 
may term these organic exercises. Corrective exercises form a depart- 
ment of physical culture, the purpose of which is to overcome bodily de- 
fects and special weaknesses in various parts of the body. To a large 
extent it is the corrective influence of many systems of exercise that give 
them their greatest value. Finally, we may consider what may be termed 
constitutional exercise, the chief purpose of which is not to develop the 
muscular system, but to build vitality and improve the general health. 

ORGANIC EXERCISE. 

Strong Mnscles or Strong Organs. — We have said that the first purpose 
of physical culture should be health and vitality rather than mere mus- 
cular strength. We need both, but the internal strength is the more im- 
portant. There was a time when the thought of physical culture was 
associated chiefly with the biceps, the large, two-headed muscle of the 
upper arm. The physical training conceptions of that day had to do 
merely with strong arms and legs, and, to a certain extent, the ability to 
lift weights. Physical culture was something for the wrestler and boxer. 
But that day has gone by. Physical culture is now a means of health- 
building for the professional or business man, or anyone else, and is con- 
cerned chiefly with nervous energy and internal strength. The man of 
to-day wants strong organs most of all. He cares little about his biceps, 
except as it may be a means of promoting the general circulation and 
influencing the internal organs. 

Strength of Back, Chest and Abdomen. — For the above reasons any 



BODY BUILDING FOR MEN". 1655 

system of physical culture intended for the average man rather than for 
one specializing in athletics should consist chiefly of exercise for strength- 
ening the trunk of the body and the internal vital organs. The exercises 
which we are illustrating are practically all of this type. An elaborate 
system of exercises for the arms and legs is of little value compared to a 
few simplified movements for strengthening the back, improving the chest 
and giving one firm abdominal walls. The exercises illustrated have been 
carefully selected for this purpose. It does not matter so much what exer- 
cise one takes so long as it accomplishes results. One may do as many 
exercises as he pleases, but such movements as have been illustrated are 
of the very greatest importance. 

Exercises that affect the region of the back, sides, chest and stomach 
have a direct effect upon the internal organs, not only because the in- 
creased circulation in these muscles means an increased blood supply to 
the internal parts adjacent to them, but also because movements of the 
trunk of the body have the effect of compressing, stretching and other- 
wise moving the internal parts to a considerable extent, thus promoting 
functional activity. !No one can be absolutely healthy without more or 
less activity of this kind, whether in the form of work or exercise. Exer- 
cises involving the region of the stomach and abdomen are of particular 
importance for the sake of firm abdominal walls and a general condition 
of strength and vigor throughout all these parts. 

Breathing Exercises. — Voluntary deep breathing is a commendable 
form of organic exercise that directly affects the lungs and in that way 
influences the entire body. In civilization, and especially indoors, men 
and women neglect to breathe deeply. Inactivity and sedentary life are 
responsible for a degree of shallow breathing that is conducive to pale 
faces and lack of energy. One cannot live without oxygen and the more 
oxygen he inhales the better the condition of his blood. Deeper breathing 
also means the more perfect elimination of carbonic acid gas. 

Now, ordinary muscular exercise is at the same time the most per- 
fect form of deep breathing exercise. Under such conditions deep breath- 
ing is spontaneous. The lungs automatically adapt themselves to the 
oxygen requirements of the system. Muscular effort creates a demand 
for oxygen, or what one may call a condition of oxygen-hunger. Pro- 
longed muscular activity, therefore, insures a perfect lung development. 
Under such conditons one does not need to think of special deep breathing 
exercises. Wild animals do not need to be taught deep breathing. 

Diaphragmatic Breathing. — One whose occupation keeps him confined 



1656 PHYSICAL CULTURE. 

for a large part of the day, however, should practice voluntary deep 
breathing frequently. This should take the form of diaphragmatic or so- 
called abdominal breathing. Chest breathing is unnatural except under 
conditions of extreme muscular exertion, as in running or wrestling. If 
one requires a tremendous amount of oxygen, chest breathing is instinc- 
tively resorted to temporarily to supply the demand. Under ordinary 
conditions, however, the natural method of breathing involves chiefly the 
expansion of the body at the waist line and in the region of the abdomen. 
This is because the diaphragm, during the process of inhaling the breath, 
presses downward in such a way as to cause the expansion of the body 
below it. The diaphragm is a large, flat muscular structure which forms 
a partition between the thoracic cavity and the abdominal cavity. It 
serves as a floor for the heart and lungs and as a ceiling for the stomach 
and other functional organs lying underneath. If you take an erect 
position and inhale a breath, drawing it down to the lower part of the 
lungs in the proper manner, you will find that the expansion is at and 
below the waist line, with perhaps a little expansion of the floating ribs. 
It is remarkable how much air can be inhaled and exhaled without ex- 
panding the upper chest. This is a form of deep breathing to be practiced 
as often as you can think of it. Inhale only through the nose. Exhala- 
tion may be either through the nose or mouth, but preferably through 
the nose. 

While it was thought years ago that abdominal breathing was natural 
for men yet it was assumed somehow that chest breathing was the only 
natural method for women. The error of this assumption is now well 
understood. Chest breathing among women is found to be only the artifi- 
cial result of corset wearing and tight lacing. If there is sufficient free- 
dom at the waist line and below, women naturally breathe in the same 
manner as men. 

The breath is never entirely exhaled. There is always a residue 
in the lungs and air passages. The fresh air inhaled is therefore only 
mixed with this residue of "dead air" in the lungs. In order that deep 
breathing may be as effective as possible, therefore, and the supply of oxy- 
gen as great as possible, it is well to exhale as much as one can before 
inhaling. In this way the new supply in the lungs is more nearly perfect. 

Breathing exercises are valuable the first thing in the morning. If 
one feels "more tired than when he went to bed" it is often because of an 
accumulation of carbonic acid due to shallow breathing when asleep. 
Deep breathing exercise will overcome this condition quickly. A little 




i. Stretching the arms vigorously high above the head, an exercise especially 
good for the spine. 2. First position in a vigorous exercise for the back. From 
this position, resisting with the leg, straighten up to the position shown in figure 
3, pulling the leg upward. Repeat several times with each leg. 



E.J. 




Two good back exercises, i. Squat low down and stretch the arms vigor- 
ously far forward, touching the floor at a point as far as you can possibly reach. 
2. First standing erect, with arms high above the head, and feet apart, swing 
down and touch the floor between the feet and at a point as far back as possible. 



E. J. S. 



BODY BUILDING FOR MEN. 1657 

exercises. The first of these is merely to stretch the arms high above the 
head. This will raise the chest, retract the abdomen and bring about a 
normal arching of the back. Maintain this position of the torso or trunk 
while bringing the hands down to the sides and you will find yourself 
standing correctly poised. Do the same thing sitting down. Another 
simple exercise is the familiar stretching and yawning movement in which 
the arms are doubled and the elbows brought up to a level of the head and 
then backward, with the head also drawn back. It elevates the chest and 
arches the back. Another splendid exercise is to clasp hands behind the 
back and then pull the shoulders backward and downward. Any one of 
these three movements may be put into practice a hundred times a day to 
help you maintain good bodily carriage. The last of the three may be 
practiced upon the street without attracting notice. 

CONSTITUTIONAL EXERCISE. 

Exercise for Functional Strength — The relation of muscular exercise 
to the internal functions deserves special consideration. It is true that all 
development exercise is somewhat constitutional in its influence inasmuch 
as it affects the internal organs to some extent. It is also true that all 
constitutional exercises, such as walking and hill climbing, are somewhat 
muscle-building in character. Yet certain forms of exercise are useful 
chiefly for muscle building, while others are valuable mainly for vitality 
building. It may be said that any form of exercise which keeps the in- 
ternal organs vigorously at work for a considerable period of time, even 
though it may not involve much muscular effort, may be regarded as 
constitutional in its effect because of having its chief influence upon the 
heart, lungs, kidneys, liver and internal functions generally. 

In other words, exercises which build endurance are constitutional 
in their effect, as compared with exercises which merely build strength. 
Great strength in a muscle depends upon its capacity to overcome resis- 
tance. This power is developed by daily work in which great resistance 
is overcome, even though one may make only two or three such efforts 
each day. One may lift a certain weight only once or twice each day, 
and by gradually training the muscles to overcome a still greater resis- 
tance he will develop the power to lift a heavy weight. In this way the 
muscles may be enlarged but without involving the same amount of con- 
tinued activity of the heart, lungs and internal organs that would be 
secured in long distance running or a ten mile walk. 



1658 PHYSICAL CULTURE. 

Vitality Building.— Vitality building, therefore, really depends upon 
a sufficient amount of exercise as measured in time rather than in the 
severity or intense character of the work. For real constitutional benefit 
one should each day enjoy some exercise extending over a period of two 
or three hours at least, even if this consists only in walking. Golf is par- 
ticularly valuable. Tennis is splendid. Hill climbing is a superb con- 
stitutional exercise. It keeps your circulation active and induces both 
deep breathing and free perspiration, both valuable blood-purifying meas- 
ures. A system of ten-minute exercise is valuable so far as it goes, and is 
a thousand times better than no exercise at all ; but for real constitutional 
results one should have some outdoor activity covering a period measured 
in hours rather than in minutes. One naturally cannot be too strenuous 
for a period of hours, and therefore walking, golf or some other moderate 
exercise, long continued, is best for vitality building purposes. 

What Endurance Means. — Endurance, as distinguished from strength, 
means the capacity for continued exertion, or many repetitions of a mus- 
cular effort. One may have strength without endurance, but endurance 
is the more important. Endurance depends upon pure blood and a condi- 
tion of internal cleanliness as determined by the ability to eliminate 
fatigue-poisons rapidly. It means functional strength and vitality. In 
building endurance, therefore, one builds vitality and internal strength. 
Those who are very strong will find it advantageous to practice cross- 
country running, wrestling, rowing and other vigorous exercises for the 
sake of endurance. Naturally, one should avoid over-exertion. To carry 
these strenuous pastimes too far would mean nervous exhaustion. But 
generally speaking, endurance means vitality. For those of less physical 
vigor it is sufficient to play golf, climb hills and take long walks. Horse- 
back riding, cycling and other pastimes not too strenuous may be sug- 
gested for the same purpose. 

We have previously referred to organic exercises as involving special 
movements for the trunk of the body which directly influence the internal 
organs. These will be decidedly constitutional in their effect, but not to 
the same extent as those which involve continued functional stimula- 
tion, such as will be found in prolonged activity. 

DEVELOPMENT EXERCISES. 

A Perfect Body. — While we have emphasized the importance of con- 
stitutional and organic exercise, yet a normal development is really neces- 



■:;.& 






An exercise for the muscles along the front of the body from the thighs up 
the arms i First position, with hands and feet on floor, hips held as high as 
sRihle Lower the hips to the position in figure 2, then rise to the first position, 

. 1 j-i \7,v— .» rmr\A fnr + Vi *» aViHnmin; 



to the arms 1. First position, witn nanas ana icci uu uuw, m^s nciu d» high _ 
possible. Lower the hips to the position in figure 2, then rise to the first position, 
and repeat several times. Very good for the abdominal muscles. 



E. T. S. 



Some exercises for the stomach and abdomen, especially valuable in cases of constipation. I. Reach 
far forward until you can take hold of the soles of the feet with the legs straight. Then pull the 
body still further down and forward. 2. Lying on the back, double the legs back against the abdo- 
men as shown, then stretch them out on the floor. Repeat a number of times. 3. Lying flat on the 
back, raise the legs and bring them back over the head, touching the floor if possible, as shown. Re- 
peat. 4. Lying on the back, raise the legs to the perpendicular, elbows braced on the floor, then 
lower the legs alternately to each side, about half way to the floor. 5. With legs held perpendicu- 
larly, swing them apart and then bring them together again. Also, in this position, practice a run- 
ning movement of the legs. 

<S) E. I. S. 



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A strenuous exercise for the abdominal muscles, i. First position, lying flat 
on the back with arms stretched back of the head. 2. Then, with a quick, ener- 
getic action, swing upper body and legs up at the same time until the fingers 
touch the toes. Repeat several times. You will have to do this with snap in 
order to accomplish it. 



K.J S. 



BODY BUILDING FOR MEN. 1659 

sary in order properly to enjoy constitutional exercises and to influence 
the internal organs in the manner suggested. The more perfect the ex- 
ternal muscular system, the more satisfactorily can one strengthen the 
internal organism. 

There is no need to strive for Herculean strength, but a natural, nor- 
mal development is essential. One should have a body of which he need 
not be ashamed. Symmetrical and harmonious outlines usually mean 
health as well as muscle. Remember also that any exercise which will 
strengthen the muscles will at the same time mean stronger bones, stronger 
ligaments and tendons, more healthy cartilages and a more firm, clean 
and healthy condition of every structure of the body. In overcoming 
resistance not only are the muscles strengthened but there is a certain 
amount of stress and strain on the tendons, the bones, the ligaments and 
all other parts involved. Even the arteries and veins are affected. The 
contraction of the muscles means pressure upon the blood vessels, thereby 
directly affecting the circulation. In the limbs, also, the movements tend 
to stretch and to shorten the arteries, according to the character of each 
movement. Accordingly, while advocating organic and constitutional exer- 
cise we do not belittle the value of muscular development. 

Exercise versus Work. — It is often said that many men and women 
secure sufficient exercise in the course of their work. This involves a 
fundamental fallacy inasmuch as certain muscles are overworked, in most 
instances, while other muscles are unemployed and therefore undeveloped. 
Work usually means a one-sided development, sometimes with exhaustion 
of those muscles which are employed. In some cases, as in writers' cramp, 
telegraphers' cramp and other occupational neuroses, there is exhaustion 
of the nerve centres. Most "work" is of a character to stiffen and fatigue 
one, but without building any special degree of strength. 

Exercise, therefore, is of just as much value to the manual worker 
as to anyone else. Some forms of work, such as chopping wood and pitch- 
ing hay, are splendid exercise. Others, ploughing, for instance, are 
purely stiffening in their results. After ploughing all day some quick, 
light exercise will be refreshing and strengthening. One should always 
exercise those muscles not employed in his work. 

Limitations of Athletics. — Athletic games are to be recommended 
for those physically suited to them. They will not, however, take the 
place of scientific physical training where one is in need of symmetrical 
development. Specializing in athletics frequently overworks certain mus- 
cles while neglecting others, just as is the case with many forms of work. 



1660 PHYSICAL CULTURE. 

All-around athletics should be preferred. In all cases the young man 
before going into any athletic competition should prepare himself by 
systematic physical training to build up a normal development and 
strengthen any weak parts. 

Light versus Heavy Exercise. — There is much controversy as to the 
relative value of light and heavy exercise. Both are valuable for special 
purposes. For one who is strong very light exercise is practically no exer- 
cise at all. He will require some form of exertion which gives resistance 
to his powerful muscles. Feats of great strength are perfectly natural 
where cne is sufficiently strong so that there is no strain upon the vital 
organs in performing them. One who is weak and undeveloped, however, 
cannot attempt heavy exercise and should commence with light move- 
ments. As he gains in strength he may use exercises involving more re- 
sistance. It requires the expenditure of strength to build strength, and 
if he hopes to become very strong it will be necessary to use ever-increas- 
ing resistance. He should not, however, force himself too much. The 
theory that one can gain the strength of a Hercules by means of light 
exercise is without foundation. Pay no attention to the mail-order expert 
who tells you that you can have "muscles like mine" through five minutes 
of light calisthenic work, according to "his system." The facts are that 
the mail-order expert gained his amazing development from hours of 
weight lifting each day. 

"Calisthenics" are valuable for all-around purposes, and in class 
work are suited to the needs of the average individual. In advanced phy- 
sical culture, however, they are no longer sufficiently vigorous. Further- 
more, the ordinary calisthenic "drill" contains a number of exercises for 
arms and legs which are of limited value as compared to such movements 
of the trunk of the body as are illustrated in this department of this work. 

Weight Lifting. — If one wishes to become a professional "strong 
man" and has exceptional vitality, with a powerful frame to begin with, 
weight lifting is the one and only means of securing the greatest possible 
strength. It is not, however, advisable for the average man. There is no 
real objection to weight lifting for one who is already strong if he does 
not overdo it. One should be sure that he has a strong heart before 
using weights. It is possible by practicing speed exercises to maintain 
some pliability and speed in the muscles while handling weights, but it is 
nevertheless true that weight lifting has a tendency to promote stiffness 
of the muscles and a more or less muscle-bound condition. 

Dumb-bells. — Dumb-bells of light weight were popular one or two 



BODY BTTILDIXG FOR MEff. 1661 

generations ago, but are not now much used. A dumb-bell drill is really a 
calisthenic drill in which these light weights are held in the hands for 
the purpose of giving some resistance and to make tne movements more 
effective. If you practice calisthenics, dumb-bells are as useful for this 
purpose as ever, but they are inclined to make one slow even though they 
help to build strength. One can use a pair of flat-irons for the same 
purpose. 

Tensing Exercise — This is a form of exercise, much advocated 
and taught by mail-order experts, which consists simply of a method of 
hardening or "tensing" the muscles. One muscle or set of muscles is 
used to resist the contraction of the opposing muscle or set of muscles. 
For the arm, for instance, the flexor or biceps is used to resist the exten- 
sor or triceps muscles. High-sounding, meaningless terms, such as "physi- 
ological exercise" or "concentration exercise" are applied to this form of 
exercise by mail-order instructors. Tensing exercises, however, while 
somewhat effective, are not to be recommended because of their muscle- 
binding and stiffening tendencies. They call for an unnatural use of the 
muscles. The muscles were intended for purposes of movement and not 
to resist each other. Exercises involving bodily movement, or exercises 
against external resistance are infinitely superior to any of these freak 
"systems." 

Stretching Exercise. — Stretching is a natural and spontaneous form 
of muscular action. When systematized stretching gives a fairly satis- 
factory method of exercise. It can never, however, take the place of active 
movement exercises. It cannot influence the heart or functional system 
to the same extent as active games and real muscular exertion. One may 
advantageously practice a few minutes of stretching for all parts of the 
body the first thing in the morning, but should not depend upon this 
limited form of exercise for all of his physical requirements. 

Complete and Incomplete Movements. — It should be said, however, 
that a certain amount of stretching should form a part of all systematic 
exercise. All exercise movements should be as "complete" as possible, in 
order to stretch the muscles and other tissues. In our ordinary, everyday 
work our movements are usually limited in scope. We do not extend the 
arm fully or flex it fully. We do not bend as far to either side as we can 
nor stretch the arms as high above the head as we can. Special exercises, 
therefore, should extend the scope of our movements to their natural 
limit. In extending the arm in exercise it should be straightened abso- 
lutely. In bending at the elbow it should be flexed as far as it will go. 



1662 PHYSICAL CULTURE. 

In bending the body we should bend as far as we can in each direction, 
and in raising the arms above the head we should raise them as high 
as we can stretch. This principle should be earnestly kept in mind, in 
order to keep the muscles supple and elastic, and in order to promote the 
circulation in the tendons, joints, ligaments and other structures apart 
from the muscles. The back, for instance, should be vigorously stretched 
in all bending exercises so as to influence the cartilages of the spine, 
thus keeping them elastic and healthy. It is, in part, the stretching of 
all sections of the body in systematized exercise that gives it its unusual 
value, and to neglect this feature is to fail to get the best results. 

Gymnasium and Apparatus Work. — Practically all apparatus work in 
the gymnasium can be recommended as an effective form of exercise. Too 
much emphasis need not be placed upon apparatus work because thou- 
sands of people do not have the opportunity of visiting a gynasium regu- 
larly, and therefore should depend upon such exercises in the home as we 
have illustrated. But if a gymnasium is convenient the various iorms of 
apparatus can be recommended not only for strengthening the body, and 
especially the arms, but because such apparatus helps to lend interest to 
the work of physical training. It is an excellent plan, especially where 
there is a family of children and a convenient yard for the purpose, to 
instal a little home-made apparatus. A horizontal bar, parallel bars, a 
vaulting horse and a trapeze or flying rings will all be useful in this way. 

Owing to the elevated character of most forms of apparatus, such as 
the horizontal bar, parallel bars and rings, it may be said that exercise of 
this kind bears a certain relation to the natural life and activities of pre- 
historic man, and especially to those of our alleged ape-like ancestors, 
who lived in the trees. In other words, exercise of this type is strictly 
natural. Apparatus work is usually most effective for improving the 
shoulders, chest and arms, although to a certain extent valuable for the 
other parts of the body as well. 

Rapidity of Exercise. — The question of the speed at which exercise 
should be carried on is frequently brought up. Should certain move- 
ments be performed rapidly or slowly ? This depends upon the character 
of the exercise and upon the individual. As a general thing, movements 
should be fairly active in character and of a speed which one can best 
enjoy. Very great speed calls for more energy. Very slow movements 
are stiffening in their results, also fatiguing. As a general thing, exer- 
cises performed with a "swing" and a fair degree of speed are suggested. 
The quality of rhythm is also helpful. 



BODY BUILDING FOR ME^. 1663 

Stimulating Exercise — Fast movements have a stimulating effect upon 
the nervous system. They wake one up. They call for more energy than 
slow movements and they arouse the energies of the body more thoroughly. 
They are even mentally stimulating if not carried to the point of too much 
fatigue. Also they are refreshing. Slow movements are sedative in char- 
acter. If one wishes to sleep soundly a few very slow movements, or 
walking very slowly, would make him feel tired and in a condition to 
sleep. A brisk walk, however, is mentally stimulating and all fast exer- 
cises are energizing. If engaged in any work of a monotonous, slow 
and stiffening character, then a couple of minutes of very fast exercise 
will be found refreshing. If stiffened from a slow walk of ten miles, a 
quick run will arouse an active circulation and make one feel fresh and 
energetic. 

Relaxation and Contraction. — The best results in exercise of any kind 
will be secured from a policy of alternate contraction and relaxation of 
the muscles. In other words, the state of tension or contraction should not 
be prolonged, but momentary in character. There should be a moment of 
contraction and then a brief interval of relaxation, and then another mo- 
ment of contraction. During the brief interval of relaxation a renewed 
blood supply is allowed to flow into the capillaries in the muscles, and in 
that way the exercise can be continued without discomfort and with the 
very best results. Prolonged stress or tension of the muscles interferes 
with the circulation by reason of the continued pressure on the blood 
vessels, and may result in a stiffened or cramped condition. 

Occupational Exercise. — The character of the exercise best suited to 
various men and women will depend largely upon the nature of their 
occupation. One who does hard physical work will not need strenuous 
exercise but rather activity of a quick, light character. One whose occu- 
pation involves sitting down all day will naturally require some vigorous 
exertion. He needs real exercise, and if possessing much vitality and a 
strong frame he may benefit most by exercise of a decidedly strength- 
building character. 

Exercise in Relation to Bodily Weight. — Undoubtedly those who are 
thin will require different methods of training from those who carry an 
excess of flesh. The thin man usually needs to conserve his vitality and 
must carefully avoid over-exertion. This is especially true if he is of a 
nervous temperament. "What he needs is a small amount of exercise, but 
of a muscle-building character. Men are thin not simply through lack of 
fat but through lack of muscle. They need strength-building exercise 



1664 PHYSICAL CULTURE. 

for enlarging the muscles, but only a small amount of it because they 
cannot spare too much energy. They should not, however, strain them- 
selves. Also they need a certain amount of walking for constitutional 
purposes, but should not do any running. 

On the other hand, the man who is over-weight usually has suffi- 
ciently large muscles already, in combination with his fat. Reference is 
made to the ordinary case of superfluous flesh, not those cases in which 
fat is a disease, for such cases need a doctor. Many stout men are power- 
ful — that is to say, "awfully strong for a minute." They do not need 
strength-building exercise. What they need is fast, active exercise such as 
will build endurance. Their activity should be light, but continuous 
enough to burn up the fatty tissue. There should be no strain, but the 
exercise should be a matter of hours. 

At the same time those who are over-weight must depend largely upon 
diet to secure a satisfactory reduction, especially eliminating the fat- 
forming foods, or in other words, the carbohydrates and fats. If they 
will eliminate bread from the diet together with cereals, rice, potatoes 
and other starchy food, and also sugar and other sweets, it is usually 
a simple matter to reduce weight. 

Age and Exercise. — Age is usually the period of decreasing activity, 
but to a certain extent it is due to decreased activity. Age is not merely 
a matter of years ; it is a bodily condition. Some men are old at thirty, 
others are still young in body and mind at seventy. To maintain youth 
is largely a matter of keeping physically active as well as observing other 
rules of health. Exercise is, therefore, just as important in advancing 
years as in youth. 

Exercise for men above sixty years need not be so active or stren- 
uous as that for young men, but it should be of a character to maintain 
suppleness, and especially it should be conducive to an erect bearing. 
What we have said about the importance of bodily posture applies espe- 
cially in advancing years. It is found that healthy men in old age often 
possess remarkable endurance. Many records for long distance walking 
have been made by men between sixty-five and seventy-five years of age. 
Walking, golf, hill climbing and activities of a similar character are very 
highly to be commended. Appropriate exercise is one of the most effective 
means of avoiding the hardening of the arteries which is commonly asso- 
ciated with the declining years of life. 

Exercise and the Bath. — A cold bath may be used in the morning as a 
tonic and as a means of improved circulation, but it should follow the 



BODY BUILDING FOB MEN. 1665 

morning exercise. A cold bath is only valuable when one can enjoy it and 
recuperate promptly with warmth. If one feels chilly or nervous, or finds 
himself trembling afterwards it is weakening and harmful. 

Success with cold bathing and the ability to recuperate depend 
largely upon being thoroughly warm before taking the bath. For this 
reason also it is better to take the bath in a warm room. One recuperates 
more readily. Exercise preceding the bath has the effect of thoroughly 
warming the body so that one may enjoy it and benefit from it. Never 
attempt a cold bath when already chilled, when the hands and feet are 
cold or when the skin takes the form of "goose flesh. " 

The shorter the bath the better. Simply stay in the cold water for a 
moment, whether a plunge or shower is used. If perspiring freely from 
exercise this is especially important. After the bath one should, in such 
case, use a warm sweater or bath-robe so that he may continue to perspire 
somewhat and cool off only gradually. One should not cool off too quickly 
or stay in a cold bath too long when perspiring. Under such conditions 
also it is a good plan to use a warm shower first and to wind up with a 
momentary cold shower, if all shower bath conveniences are available. 
Only one or two hot baths with soap a week are required for purposes 
of cleanliness, and such hot baths should always be followed with a cold 
shower or cold sponge. 

Cold baths have a pronounced effect upon the circulation and are a 
tonic of great value for those with whom they agree. One of limited 
vitality, however, should be careful. 

Air Baths and Sun Baths. — Air baths are of distinct value for their 
tonic effect on the nerves and for promoting the functions of the skin in 
general. Clothing is an artificial form of protection, tending to smother 
the skin and interfere with the elimination of waste matter through the 
pores. To take an air bath, simply remove the clothing in a comfortably 
warm room and allow the air to come in contact with the surface of the 
body. Air baths are conducive to good health and circulation, but it is 
always important that the hands and feet should be kept warm through 
good circulation. 

Sun baths are stimulating and energizing, if properly taken. The 
sun is the source of all life and energy upon the earth, and the sun's rays 
directly stimulate the bodily metabolism. A sun bath and air bath may be 
combined, if convenient. Care should be taken by those of fair, light 
skins not to carry them too far, and especially in midsummer in the 
middle of the day. The vertical or nearly vertical rays of the sun have 



1666 PHYSICAL CULTURE. 

a chemical effect which, although stimulating for a short time, become 
destructive to the nerve-protoplasm if continued too long in the case of 
those of blonde or unpigmented skins. Those of dark complexions can 
endure much more sunshine. The best time for a sun bath in summer is 
early or late in the day, though in winter one may take a sun bath at noon. 
There is no doubt that everyone requires a certain amount of sunshine the 
year around as a means of stimulating the formation of red blood cells 
and energizing the system generally. If care is taken to avoid the chem- 
ical action of the vertical rays, sun baths will be of great value in 
building vitality and strength. 

Clothing and Sunshine — Light colored clothing may generally be 
recommended as a means of permitting light to reach the skin. Gray 
and tan are excellent and serviceable colors for this reason. If engaged in 
farm work or otherwise too much exposed to the direct rays of the sun 
in the summer, some protection from the light may be desirable. Light 
colored fabrics are cool, but admit the light. Black or dark colored 
fabrics absorb the heat, but shut out the light. In a tropical climate or 
under the vertical rays of the sun, where protection from both light and 
heat are desired, one should wear black or dark underclothing to shut out 
the light, and white or light colored outside clothing to reflect the heat 
and keep cool. Hats should be white or light colored on top, with a dark 
lining. Arabs and others exposed to much sunshine wear white turbans 
and light colored clothing to keep cool. 

Friction Rubs. — -Supplementing air baths and sun baths, friction of 
the skin is of great value in promoting its functional activity. A coarse 
Turkish towel is excellent for this purpose, although soft brushes may be 
used. If the skin is tender and sensitive one may even use the palms of 
the hands. Five or ten minutes of this friction of the skin, briskly rub- 
bing every part of the body, will more than repay one through the im- 
proved texture of the skin itself and the healthful influence of this treat- 
ment upon the body in general. 



PHYSICAL CULTURE 



PART II. 
PHYSICAL DEVELOPMENT FOR WOMEN. 



Strength and Womanhood. — It is a mistake to suppose that bodily 
strength is a possession to be cultivated exclusively by the male sex. The 
burdens naturally placed upon womanhood are such that strength and 
vitality are, if anything, even more desirable for women than for men. 

Great muscular strength is not desired. But a certain degree of 
strength, concomitant with a natural and normal bodily development, is 
absolutely essential. The biological peculiarities of each sex are to be 
considered. Anthropological studies have shown that men are naturally 
better suited for exertions of a violent and strenuous character, but that 
in work or any form of activity requiring moderate exertion only, women 
on the average have better powers of endurance. It need not be said 
that women have more vitality, though there may be reason for thinking 
so, but it is undoubtedly true that they naturally have remarkable powers 
of endurance when at their best. They are not fitted muscularly for ex- 
tremes of heavy lifting, nor for hunting and war, and so it is only natural 
that exercise of that character and games which simulate these activities 
should be limited to men. But within the natural limits of a woman's 
strength exercise and development are fully as important as in the case 
of men, and activities that promote grace and elasticity rather than 
strength are particularly commended. 

Bodily Development. — Every woman desires a good carriage. Every 
woman desires a good figure. A normal bodily development, with its 
lines of strength and grace, indicates vitality and a conditon of physical 
wholesomeness. It is impossible to carry the body properly or to enjoy 
the possession of a go©d figure without a satisfactory muscular develop- 
ment. It is quite true that women naturally are supplied with slightly 

1667 
105 



1668 PHYSICAL CULTURE. 

more fatty tissue than men, but the real outlines of the body, neverthe- 
less, are determined by the fundamental muscular structure. Without it, 
the whole body lacks character. Fat, without an underlying muscular 
formation, means shapelessness. The beauty, contour and shapely lines 
of healthy womanhood are determined almost entirely by the muscular 
development. The external layer of fat simply serves to fill in and make 
smooth the various parts. 

Masculine or Feminine Outlines It has sometimes been suggested by 

uninformed and prejudiced writers that physical exercise tends to give 
a woman masculine outlines. This contention, however, is not borne out 
by the facts, inasmuch as the structure of a woman's body differs funda- 
mentally from that of a man. Xo amount of exercise, no matter how far 
she may carry her physical training, can possibly give a woman the an- 
gular, lumpy and conspicuous muscular outlines of the over-trained male 
athlete. Humorous writers have sometimes referred to professional 
"strong men" as giving the appearance of having a large number of 
tennis balls concealed under the skin. This type of physical develop- 
ment, however, cannot possibly be secured by women, inasmuch as their 
muscles partake of a long, smooth character, productive of softer outlines. 

Exercise for women, instead of making them masculine in appear- 
ance, only serves to accentuate their feminine qualities by reason of pro- 
moting better health. Their feminine attributes are more distinctly em- 
phasized. The greater the degree of physical development in each sex 
the more perfectly will the secondary sex characteristics of each be made 
manifest. The more vitality that each possesses the more perfectly will 
they be differentiated in these respects. 

The Right Kind of Exercise — To a large extent all considerations 
applying to exercise in general, and especially to exercise for corrective 
purposes, will apply very forcibly in the case of women. It is not strong 
arms and legs that are most desired. On the contrary, physical training 
for women should be chiefly directed to building up strength of the trunk 
of the body. Even more than men women need strong backs, good chests 
and particularly a strong and firm condition of the abdominal region. To 
a large extent, therefore, the exercises we are illustrating are of a type 
to bring about increased strength in the trunk of the body. Aside from 
these special exercises all activities that involve grace and suppleness are 
particularly commendable. 

Housework as a Form of Exercise. — Thousands of women are under 
the impression that they get plenty of exercise in the form of housework. 



BODY BUILDING FOE WOMEN. 1669 

Unfortunately, they are mistaken. Housework is not exercise. If it 
were, nearly all women would be models of physical perfection. House- 
work requires a certain amount of activity and by special study certain 
forms of housework can be employed as exercise by doing it energetically 
and by modifying ordinary movements in such a way as to stretch the 
body and improve the posture. As usually performed, however, house- 
work involves the use of only a limited number of muscles. Most of 
the activities in the home are of a nature to bend the back, cramp the 
chest, pull the shoulders forward and in other ways to operate against 
proper poise and the active use of the entire muscular system. 

The houseworker probably needs exercise of the right kind even 
more than any one else. Housework has a fatiguing effect upon the 
body but does not refresh and strengthen like exercise. Houseworkers 
need special movements for raising and expanding the chest, pulling the 
shoulders back, straightening the back, bringing the head back and up, 
and in other ways for strengthening and improving the trunk of the 
body as a whole. 

Poise and Carriage. — All that we have said in the section on "Phy- 
sical Culture and Body Building" and about the importance of correct 
posture applies with special emphasis in the case of women, not only for 
the sake of health but for the sake of personal attractiveness and good 
appearance. The elusive quality which we often term "style" is not a 
question of clothing but a question of bearing. It is entirely a question 
of proper carriage. A woman may be gowned in the most expensive 
fabrics, but if she does not carry herself like a queen she has no "style." 
On the other hand, a woman with a well developed body, full of vitality 
and energy, may wear the most economical and simple kind of a dress, 
and yet by her grace of carriage and physical poise will give the sug- 
gestion of "style." 

It is this quality that physical culture, and physical culture only, 
can develop in women. This quality may be the possession of every 
woman who will make the effort to perfect herself physically and to 
secure an upright carriage of the body. Posture alone may be insuffi- 
cient, inasmuch as one might stand erect, but stiffly. Style and good 
carriage involve not only an erect position, but a certain freedom and 
grace of movement that can only be secured by proper muscular co-ordin- 
ation, as developed through exercise. One must have control of her 
physical organism in such a way that every movement is free and easy. 
Active play during girlhood tends to give one this grace and muscular 



1670 PHYSICAL CULTURE. 

control. Dancing helps to develop it, but physical culture is the most 
valuable of all measures for improving one in this particular respect. 

Why Women Wear Corsets. — There is no question that the primary 
purpose of the corset was to supply in an artificial way the erect bearing 
which would naturally be the expression of vitality and a normal, vigor- 
ous bodily development. It may appear that many women at the present 
day wear the corset as a means of bodily support, and come to depend 
upon it for such support, but the corset when it was first worn was de- 
signed to make the figure more attractive. Even to-day many women 
continue to wear corsets because of the feeling that they would "look 
like a fright" without them. Considering their undeveloped physical 
condition it is quite true that they would be unattractive in their natural 
state. The corset tends to hold one erect, and the persistence with which 
corset wearing has been practiced throughout many centuries is largely 
the manifestation of the normal instinct of women to make themselves 
attractive and presentable. It is an attempt to supply by artificial means 
what should be supplied as a result of health and vigor. A prominent 
and protruding abdomen, largely as a result of improper carriage, and 
associated with drooping shoulders and a fiat-chested condition, is an 
intolerable outrage to the aesthetic sense of every healthy woman. The 
corset affords a way out of the difficulty. 

Are Corsets Unnecessary. — Books and articles without end have been 
written in denunciation of the corset. There is no question of the harm 
done in many cases through tight lacing and the wearing of improper 
corsets. It need not be said, however, that corsets are in all cases in- 
jurious if they are well designed and properly fitted. The great diffi- 
culty, however, is that women depend upon the corset for their "shape." 
Many of them feel that they have no shape at all without this contri- 
vance. Instead of being fitted to the corset, however, as is the case in 
most instances, the corset should be selected to fit the figure, and first of 
all every woman should have a figure of her own to which the corset 
should conform. Instead of being shapeless without her corset she should 
be shapely, and this is entirely a matter of physical development. 

The torso of a woman, like that of a man, is normally supplied 
with a muscular structure which, when properly developed, really pro- 
vides a natural corset for her. It is a corset of vigorous muscles which 
will keep her body firm and strong and beautiful. If these muscles are 
properly developed she will need no corset in order to give her shape. 
In present fashions in dress, and particularly in the wearing of separate 



BODY BUILDING FOR WOMEN. 1671 

waists and skirts, involving tight waist bands, something in the nature of 
a girdle or corset may be required for comfort and for proper adjustment 
of the clothing, but no one should be compelled to wear a corset just to 
"give her a figure." She should depend upon the natural corset of the 
muscles of her waist line and abdomen. If these muscles are weakened 
and allowed to degenerate with an accumulation of fatty tissue, and par- 
ticularly if the carriage of the body is faulty, then she will be truly 
shapeless and unpresentable without artificial support. 

A strong back and an erect posture, however, should by all means 
be cultivated by women. Erect posture will mean a full and well- 
rounded chest and a retracted abdomen. Furthermore, some of the exer- 
cises illustrated in this section will be of special value for strengthening 
the muscles in the region of the abdomen and waist line in the manner 
desired. 

Weaknesses of Women. — There is no question that the weak point 
in the case of many women is the pelvic region. The displacements of 
the female organs are the cause of great suffering and contribute to 
various nervous disturbances. A prolapsed or otherwise displaced con- 
dition of these organs is usually the result of a weakened condition of 
the ligaments involved and also of the adjacent muscles, organs and 
structures generally. By toning up and building strength in all these 
parts it is frequently a very simple matter to overcome difficulties of this 
type. Faulty carriage also has a great deal to do with weaknesses of this 
kind and should require special attention. All exercises, however, which 
tend to build strength of the external abdominal muscles will likewise 
favorably affect the pelvic organs, together with the digestive and other 
functional organs. Particularly commendable are those movements for 
strengthening the abdomen which may be practiced while lying down. 
In the case of prolapsed organs excessive exertion or muscular strain 
while standing may in some cases aggravate the trouble. 

As a special means of relief in the case of prolapsus of the female 
organs and also as a means of building strength, reclining exercises per- 
formed on an inclined plane with the hips and feet higher than the level 
of the head, will be advantageous. In this case the force of gravitation 
tends to restore these organs to their normal position. One may take a 
large ironing board, placing one end of it upon the side of the bed, the 
lower end on the floor, and while lying with the feet elevated upon this 
board she may execute simple exercises for the legs, raising them to 



1672 PHYSICAL CULTURE. 

tlie perpendicular, flexing the knees against the chest and devising other 
movements that will bring into play the abdominal muscles. 

A still more effective type of exercise as a means of relief in such 
conditons is one which we have illustrated, in which the body is raised 
to a practically upside down position. This can be executed while lying 
in bed. If you have a brass or iron bedstead, take hold of the rods at 
the head of the bed with your hands, raise the legs first to a perpen- 
dicular position, and then stretching them still further upward, raise the 
hips and back until the weight of the body is practically supported by the 
shoulders, and the torso as well as the legs are held for a few moments 
in an upside down position. Study the illustrations carefully. 

Apart from special exercises of this type the all-around building of 
strength and an improvement in the circulation, together with good pos- 
ture and freedom from the constriction of corsets or skirt-bands which 
compress the lower part of the body, will be very effective by way of 
avoiding and also remedying many of the tormenting weaknesses of 
women. 

Exercise for Constipation. — In connection with weaknesses of women 
the necessity for overcoming any tendencies toward constipation assumes 
special importance. All exercises that tend to strengthen the abdomen 
will be very effective in this direction, while brisk walking, rope skipping, 
dancing, tennis and active exercise generally, if one is strong enough, 
will be helpful. Deep abdominal massage, using a circular movement in 
the direction of the hands of a clock, will be valuable. In connection 
with such exercise and massage, dietetic measures will be necessary. One 
should drink freely of water and use plenty of fruit and green vegetables. 
White bread is the most common cause of constipation and should be 
avoided, together with cakes, cookies, crackers, crullers and white flour 
products generally. Instead, whole wheat bread or graham bread should 
be used. Bran is especially good, either used in muffins or mixed with 
one's cereal. All whole wheat or whole grain breakfast foods are satis- 
factory. Cheese, rice, tapioca, spaghetti and other starchy foods are 
likewise constipating and should be avoided. Fresh milk is sometimes 
conducive to constipation, and in a serious case it would be better to use 
buttermilk or fermented milk instead. 

By following these suggestions on diet strictly, together with suffi- 
cient exercise and water drinking, stubborn cases of constipation may 
usually be overcome without the help of cathartic treatment. In a 



BODY BUILDING FOE WOMEN. 1673 

serious case an enema will usually be found more satisfactory than a 
cathartic. 

Exercise During Pregnancy — If ever strength and health are desir- 
able in the case of a woman, it is in connection with the trials of ma- 
ternity. Physical weakness, under such circumstances, is responsible 
for much suffering and difficulty of recuperation. It is a well-known 
fact that the women of savage races experience very little of the weak- 
ness and difficulty in recuperating from childbirth that is prevalent in 
civilized communities. There is also some evidence that, to a certain 
extent, painlessness in childbirth may be enjoyed as a result of a normal, 
vigorous and healthy physical condition. If pain cannot be entirely 
avoided, at least in many cases it may be greatly lessened by proper 
physical preparation for maternity, in which the building of strength is 
an important factor. And in all cases exercise enables one to recuperate 
much more quickly and to avoid permanent weakening results. 

The prospective mother should, above all things, get plenty of sleep 
and outdoor air. The inclination to remain indoors during this period 
"for fear of being seen" is little short of criminal in its results, inasmuch 
as it bears upon the health and vitality of the unborn child, as well as 
impairing the health of the mother. Nutrition is a most important mat- 
ter at this time, and the lack of fresh air, by interfering with the appetite, 
is also indirectly detrimental in this way. 

Walking is one of the most valuable of all forms of exercise during 
this period because of its vitality building influence. It should be made 
the special duty of every prospective mother to take a long walk some 
time each day. 

Special exercises, however, are important for strengthening the 
abdominal walls and for promoting the health and vigor of all the bodily 
structure concerned. In these exercises the aim should be elasticity and 
suppleness rather than excessive strength. In other words, these exer- 
cises should not be carried so far as to produce an abnormal muscular 
development or a condition of muscular rigidity. It is best, accord- 
ingly, to employ active exercise of this type during the first three or 
four months of pregnancy, and thereafter to use less vigorous movements 
involving this part of the* body, but particularly to depend upon daily 
long walks. Motoring and other pastimes which take one out of doors 
are particularly suggested. In the latter months of pregnancy special 
care should be taken to avoid any strain. Stretching or bending exercises 



1674 PHYSICAL CULTURE. 

should then be taken with caution, and only to the point at which they 
are easy and comfortable to execute. 

Bust Development — The question of improving the bust is one of 
special interest in the case of large numbers of women. A normal bust 
development is invariably associated with a condition of vitality and 
perfect womanhood. In many cases a source of complaint is found in 
a lack of development and in other cases in excessive development, with 
the desire to reduce the bust. In either case, good results can usually 
be secured by physical culture methods. 

Exercises which involve the muscles of the upper chest have a decided 
effect in improving the firmness and contour of the breasts. It cannot be 
said that in all cases exercise will increase the size of the bust, but in all 
cases it will increase their firmness and beauty. Where there is a ten- 
dency to droop this firmness has everything to do with their character 
and contour. 

The increased size of the bust, where it is lacking or defective, must 
first of all depend upon improved nutrition and the development of 
vitality. The glandular structure depends upon the general health and 
active circulation, and to bring about an improvement in this respect all 
all possible measures that affect the general health must be considered. 
In many cases a general gain in health is necessary, requiring more sleep, 
better nutrition through appropriate foods, freedom from mental strain 
or worry, freedom from overwork and particularly as much outdoor life 
as possible. 

The bathing of the breast with cold water may be particularly 
suggested. Massage, under such conditions, is likewise valuable, but it 
should never take the form of pulling or stroking downward because this 
will tend to increase still further any sagging or drooping of the parts. 
Massage strokes should take an upward direction. 

It should be said that there is a widespread, popular misconception 
as to what should be the normal size of the bust. Under natural condi- 
tions and the most perfect health the bust should not be too large. It is 
only under conditions of maternity and approaching maternity that these 
glands are particularly enlarged. At other times they should be of only 
moderate size, and it is only under such conditions that the most per- 
fect contour can be maintained. When the breasts are too large it is 
almost impossible to prevent their drooping or hanging. A study of 
works of art, both antique and modern will show one very quickly that 
the perfect bust is not excessive in size. 




, 



General Exercises for Women, i. Sitting on the floor, stretch the fingers 
forward to the toes, or farther, if possible, repeating several times. 2. Lying on 
the back, bring the legs to the perpendicular position shown, then down to the 
floor, and repeat until slightly tired. 3. First standing erect with arms at sides. 
bend the knees and lower the body to the squatting position shown, at the same 
time swinging the arms high above the head. Lower the arms when rising. 
4. Bend and stretch backward as well as you can for a moment, rest and then 
repeat. This is a superb exercise for back, chest, stomach and abdomen. 

© E. J. S. 



* 






Exercises for Grace and Agility., i. With hands on hips, jump to the posi- 
tion shown, with feet wide apart. Next, change positions of the feet with a 
little jump, bringing the left foot forward. Also, in this position, twist or turn 
the body first to one side then to the other. 2. Standing first with feet together, 
jump to the charging position, with arms outstretched. Return and charge in 
the same way with the other foot forward. These exercises should be executed 
on the toes. An exercise for chest and bust is shown in 3 and 4. With the arms 
outstretched at sides, and well back, bring them forward and cross in front of the 
chest as far as possible. Swing back and repeat. 

© E. J. S. 




f 





An exercise for the bust shown in i and 2. Reclining, and with some small 
weights in the hands, stretch the arms up and back. Then bring them downward 
and cross them over the chest as shown in 2. 3. An exercise for the abdomen. 
Lying on back, rise to sitting position. This will be easier if arms are folded in 
front. If necessary use a weight to hold the feet down, or thrust them under 
some piece of furniture. 4. An exercise for the back, raising the hips as high as 
possible in the position shown. Another simple exercise, of special value to 
female weaknesses, is to raise the hips high with the weight on the shoulders 
instead of on the elbows. 

(C) E. T. S. 




I. Doubling one knee hard against the body, alternating with each leg. An 
excellent exercise for remedying constipation. 2. An exercise for the back. Sit 
on the floor, place hands on the floor a little ways back, and then raise the hips, 
as illustrated, until the body occupies a straight line. 3. An exercise for develop- 
ing and improving the hips. Assume a position on hands and feet, then raise 
one leg at a time as high as possible. Try to raise the leg a little higher each 
time, and repeat a number of times with each leg. 



E. T S. 




Some bed exercises especially suited to w 
i. By taking hold of the bedposts in this way 
cuted, A good preliminary position. Resting 
give relief for prolapsed organs. 2. Raise the 
both hands, and pull yourself up to a sitting p 
the abdominal muscles than when rising to a s 
legs. Alternate legs. 3. A twisting exercise 
back, swing the left leg far over to the right 
other leg. 



omen, and helpful in weaknesses of women. 

all leg movements can be more perfectly exe- 

with the foot of the bed or couch raised will 

head and shoulders by clasping the knee with 

osition. In this way there is less strain upon 

itting position with such help from arms and 

for the abdomen and trunk. Lying on the 

side, stretching as shown. Same with the 



E. J. S. 





An effective exercise for relief in falling of the womb or other female weak- 
ness, i. First lying on the back, raise the legs to the position shown. Then, 
pushing upward, raise the hips and finally the back, finally stretching upward to 
the position shown in figure 2, with the weight on the shoulders. Hold this for 
a few moments, return, and repeat two or three times. In the case of fallen 
organs, this exercise causes them to return to their normal position through the 
simple force of gravitation. 



© K. J- S. 



BODY BUILDING FOR WOMEN. 1675 

Apart from exercises for the muscles of the chest, the appearance 
of the bust depends very large upon proper carriage and the develop- 
ment of the chest. A good bust is impossible in connection with a flat- 
chested condition. If the chest is round, full and well developed, and 
the carriage erect in such a way that the chest is properly raised, a bust 
of moderate size will assume its true proportions of harmonious outline 
and symmetry. One cannot, therefore, pay too much attention to im- 
proving the conditon of the chest as a whole. 

The reduction of the bust when too large is a much more difficult 
matter in many cases, and if one is over-weight it will be necessary to 
employ special reducing methods for the entire body. Massage is espe- 
cially advantageous for bust reduction, and kneading with a circular 
movement is to be suggested. The exercises already mentioned for bring- 
ing into play the muscles of the upper chest are of even more importance, 
if anything, as a means of removing the superfluous fat. These should 
be practiced at least two or three times each day. The bathing of the 
parts with cold water is likewise especially valuable for improving the 
circulation, oxidizing the adipose tissue and for improving their firm- 
ness. 

The Thin Woman — It is not generally recognized that a lack of 
flesh upon the part of women is to a large extent the result of a lack of 
physical development. It is quite true that it frequently means poor 
nutrition and a lack of vitality, but nutrition is improved in part by 
exercise and the better appetite that comes with exercise and open-air life. 

At the same time, a thin arm means an undeveloped arm. A body 
not properly filled out means one lacking in general muscular develop- 
ment. A thin woman, often of a nervous temperament, cannot afford to 
waste her energy in an excess of exercise, but she should persistently 
and systematically exercise every part of the body by a little really ener- 
getic exercise each day. By using each and every muscle only a little 
bit, but with sufficient effort to prove to Nature the need of greater 
strength, Nature will respond by building strength and developing the 
muscles. As a woman builds up her muscular structures she will enjoy 
improved functional tone and her flesh will be rounded out in the man- 
ner that is natural to her when in good health. Physical stagnation is 
just as detrimental to a woman as to a man. 

Recreational Exercises — It is true that outdoor recreations cannot 
take the place of systematic movements in improving the body, but they 



1676 PHYSICAL CULTURE. 

have a marked constitutional effect and are also helpful in the case of 
women for developing grace, agility and muscular control. 

Dancing is a form of activity particularly well suited to the physical 
requirements of women. Although not necessarily an outdoor exercise, 
it is hest practiced in an open-air pavilion. The ordinary social dances 
are valuable, though to a less extent than folk-dances and fancy dances 
of various kinds. Toe dancing alone is somewhat artificial and unna- 
tural, although even that is not really harmful in any way, and would 
be helpful. 

Tennis is well suited to women and many of them become fully as 
expert as the best male players. It is an active game, but without any 
special strain for those in condition to play it. Rope-skipping may be 
made very interesting with a study of fancy steps, and is valuable for 
women, although where there is prolapsus of the pelvic organs one should 
strengthen these parts before attempting rope-skipping. 

Swimming is an ideal exercise for women inasmuch as it is particu- 
larly well suited to their bodily structure. Fencing is another active and 
enjoyable competitive exercise, conducive to grace and muscular control. 
Other games and sports may be recommended for those to whom they 
naturally appeal. 

For Women Who Worry. — Worry may often be overcome by relaxa- 
tion exercises or some active and stimulating form of exercise, such as 
tennis, rope-skipping, running or dancing. Such activity will take one 
out of the mental rut of her worry, By overcoming physical depres- 
sion one also overcomes the mental depression associated with it. By 
arousing an active circulation and stimulating all the bodily forces, one 
takes an entirely different view of things. By promoting deep breathing 
and by thus changing the blue blood into red blood the "blues' ' will na- 
turally fade away. There is no other possible means of overcoming 
worry that is so effective as stimulating exercise, although where there 
is any liver trouble, dyspepsia or constipation as a fundamental cause of 
this mental condition, proper attention should be given to these disorders. 

Relaxation Exercises. — For nervous persons generally and especially 
for women of nervous temperament, relaxation exercises are of great 
value. They enable one to overcome that condition of nervous tension 
which is, in many cases, such a waste of vitality. Learn to relax. One 
may train herself to "let go" of the tense muscles, and in that way relax 
the nerves. We have voluntary control of our muscles and through their 
use we may, to a large extent, control our nerves and mental states. 



BODY BUILDING FOE WOMEX. 1677 

The most convenient relaxing exercises are those performed lying on 
a soft bed, with a good spring. Eaise one foot at a time ten or twelve 
inches, hold it for a moment and then relax, letting it drop absolutely 
limp upon the bed. Eepeat several times. Then try it with both legs 
together. With the arms at the sides raise them a few inches and let 
them drop seemingly lifeless. Raise the head and shoulders two or three 
inches and then let them drop back relaxed. Xext with the weight on 
the shoulders and feet raise the hips and back three or four inches from 
the bed, hold the position for a moment and then let the body drop limp 
upon the bed. It may bounce if properly relaxed. By frequent repeti- 
tions you will readily learn to relax the muscles voluntarily, and by 
overcoming the tightness or muscular tension you will at the same time 
relax the nerves. Those who have difficulty in going to sleep should 
practice these relaxing exercises on going to bed each night. 

Similar relaxation movements can be performed while standing by 
raising one arm or one leg at a time and then letting it drop limp, swing- 
ing loosely at the side. Another excellent movement is to let the head 
suddenly drop limp upon the chest, with arms swinging loosely. For 
another, hold the arms extended in front, hands hanging limp from the 
wrists, and then shake the hands loosely. 

Cold Baths for Women. — The effect of cold bathing in the case of 
women is exactly the same as in the case of men, and what we have said 
in the section on physical culture in regard to bathing, air baths, sun 
baths and friction rubbing will likewise apply to women, although in the 
matter of cold bathing women of limited strength should be especially 
careful. It is, of course, advisable to avoid cold bathing during the 
monthly periods, and to be careful about exercise at such times unless 
very strong. 

Clothing. — The dress of women has sucn an important influence 
upon physical activity and health that a word on the subject is neces- 
sary. We have already referred to the influence of the corset, though 
it should be said that when avoiding a corset the wearing of tight skirt- 
bands and the weight of heavy skirts may be even more serious. Any 
form of clothing which permits free bodily movement may be suggested, 
and princess gowns, house dresses and other forms of apparel which are 
supported from the shoulders should be much used on general principles. 
Hose supporters, if possible, should be suspended from the shoulders 
rather than from the waist. Skirts should be as light as possible, fairly 
full and fairly short so as to give the greatest freedom in walking. 



1678 PHYSICAL CULTURE. 

A gymnasium suit, being naturally intended to provide for the 
greatest freedom of movement, would likewise be especially valuable for 
purposes of housework in the privacy of the home. Such a plan is to 
be highly recommended and would undoubtedly mean improved health 
and a more perfect bodily development. 

Probably the greatest offense against the body in modern clothing 
is found in our conventional foot-gear, especially that of women. The 
only perfect foot covering would be a moccasin or sandal, that gives the 
muscles of the human foot the same freedom that it enjoys when bare. 
Going barefooted will cure most foot troubles. Sandals are also sug- 
gested for this purpose. Shoes, as nearly as possible, should approach 
the outlines of the human foot. There should be plenty of room for the 
toes, and the big toe should occupy a position following the straight in- 
side line of the foot. Shoes should fit snug around the instep or shank, 
but with room to double the toes inside of the shoe. Square-toed shoes 
are not necessary if the straight inside line is followed and there is 
plenty of room for the toes. • The ordinary pointed shoe, however, is built 
on very bad lines. 

The addition of an artificial heel to the shoe is undoubtedly one 
of the greatest crimes of the shoemaker. ISTature would have supplied us 
with a natural high heel if it were desirable. The high heel places a 
strain upon the entire foot, and by throwing the body out of balance it 
places a strain upon the spine, and to some extent upon the pelvic organs. 
High heels are a common source of nervous disturbance. The flat heels 
found in tennis shoes and in the so-called "spring-heeled" shoes of school 
children are to be recommended. 

Extremes of Dress Reform — For sensible attire extremes in dress 
reform are not necessary if only the comfort and freedom of the body 
are permitted in the clothing worn. It is not desirable for women to 
adopt the dress of men. It is perfectly natural that the clothing of the 
two sexes should be absolutely distinctive. Soft, clinging fabrics are 
especially suited to the feminine nature and bodily requirements, while 
strong, firm fabrics and more severe or formal outlines are suited to the 
masculine nature and bodily conformation. The secondary sex charac- 
teristics of men and women are so distinctive that it is only natural 
that the clothing of the two sexes should harmonize with these differences. 
Masculine attire for women, therefore, has no sound basis, but sensible 
and comfortable dress is a matter that directly- affects the health of 
everyone. 



PHYSICAL CULTURE 



PAET III. 
PHYSICAL TRAINING FOR CHILDREN. 



Strength in Childhood — All mothers and fathers wish their children 
to be strong and health y. Many youngsters are naturally so. It is partly 
a question of being born with a vigorous constitution, and this depends 
largely upon the health and vitality of the parents. 

But only taking into consideration the children after they are 
here, and especially those who are born not exceptionally rugged, is it 
possible to improve their physical make-up? Can vital resistance, red- 
blooded health and all-around strength be cultivated in the infant and 
the child ? Assuredly. The child with a naturally strong constitution 
undoubtedly has an advantage over those less favored by nature, but by 
proper methods the latter may also attain a satisfactory degree of strength 
and health. 

To a large extent the physical improvement of children is a matter 
of proper food, fresh air, sufficient sleep, appropriate clothing and other 
factors tending to build vitality and promote health. Not one of these 
can be ignored. Probably the first in importance is the question of 
nutrition, and without doubt the greatest of all mistakes are to be noted 
in this quarter. But there are also mistakes enough in connection with 
these other requirements to prevent the satisfactory growth and develop- 
ment of many children. 

Children need all the sleep they can get. Up to five years of age, 
if possible, they should sleep two or three hours each afternoon. They 
need almost continuous fresh air. They should practically live out of 
doors the year round. Their diet should be plain, wholesome and nour- 
ishing, with an abundance of milk, with no food allowed between meals 
to spoil the appetite, and especially with no cheap candy to overtax the 

1679 



1680 PHYSICAL CULTURE. 

liver, spoil the teeth and interfere generally with good nutrition. All 
these influences are of the greatest importance, but in this particular 
place we are concerned chiefly with the strengthening of the children 
through play and exercise. 

Play Versus Exercise — Most children, if unhampered by the artificial 
restrictions of civilized life, would secure sufficient exercise from the 
spontaneous activity of play. Play is the one great and universal means 
of strength building and education. Young animals educate themselves 
through play. In the hivman race play serves as a means of both phy- 
sical and mental education. The child first develops its mind through 
the use of its muscles. Continuous activity is the one invariable char- 
acteristic of all healthy children, and it may also be said that under 
many conditions play is the very best form of physical training. At 
least this is true of those children who are naturally strong and energetic. 

But play has certain limitations where bodily defects of any kind 
are concerned and where the children are inclined to be frail. . Under 
such conditions, special attention will be required. Systematic and 
persistent exercises directly affecting the weakened parts will bring about 
a condition of symmetry and harmonious strength, and this result can 
be gained in no other way. 

Outdoor Play — We may say that those children who are so full of 
energy that they are constantly on the move and simply cannot keep still, 
will usually need no special attention in the way of physical culture. 
You cannot do better than to turn them outdoors into a nice, grassy 
yard, where they will have full freedom to wrestle and run, to push and 
pull, to roll and romp and play all kinds of games that may appeal to 
them. Depend upon it, such children will take care of themselves in 
the matter of strength and healthy growth. All they need is good food, 
plenty of sleep, outdoor play-space and such clothing as will not interfere 
with their bodily activities in any way. 

It is important that girls should be sensibly dressed so that they can 
play absolutely the same type of games as the boys. Dainty and pretty 
clothing will do very well for Sunday, but for the play hours the cloth- 
ing of girls as well as of boys should be serviceable in color, texture and 
construction. Little girls, by way of underclothing, should wear bloom- 
ers which will give them full freedom to climb trees, if desired, or to 
run, wrestle and romp as much as they choose. 

The confinement of city life is almost a crime against childhood. 
If possible, children should be raised in the country. Even the best ven- 



BODY BUILDING FOB CHILDBEN. 1681 

tilation cannot make indoor rooms as satisfactory as the open air. The 
outdoor world and the sunshine are absolutely essential. A nursery or 
play-room in the house may be advantageous in extraordinarily stormy 
weather, but in the case of ordinary snow and rain the children should 
be provided with suitable clothing and be allowed to stay out of doors. 
When raining they may wear appropriate rubber coats, rubber boots and 
helmets such as will permit them to run around out in the open just the 
same as in clear weather. They may enjoy it even more. 

If the little folks must play indoors in the winter-time, then give 
them a room well provided with windows, open the windows wide and 
let them put on their sweaters, overcoats, gaiters, mittens and caps so 
that they will be provided for the cold air just about the same as if out 
of doors. Every nursery and playroom should be as nearly as possible 
an outdoor playroom, so that the children will have good health, good 
appetites and beautiful rosy cheeks. Much emphasis is here placed on 
this particular question of fresh air because it is, if anything, even more 
important than any method of exercise. Furthermore, fresh air is so 
conducive to energy that the children will naturally turn to active play. 
And the more noise they make, the better. It indicates a healthy, nor- 
mal childhood. 

But if open air life is of such value in the case of rugged and vigor- 
ous children, it is even more important where delicate children are con- 
cerned. The latter should not be sent to school too early but should be 
kept out of doors and, if possible, arrangements should be made on any 
convenient porch, balcony or roof, or possibly in a tent, for outdoor 
sleeping. 

What Children Need Exercise? — The children who particularly re- 
quire physical training are those who are thin, pale and generally deli- 
cate. The child who plays only with blocks and picture cards, who pre- 
fers to sit on a rug rather than to run about, who never makes any noise 
and whom his parents regard as a very, very "good" little boy, will need 
special attention. Those who are always running, wrestling and fight- 
ing will get along well enough, but the quiet child and especially the 
nervous child should be encouraged in the direction of active play and 
in all forms of outdoor life. He should not be exhausted by a too 
strenuous program, but he should be given enough exercise to make him 
muscularly tired, to make him sleep better, to improve his appetite and 
in that way to bring about a revolutionary change for the better in his 
entire physical make-up. 



1682 PHYSICAL CULTURE. 

Children who are of an excitable nature or who suffer from hys- 
terical tendencies should be discouraged in mental pastimes and kept out 
of doors. Having a mental temperament, these children usually learn 
very quickly at school and one can afford to let them start their school 
life later than the average child. Give them a chance to build up a 
vigorous physique. 

Those having weak eyes or eye defects should be discouraged in 
pastimes involving eye strain, such as playing with pictures and books. 
The eyes of young children are really suited to fairly large objects at a 
little distance. They should have large balls to play with, shovels, dig- 
ging implements and other things that do not call for close concentra- 
tion of sight. In fact, this is true of all children. Kindergarten work, 
because frequently trying on the eyes, is of doubtful value. All such 
children should have their eyes thoroughly and carefully examined, and 
when necessary glasses should be used to remove any eye strain until 
the eyes become stronger. The eyes invariably improve with better 
general health. 

Adenoids are usually developed from a lack of outdoor air and 
active play. When once established they should be removed as soon as 
discovered, but they may be prevented just as swollen tonsils may fre- 
quently be prevented by open air activity. Mouth breathing should be 
avoided. Defective hearing is often catarrhal in origin, and the build- 
ing up of the general health will usually mean an improvement in the 
hearing. 

Corrective Exercise. — Bodily defects can usually be remedied far 
more successfully in childhood than in later life by special and systematic 
exercise. All gymnastic work is somewhat corrective in character, though 
to get the best results this work should be individualized, depending upon 
the personal requirements of each child. For round shoulders, spinal 
curvature and conditions in which one shoulder is lower than the other, 
stretching and body bending exercises are effective. Stretching the 
arms high above the head, swinging by the hands from a horizontal bar 
and twisting the body at the waist should be diligently practiced. If one 
shoulder is lower than the other, that shoulder should be stretched up- 
ward repeatedly. Let the child place a pencil mark on the wall as high 
as he can reach. Let him each day strive to stretch still higher to beat 
his previous mark. Wrestling and all physical exercises for the back 
will likewise tend to improve this condition. Bodily posture, both stand- 
ing and sitting, is most important. The erect position can best be secured 



BODY BUILDING FOE. CHILDREN. 1683 

by stretching the arms high, also by bringing the arms back, thus pulling 
the shoulders backward. This exercise will likewise raise and expand 
the chest, overcoming any flat-chested tendency. 

Where the abdominal muscles are weak, and especially where there 
is constipation and digestive weakness, bending exercises and those which 
double the legs against the body will be useful. Let the child lie on his 
back, hold his feet steady, and then let him raise himself to a sitting 
position without the use of his hands. Also, while hanging by the hands, 
let him raise the legs to a horizontal position. 

In any tendency to bow-legs or knock-knees all strengthening exer- 
cises for the legs will be useful, particularly deep-knee-bending, or squat- 
ting and rising. Mechanical pressure or rubbing, either outside or in- 
side the knee, as required, may have some effect in childhood, although 
these defects cannot be altered at or after maturity. Good food has much 
to do with it, and milk should be used freely. 

For weak ankles or flat-foot there is nothing like going barefoot. 
If a child seems to favor one leg — that is, stand mostly on the other foot — 
he may have some weakness in this direction. Sandals and moccasins 
are just about as good as going barefoot, but all possible exercise for the 
legs and feet should be encouraged to strengthen the weakened parts. 
Skating, dancing, rope-skipping and running are very effective if one can 
practice them. Foot exercises, such as rising high on the toes and on 
the heels, bending the feet inwards and outwards and also circular move- 
ments of the feet are remediable in such cases. 

In the same way weak hands and wrists may be strengthened by ex- 
ercises with a broomstick, using especially a competitive game in which 
two children try to pull or twist the stick away from each other. 

A thin neck usually goes with an undeveloped and delicate condi- 
tion of body generally, and all kinds of development exercises are neces- 
sary together with special movements for the neck itself. The latter 
should consist of bending the head far backward and forward and far to 
each side, as well as twisting or turning the head. By way of advanced 
exercises, after some strength is developed, the weight of the body should 
be partly supported by the head while lying on the back and also in a 
position face downward. In the latter exercise first get down on hands 
and knees, place the head on the floor, then lift the hands and if possible 
the knees. A good strong neck is always associated with a condition of 
vitality. 

How Much Exercise. — There should be no forcing of the child's 
106 



1684 PHYSICAL CULTURE. 

growth and no excess in exercise. Do not strive for feats of strength or 
to make a circus performer of the youngster. Such "stunts" as throwing 
the child high in the air, tossing him up for somersaults and dangerous 
feats of any kind should be avoided. Exercise should be intended merely 
for a normal development and healthy growth. Beyond this, training is 
not advisable. When the child shows the least lack of pleasure in the 
exercise it is probably time to quit. 

How Children Should Exercise — So far as possible, even systematic 
or special training should take the form of play. It should be made 
pleasurable, and if the parent will take an interest so as to make it as 
much "fun" as possible there will be no difficulty in keeping the child's 
interest. A great many exercises can be employed in the form of stunts 
or tricks, and where there are several children they can compete with 
each other in doing them. Who can stretch the higher ? Who can make 
a better backward bend \ Who can balance longest on one foot in certain 
stretching feats % Who can expand his chest the most % Who can raise 
his back the highest when lying on his back with the weight of the body 
on the feet and head ? The competitive or play spirit in all such exer- 
cises will help greatly. 

Competitive Games. — There is a great variety of competitive games 
and exercises that may be especially suggested for all-around develop- 
ment. Hand wrestling is ideal for children. Taking a firm position, 
with feet well apart, let them "shake hands" with the right hand and 
then see who can pull, push or jerk the other out of balance so as to make 
him move his feet or touch the floor with his other hand or any part of 
the body. This is splendid exercise. After fixe "falls" change off to 
the left hand. Ordinary wrestling is a superb exercise for boys if prac- 
ticed on the grass. It will be advantageous, however, to study wrestling 
holds. There is a simple "tug-of-war," in which two children, taking 
hold of the same broomstick and sitting down with the feet braced 
against each other, try to pull each other over. Let the two take hold 
of a broomstick high above the head and bring it downward between 
them, each one trying to twist the stick in the hands of the other. This 
requires and develops a tight grip. There is a great variety of exercises 
of this type, all appealing to the mind of a child and all valuable. If 
gymnastic apparatus is available it will be a great help, but it should 
not be taken seriously. The children should not strive to make records 
or to do difficult feats. They should simply "play" on the apparatus so 




Children will find an ordinary chair a satisfactory piece of exercise apparatus. 
I. Using a chair for a regular exercise drill. 2. A good "stunt" for boys, per- 
formed on the backs of two chairs. 3. Combination balancing and stretching ex- 
ercises are splendid for girls, developing grace and muscular control. This is a 
good example. 4. Another balancing exercise of great value, to be performed on 
each foot alternately. 



E. T. S. 




" 




i 








Competitive games and exercises particularly appeal to children, and should 
be encouraged, i. "Rooster fight." With arms folded, and hopping on one foot, 
each tries to "bump" the other over, or make him put down the other foot. 2. A 
typical wrestling hold. Wrestling is an ideal exercise for naturally rugged chil- 
dren. 3. Testing the grip. Let each grip the broomstick tightly, and then try to 
make it turn in the other's hands as it is brought down between them. 4. Hand 
wrestling is a clean and delightful sport. Taking this position, each boys tries 
to pull, push or jerk the other off his balance. To move either foot or touch the 
floor means a fall. 

©E. J. S. 



BODY BUILDING FOB CHILDREN. 1685 

as to get the most fun. For girls, folk-dancing is especially suited. 
Simple balancing exercises will give grace, poise and bodily control. 

Children are not suited to endurance work. Their exercise should 
be active in character, but not long continued. There should be a variety 
in their exercise. This is one reason why baseball is a splendid game for 
boys old enough to play it. 

The Slender Child. — Slenderness in itself does not indicate a lack 
of vigor. Children, like adults, are of various types. Some are naturally 
more short and stocky, while others are taller with light bones. The frail 
child is thin from lack of development, but the naturally slender child 
may be only light-boned, and may really be in perfect health, with good 
color and remarkable strength and vitality for his weight. Such a 
child is usually a good runner and very active, but when the slender 
child is pale and inactive, with a thin neck, drooping head, round 
shoulders, a flat chest and pouchy abdomen, he needs a rigid course of 
physical training 

From the age of twelve to sixteen or seventeen some children are 
slender because of growing tall very fast. Their vitality is often expended 
in this rapid growth and they may not have the stamina of boys and girls 
who have grown more slowly and who have filled out more during the 
process. These apparently "over-grown" young people will fill out later 
if in good health, but they should not attempt to compete in athletic games 
with others of their height simply because they are tall. They cannot be 
expected to have the same endurance. Athletic work for all young people 
during the period from boyhood or girlhood to manhood and womanhood 
should be carefully supervised. Athletics are undoubtedly of great value ; 
but in occasional instances may be carried too far if not closely looked 
after. Athletic directors are supposed to look after this, but it should be 
the duty of every parent to take a personal interest in the matter. 

Exercise for Babies.-A healthy baby, as a rule, requires no special 
exercise. What he needs most of all is sufficient freedom in his clothing to 
allow him to kick and use his arms. Babies should not be bundled too 
much. An air bath once each day in a warm room will be of great value. 
This may precede the daily bath. Place the baby on a heavy quilt on 
the floor and let him kick, roll and wiggle. In this way he will gain the 
strength that will enable him to creep when he gets ready for it. 

Passive exercises may be given the baby by moving his arms and 
legs in a manner suggested by ordinary calisthenic work. Such move- 
ments will stretch his little body, expand his chest and improve his 



1686 PHYSICAL CULTURE. 

circulation. Take the little arms, raise them above the head, then down, 
draw them out to the side and then back. Double the knees up against 
the chest, then straighten them. Put the child through a variety of other 
movements. Let him take hold of your fingers and then partially lift 
him. You will soon find that he can sustain his entire weight by his 
grip. Massage will be especially valuable, kneading the arms and legs 
lightly but thoroughly, and especially massaging or rubbing the back, 
chest and abdomen. A quick, circling movement is especially suggested 
for massage of the back, chest and stomach. This massage, if used, may 
follow any exercise given and precede the bath. When the baby learns 
to creep or hitch this will mean a great deal of exercise. He should not 
be forced or urged to walk until he does it of his own accord. 



BOOK XVIII 

Is a treatise on Full or Complete Breathing as 
practiced by the Hindu Yogis, together with a series 
of Remedial Exercises designed to correct bodily 
infirmities. 



Breath, Cleansing 1696 

Nerve Vitalizing 1696 

Retained 1697 

Science of 1689 

Vocal 1697 

Breathing, Full or Complete 1693 

High 1692 

Low 1693 

Mid 1693 

Mouth 1691 

Nose 1691 

Rhythmic 1699 

Chest Expansion 1698 

Circulation, Stimulation of 1699 

Cleansing Breath 1696 

Complete Breathing 1693 

Exercises in 1701 

and Weak Lungs 1702 

Douche, Nasal 1692 

Exercises in Complete Breathing 1701 

Morning 1699 

Walking 1698 

Full Breathing 1693 

High Breathing 1692 

Low Breathing 1693 

Lung Cell 'Stimulation 1697 

Mid Breathing 1693 

Morning Breathing Exercise 1699 

Mouth-breathing 1691 

Nasal Douche 1692 

Nerve Vitalizing Breath 1696 

Nose-breathing 1691 

Respiratory System 1689 



Retained Breath 1697 

Rhythmic Breathing 1699 

Rib Stretching 1698 

Science of Breath 1689 

Stimulation of Circulation 1699 

of Lung Cells 1697 

Vocal Breath 1697 

Walking Exercise 1698 

Weak Lungs and Complete 

Breathing 1702 

ILLUSTRATIONS 

Cleansing Breath 1696 

Correct Position for Complete 

Breathing 1696 

Filling Upper Lobe of Right Lung. . .1696 
Nerve Vitalizing Breath 1696 

REMEDIAL EXERCISES 

Abdominal Organs, Exercise for 1704 

Asthma, Exercise for 1705 

Bronchitis, Exercise for 1705 

Catarrhal Conditions, Exercise for.. 1705 

Exercise for Abdominal Organs 1704 

Asthma 1705 

Bronchitis 1705 

Catarrhal Conditions 1705 

Hay Fever 1705 

Ovaries 1704 

Prolapsed Organs 1705 

Hay Fever, Exercise for 1705 

Ovaries, Exercise for 1704 

Prolapsed Organs, Exercise for 1705 



1687 



Book XVIII 



THE SCIENCE OF BREATH 



THE RESPIRATORY SYSTEM. 

It is an axiom that "breath is life." It may likewise be said that the 
manner of breathing vitally affects the length of life, yet few people 
appreciate the significance of this fact. 

Breathing is dependent npon the organs of respiration — that is to 
say, upon the lungs and the air passages leading to them. There are two 
lungs, separated from each other by the heart, the large blood-vessels and 
the large air tubes, each being connected with the heart by arteries and 
veins. The lungs themselves are porous and spongy, their tissues having 
great elasticity. They are covered by a sac or thin double wall, known 
as the pleura, one side of which is attached to the lungs and the other to 
the inner walls of the chest. The pleura secretes a fluid which acts as 
a lubricant to the inner surfaces involved, and enables them to glide upon 
each other without friction in their respective movements in breathing. 
The pharynx, larynx and the windpipe or trachea, together with the 
bronchial tubes, form the air passages to the lungs. Nature intends that 
we should draw air into and expel it from the lungs through these pas- 
sages and has provided the nose as the medium of passage. These are pro- 
visions of nature, yet a considerable percentage of humanity breathes 
chiefly through the mouth. In breathing air through the nose the tem- 
perature is properly regulated by mucous membranes especially adapted 
to the purpose. In breathing through the mouth this design of nature is 
frustrated. In breathing through the nose not only is the air modulated 
to the temperature which the lungs require, but it is freed of germs 
detrimental to the lungs. In breathing through the mouth a false medium 
is employed and the air passes into the lungs without divestment of 
germs which the nose channel would have thrown off. 

1689 



1690 THE SCIENCE OF BREATH. 

Air is drawn into and expelled from the lungs by action of the 
diaphragm, a strong, flat, sheet-like muscle lying across the chest and 
separating the chest-box from the abdomen. When the diaphragm ex- 
pands the elastic lung tissues are correspondingly stretched and the lung 
cavities thereby enlarged, creating a vacuum, into which air from without 
is drawn ; when the diaphragm relaxes the air is expelled. This action of 
the diaphragm is almost as automatic as that of the heart, but unlike heart- 
action it may to a very considerable extent be controlled by will-power. 

In a consideration of breathing it is necessary to have in mind the 
manner of the circulation of the blood. By the heart's action the blood 
is forced through the arteries and capillaries to all parts of the body and 
then returns to the heart through the veins, which are reached by capil- 
laries throughout the body. After regeneration by medium of the capil- 
laries of the lungs, the blood, in a red, rich condition having life-giving 
properties, passes through the left auricle into the left ventricle, and thence 
through the arteries and capillaries, distributing its life-giving properties 
to the body as it goes, but as it returns through the veins it picks up the 
waste materials of the system and reaches the right auricle of the heart, 
blue in color and robbed of its life. As this auricle becomes filled it con- 
tracts and drives the blood through an opening into the right ventricle of 
the heart, from whence it is forced into the lungs and distributed by mil- 
lions of hair-like blood-vessels to the air cells of the lungs. The texture of 
these blood-vessels of the lungs is sufficiently dense to prevent any outlet of 
blood, yet porous enough to permit the passage of oxygen which has reached 
the lungs in breathing, and this oxygen if received in sufficient quantity 
drives out the impurities, and the re-oxygenized blood passes from the 
blood-vessels of the lungs through the left auricle of the heart to the heart's 
left ventricle, from whence it is again forced through the arteries. When it 
is remembered that in the ordinary man approximately 35,000 pints of 
blood pass through the capillaries of the lungs each twenty-four hours, it 
will be evident that unless fresh air reaches the lungs in sufficient quantity 
the poisoned blood cannot be fully purified and waste products which 
should have been eliminated must return to and poison the system. When 
properly oxygenized by fresh air not only is the poison in the. blood 
eliminated, but the newly-charged blood carries some twenty-five per cent, 
of free oxygen which in its arterial course it distributes to all the cells, 
tissues, muscles and organs of the body, even the lungs themselves. In- 
sufficient oxygen means imperfect elimination of poisonous matter and 
consequently poor nutrition and ill health. 



THE SCIENCE OF BREATH. 



1691 



For proper re-oxygenation of the blood as it passes through the blood- 
vessels of the lungs it is not sufficient for the air to merely reach certain 
of the air-tubes of the lungs, but that it should reach every part of all 
the air cells, and this cannot be accomplished unless the manner of 
breathing through the nose and so regulating the action of the diaphragm 
that it will produce the requisite inhalations and exhalation of the lungs, 
and this action of the diaphragm can be regulated by the will in the same 
manner that an arm may be raised or a foot extended. This means full or 
complete breathing and implies more than is commonly meant by deep 
breathing. In shallow breathing only a portion of the lung cells are 
reached, the blood is correspondingly imperfectly oxygenized and the 
whole system suffers in proportion to the under-oxygenation. 

Reverting to the nose and mouth as mediums of breathing, man's 
mechanism is so constructed that he may breathe through either, but nose- 
breathing properly exercised brings health and strength, while mouth- 
breathing cannot but result in weakness and disease. Many diseases to 
which man is subject can undoubtedly be attributed to the ill, but common 
habit of mouth-breathing. Every mother should carefully watch her 
infant, close its lips and bring about the habit of proper breathing. When 
the child seems inclined to breathe through the mouth, the error may 
usually be corrected by tipping the head slightly forward when asleep. 
This causes the mouth to close and forces the nose to perform its func- 
tions. Contagious diseases are much more easily contracted by mouth- 
breathers than by nose-breathers. The nostrils have natural protective 
apparatus which filter all air as it passes through and do not permit ob- 
noxious ingredients to pass to the lungs. Mouth-breathing, on the other 
hand, permits the passage to the lungs of germ-laden dust and other de- 
leterious things and not only so, but permits air to pass which is not 
adapted to the sensitive requirements of the lungs in the matter of tem- 
perature and therefore causing inflammation of the respiratory organs. 
In nose-breathing the impurities which are stopped by the mucous mem- 
branes of the nostrils are duly thrown off by exhalation and should they 
by any means have penetrated beyond these membranes, they are usually 
still thrown off because of an irritation in the nostrils resulting in a sneeze, 
which ejects them. This does not happen in mouth-breathing. Those who 
have been habitual breathers through the nose are seldom troubled with 
clogged or stuffy nostrils, but those who have been addicted to mouth- 
breathing may find that the nose to a certain extent has lost its facilities 
and may be subject to clogging. In such cases the nose should be thor- 



1692 THE SCIENCE OF BREATH. 

oughly cleansed each day with tepid water, which may he administered 
through a small glass nasal douche, purchasable from any druggist, or in 
lack of such by snuffing the water up the nostrils, permitting it to run 
down the nasal passages to the throat and then ejecting it through the 
mouth. Each morning it will be found well to stand in front of an open 
window, close one nostril with the finger and breathe the air through the 
open nostril, repeating this several times, changing from one nostril to 
the other. A little vaseline or camphorated ice rubbed in the nostrils at 
time of retiring and placed as far up as the little finger will reach will 
be found very beneficial in such cases. 

The mechanical arrangements of respiration manifest themselves 
through: (1) elasticity of the lungs, and (2) the activity of the thoracic 
cavity (commonly referred to as the chest), in which the heart and lungs 
are contained, and which is bounded by the spinal column, the ribs with 
their cartilages, the breast bone and the diaphragm. There are twenty- 
four ribs, twelve on each side, emerging from the spinal column. The 
upper seven pairs which are fastened directly to the breast bone are called 
true ribs, while the lower iiye pairs which are not fastened to the breast 
bone are known as false or floating ribs, the upper three being fastened 
by cartilage to the other ribs, the remaining two pairs having no car- 
tilages and being free at their forward ends. The ribs move in respira- 
tion by means of two muscular layers called the intercostal muscles, being 
affected by the action of the diaphragm, which separates the thoracic 
cavity from the abdominal cavity. Without action of the diaphragm and 
its dependent intercostal muscles the lungs cannot expand, and upon the 
extent of the action of the diaphragm the sufficiency or insufficiency of 
the air taken into the lungs depends. A proper control of the action of 
the diaphragm is therefore necessary in order to secure proper lung ex- 
pansion and send properly oxygenized air through the arteries to the cells 
and tissues of the body. 

Respiration may be divided into four classes, namely: high breath- 
ing, mid breathing, low breathing and full or complete breathing. 

In high breathing the ribs are elevated and the collar-bone and shoul- 
der raised, the abdomen being drawn in so as to push against the dia- 
phragm, which is also raised. This action simply calls into requisition 
the upper or smallest portion of the lungs and consequently permits but 
a minimum amount of air to enter the lungs. Notwithstanding that this 
form of breathing requires the greatest expenditure of energy, it is com- 



THE SCTEXCE OF BREATH. 1693 

monly the only way of breathing with many people, especially among 
women. 

Mid breathing, known as rib breathing and intercostal breathing, 
although superior to high breathing, is nevertheless inadequate. The ab- 
domen is drawn in and the diaphragm pushed upward ; the ribs are some- 
what raised and there is a partial expansion of the chest. It is perhaps 
the most common form of breathing. 

Low breathing is known under many different names, such as deep 
breathing, diaphragmatic breathing, etc., and has much to be said in its 
favor. It is in every sense superior to high breathing and mid breathing, 
yet cannot be termed as full or complete respiration. It tills the lower 
part of the lungs and a considerable portion of the middle part, but it 
does not fill the entire lung space. 

Full or complete breathing embraces all the advantageous points of 
high, mid and low breathing without any of their objectionable features. 
The entire respiratory apparatus is brought into play and every air cell is 
reached. The complete respiratory system responds to this breathing, 
producing the maximum amount of benefit with a minimum expenditure 
of energy. The thoracic cavity is increased to its full limit in every 
direction, each part performing its natural function in a natural way. 
In no other form of breathing are all the respiratory muscles brought into 
play, but in complete breathing every respiratory muscle is used, the 
ribs are forced into useful activity and not only increase the space in 
which the lungs may be expanded, but give proper support at needed 
points. The diaphragm draws the ribs slightly downward, while other 
muscles hold them in place, and they are forced outward by the intercostal 
muscles. This increases the mid-chest cavity to its full natural capacity. 
The intercostal muscles also lift the upper ribs and force them outward, 
thereby increasing the upper chest capacity to its maximum. 

It requires study and practice to acquire such mastery of complete 
breathing as will enable one to carry on the process as the natural method 
of breathing, but the results obtainable are so great and so beneficial that 
no one, once having become master of the art, will go back to the old 
method of breathing. The complete breath is not abnormal, but on the 
contrary the only natural way of breathing, and the healthy infant, even 
in civilization will usually be found to breathe in this way, but neglect in 
the care of children and unnatural methods of living, clothing, etc., result 
in unnatural forms of breathing. While the form of complete breathing 



1694 THE SCIENCE OF BREATH. 

should be followed at all times it is not essential that the lungs should be 
completely filled at each inhalation. 

Ordinarily the average amount of air taken in breathing is adequate, 
provided the complete form be followed, for in complete breathing, be 
the quantity inhaled large or small, it is evenly distributed to all parts 
of the lungs. But at least several times a day, and the more frequently 
the better, a series of complete breaths should be taken in such manner 
as to completely fill all parts of the lungs with fresh oxygen. 

In a later part of this chapter will be found a complete series of 
exercises to be used in the development of different parts of the body, 
but the following exercise will give a clear idea of the manner of com- 
plete breathing: 

Sit or stand erect. Breathe steadily through the nose in such man- 
ner as to fill the lower part of the lungs, to accomplish which the air must 
press upon the diaphragm so as to cause it to descend with gentle pres- 
sure upon the abdominal organs, forcing the front walls of the abdomen 
forward. Xow fill the middle part of the lungs. This will push out the 
lower ribs, breast bone and chest. Xow fill the higher portion of the 
lungs, forcing the upper chest outward and lifting the whole chest, in- 
cluding the upper pairs of ribs. In this last mentioned movement there 
will be a slight drawing in of the lower part of the abdomen, giving the 
lungs support and also aiding in the filling of the highest part of the lungs. 
Although these are described as if they were three separate movements, 
the whole operation is one continuous action, commencing at the lower 
diaphragm and gradually, but continuously, coining upward until the 
highest points of the lungs have been reached. Jerky inhalation should 
be avoided and a steady, continuous action strived for. At first there 
will be a tendency to divide the inhalation into three movements, but 
comparatively little practice will overcome this. Retain the breath a few 
seconds, then slowly exhale, the chest being held in a firm position, the 
abdomen being drawn slightly inward and slowly upward as the air 
leave- the lungs. Upon complete exhalation relax the chest and abdomen. 
It will require some practice to ]>erform this exercise easily, but once 
mastered, the movement will be performed almost automatically. 

This method of breathing brings into play all parts of the respiratory 
system, the most remote air cells being exercised and the chest cavity 
expanded in every direction. It will be found advantageous in beginning 
to practice this breath before a large mirror. Lightly place the hands 
upon the abdomen so that the movement may be felt. Watch the whole 



THE SCIENCE OF BREATH. 1695 

chest movement in the mirror and endeavor to make the inhalation reach 
the different parts of the lungs in continuous, not spasmodic succession. 
While there should not be straining in taking the complete breath, it will 
be found well occasionally, at the end of an inhalation to slightly elevate 
the shoulders, which will raise the collar-bone and permit air to pass 
freely into the small upper lobe of the right lung, which is frequently a 
breeding place of tuberculosis. 

It is believed that those who habitually utilize the form of complete 
breathing in their respirations will be immune to consumption and other 
pulmonary troubles, and that with those who have already contracted 
this wasting disease, it will do much in amelioration if it does not posi- 
tively cure. Low vitality is a principal cause in consumption, and low 
vitality is largely attributable to an insufficient amount of air being in- 
haled, causing a considerable portion of the lungs to remain inactive, 
and these inactive parts become inviting fields for germs. If the lungs 
be in healthy condition they will resist germs and habitual complete 
breathing of pure air will keep the lungs in healthy condition. Consump- 
tives are almost invariably narrow chested, which simply means that they 
have been addicted to improper methods of breathing, for those who have 
been accustomed to complete breathing will always be found with full, 
healthy chests. Those who are narrow chested may develop normal pro- 
portions by adopting the mode of breathing here prescribed. 

Colds may frequently be prevented by a little vigorous breathing 
when it is felt that one is unduly exposed. If chilled, utilize the complete 
breath vigorously for a few minutes, when a glow will be felt over the 
whole body. It is claimed by some people that most colds may be quickly 
cured by complete breathing and partial fasting. 

It has been shown how under-oxygenated blood (caused by improper 
breathing) becomes poor in quality, is laden with many impurities and 
carries disease instead of nourishment throughout the system. Every or- 
gan is dependent for nourishment upon the blood, and impure blood must 
have a detrimental effect upon the entire system. The stomach and other 
organs of nutrition cannot be properly nourished when there is improper 
breathing. Not only are these organs themselves ill-nourished, and there- 
fore unable to properly perform their functions, but the food itself must 
absorb oxygen from the blood and thus itself be oxygenated before it can 
be digested and assimilated. 

The nervous system also suffers from improper breathing because the 
brain, the spinal cord, the nerve centers and the nerves themselves depend 



1696 THE SCIEXCE OF BREATH. 

upon the blood for their nourishment, and when the blood is impure they 
become inefficient mediums for generating, storing and transmitting nerve 
currents. 

EXERCISES IN FULL OR COMPLETE BREATHING. 

Whatever may be considered of them otherwise, it is a recognized 
fact that the Yogis of Hindustan are practically without exception su- 
perbly physicaly developed. Their claim is that this physical develop- 
ment is due to complete breathing, which has been practiced by them and 
their forebears for many centuries. They have many exercises, some of 
which they claim produce mental and psychic conditions, but the follow- 
ing exercises are those most generally used by them for physical develop- 
ment : 

Cleansing Breath — This has for its object the ventilation and cleans- 
ing of the lungs. It is a common practice to conclude breathing exercises 
with this cleansing breath, the claim being that it cleanses and ventilates 
the lungs and generally refreshes the entire system, and that it is espe- 
cially restful to speakers and singers who are tired from excessive use of the 
respiratory organs. (1) Inhale a full or complete breath and retain this for 
a few seconds. (2) Without swelling out the cheeks pucker up the lips 
as if about to whistle and then with considerable force exhale a small 
quantity of air through the opening. Xow stop for a moment and then 
exhale a little more and again stop, and continue in this manner until 
the air is completely exhaled. Do not forget that each time the air must 
be forced from the mouth with considerable vigor. This cleansing breath 
will be found very refreshing when one is tired or exhausted. It should 
be practiced until its performance becomes natural and easy. 

Nerve Vitalizing Breath. — The claim for this breath is that it is one 
of the strongest nerve stimulants possible to be used, developing nerve 
force, energy and vitality, and by working on important nerve centers 
stimulates and energizes the entire nervous system, sending increased 
nerve force to every part of the body. (1) Stand erect and inhale a com- 
plete breath and while retaining it extend the arms limply straight in 
front, using only sufficient nerve force to keep them in that position. (2) 
Draw the hands slowly back toward the shoulders, gradually putting nerve 
force into the muscles in such manner that when the fists reach the shoul- 
ders they will be so tightly clenched as to give the feeling of tremulous 
motion. (3) Keep the fists closed and the muscles tense and push the 
arms slowly outward to their full extent and then, still keeping them tense 





Correct Position for Complete Breathing. Filling the Upper Lobe of the Right Lung. 





Nerve Vitalizing Breath. Cleansing Breath. 

(C) E. J. S. 



THE SCIENCE OP BREATH, 



1697 



draw the fists quickly back to the shoulders. Kepeat this several times. 
(4) Exhale vigorously through the mouth and then practice the cleansing 
breath. To secure full effect not only must the lungs be thoroughly filled, 
but special attention given to drawing back the arms with speed and in 
keeping the muscles in a highly tense state. 

Vocal Breath. — The object of this breath is to develop the voice. It 
is claimed for it that it makes the voice soft and flexible, yet thoroughly 
resonant. (1) Take complete breath very slowly, but steadily, using 
utmost possible time in the inhalation. (2) Retain the air in the lungs 
for a few seconds and then vigorously expel it through the mouth with 
one strong, forceful breath. (3) Follow with a cleansing breath which 
will rest the lungs. 

Retained Breath — The object of this breath is to strengthen and de- 
velop the respiratory muscles and the lungs. It also has a tendency to 
expand the chest. It is claimed for it also that it is very beneficial to 
the organs of nutrition, the nervous system and the blood. The retention 
of the full breath has a purifying effect upon the air remaining in the 
lungs from former inhalations and not only so, but during its retention 
it gathers up all waste matter in the lungs and carries it out of the system 
when the breath is expelled, cleansing the lungs as thoroughly as a pur- 
gative does the bowels. It is recommended for various disorders of the 
stomach, liver and blood and is helpful in relieving bad breath when this 
is attributable to poorly ventilated lungs. (1) Stand erect and inhale a 
complete breath and retain it as long as it can comfortably be held. (2) 
Vigorously exhale the air through the open mouth and then practice the 
cleansing breath. In early efforts it will be found difficult to retain the 
breath for more than a very short time, but with constant practice this 
difficulty will be overcome. By timing yourself with your watch you will 
be able to note steady progress. 

Lung Cell Stimulation. — This breath is intended to stimulate the air 
cells of the lungs. Beginners must be very careful not to overdo it, and 
under no circumstances should it be practiced vigorously. It sometimes 
causes slight dizziness with beginners. In such cases the exercise should 
be discontinued for some time. To relieve the dizziness take a short walk. 
(1) Standing erect with hands at sides slowly and gradually take a com- 
plete breath and while inhaling raise the arms and with the finger-tips 
gently tap the chest at different points. (2) The lungs being filled, retain 
the breath, at the same time patting the chest with the palms of the 
hands. Then practice the cleansing breath. With those who have been 



1698 THE SCIENCE OF BREATH. 

accustomed to imperfect breathing for years, many air cells will be found 
inactive, sometimes almost atrophied, and it will take considerable time 
and careful practice to revive them to activity, but regular and continued 
practice of deep breathing and the careful daily use of this exercise will 
have most beneficial effect. 

Rib Stretching — Owing to the cartilages with which they are fas- 
tened the ribs are subject to considerable expansion, and in proper breath- 
ing j)lay an important part in respiration. It is therefore well to give 
them special exercise in order that their elasticity may be preserved. With 
people of sedentary habits the ribs are likely to become more or less stiff 
and inelastic, and in order to enjoy the full benefits of complete breathing 
this unnatural condition should be overcome. (1) Standing erect, place 
the thumbs close under the armpits with the palms on the side of the 
chest and the fingers over the breast. (2) Inhale a complete breath and 
retain it for a short time. Then slowly exhale, gently squeezing the sides 
with the hands while doing so. Follow with the cleansing breath. This 
exercise should be used with moderation. 

Chest Expansion. — The object of this exercise is to restore natural 
chest expansion when th'6 chest has become contracted from bending over 
work or other cause. (1) Stand erect and inhale a complete breath. Re- 
tain the air and while doing so extend both arms forward, bringing the 
two clenched fists together on a level with the shoulders. (2) Swing the 
fists vigorously until the arms are sideways in line with the shoulders. 
Then bring the arms back to their position in front of the body and repeat 
this movement several times. (3) Vigorously exhale through the open 
mouth and practice the cleansing breath. This exercise must be used with 
moderation and with caution. 

Walking Exercise — This exercise will not only be found generally 
helpful, but it is an excellent method of practicing the complete breath. 
One should walk in military style — that is, with head erect, chin drawn 
slightly in and shoulders back, the pace being measured. (1) While walk- 
ing, inhale a complete breath, mentally counting each step and making 
the inhalation extend over eight counts. (2) Still counting the steps, 
slowly exhale through the nostrils through the counting of eight more 
slops. (3) Continue walking and counting, but do not breathe until 
another eight steps have been taken, then repeat the inhalation and ex- 
halation in the same manner and with the same counting. This may be 
kept up until there is a feeling of being tired, when it should be dis- 
continued and resumed at pleasure. This exercise should be practiced 





Lesson A. Position 1. — This shows how the 
footpad comes up on your right side and grasps 
the lapel of jour coat, putting you " 

merer. 



at his 



Lesson A. Position 2. — Always carry an awl, 
and, as shown, jab him in under side of arm 
with all the force at your command. 





Lesson B. Position 1. — Should a person point 
a revolver at you. ordering you to hold up your 
comply with bia request. 



Lesson B. Position 2. — By throwing them up 
with great force, your clenched fist striking the 
under side of gun wrist as shown in illustra- 
tion. 



E. f. S. 




H -9 


If 










^^Hp; Bg%- 


Spr , 










■^<^mm 




b 


•v^m. 




"'fcp-Ir 



Lesson C. — Should you fear bodily harm and 
wish to subdue your opponent, bring your hand 
up with great force, crotching the nose be- 
tween fore and middle finger. 



Lesson D. Position 1. 
by the left hand. 



-Grasp your adversary 





Lesson D. Position 2. — Raise the left arm, 
turning his wrist inward with your left; slide 
your right under his left. 



Lesson D. Position 3. — Grasp the lapel of 
his coat and stiffen your right arm, pushing 
your opponent's left from you until it rests on 
your right forearm; at the same time twist his 
ieft wrist toward you and bear down. Partial 
paralysis of the nerves results. 



E. J. S. 





Lesson E. Position 1. — Grasp your adver- 
sary's left hand at the wrist and raise it in- 
wardly, using your right to push his elbow 
forward. 



Lesson E. Position 2. — This will turn his 

back toward you. Draw his left arm up, 

twisting the wrist. Take a firm hold of his 
coat collar. 





Lesson F. Position 1. — Grasp your opponent's 
lefl hand at the wrist with your left and 
raisp it inwardly, using your right to push his 
elbow forward. 



Lesson F. Position 2. — Draw his left arm up, 
twisting the wrist. Take a firm hold of his 
chin and twist his head backwards. 



© E. J. S. 





Lesson G. Position 1. — Grasp your opponent's 
hand and raise it, pressing on knuckles as 
shown above. 



Lesson G. Position 2. — Press your opponent's 
hand backward with your thumb and at the 
same time twist his hand to the right. 





Lesson H. Position 1.— Grasp your adversary 
firmly by the lapels of his coat, pulling him 
toward you. 



Lesson H. Position 2. — Step quickly to right, 
placing your left leg behind his left. Throw 
him by pushing backward and to the right. 



E. J. S. 





Lesson I. Position 1. — Grasp your opponent's 
right hand with your left, so that your fingers 
rest in the palm of his hand and your thumb 
on the back, close to the wrist. 



Lesson I. Position 2. — Raise his arm quickly 
over your head and go under, at the same time 
striking him in the solar plexus. 





Lesson T. Position 3. — You now have his 
right arm twisted so that he is helpless. 



Lesson J. Position 1. — Seize your opponent' 
right wrist with your left hand. 



E. J. S. 





Lesson J. Position 2. — Twist his arm to the 
left and raise it, going- under. 



Lesson J. Position 3. — With your right hand 
grasp your adversary's throat and pull down- 
ward with your left. You may choke your vic- 
tim or break his arm. 





Lesson K. Position 1. — Take a firm hold with 
both hands so that your thumbs will rest on 
the back of your opponent's hand. 



Lesson K. Position 2. — Press the hand back 
with your thumbs, at the same time twisting to 
the left and downward. 



E. J. S. 





Lesson L. Position 1.- 
sary's left, taking hold 
raise his arm. 



-Step to your adver- 
ith both hands, and 



Lesson L. Position 2. — Press inward and 
twist to the right. Always keep his arm raised. 





Lesson M. Position 1. — Should a thief reach 
to Steal your diamond pin or diamond stud, 
Use your left Viand, placing your three first 
fingers on his hand, forcing his arm to the left. 



L<sson M. Position 2. — Quickly take two 
steps to the right and force his arm upward. 



E. J. S. 




. 




Lesson N. Position 1. — Ph 
through your opponent's left, 
and inward, raising his arm. 



ce your right arm 
Step to the right 



Lesson N. Position 2. — He will be forced to 
bend over, as his arm is locked. 





Lesson O. Position 1. — Seize your adversary's 
left wrist with your left hand. Force his hand 
up, twisting to the left. Have your right ready 
to 



Lesson O. Position 2. — Take hold of his left. 
You can now twist his arm at will. 



E. J. S. 





Lesson P. Position 1. — Grasp your opponent's 
left hand with your left, the ball of your 
hand resting- in his palm. Twist his arm to 
the right, raising it over your head. 



Lesson P. Position 2. — Go under, grasping 
his right arm with your right hand, and pull 
down with your left. 





Lesson Q. Position 1. — Should a person grasp 
your lapels with the intention of doing you 
bodily harm, force your arms up between his, 
stepping forward. 



Lesson Q. Position 2. — Bring your left arm 
outside and under your opponent's right, plac- 
ing your right hand on his shoulder and hold- 
ing the left hand on the right arm. 



E. J. S. 





Lesson R. Position 1. — Grasp your oppo- 
nent's left hand with your right, allowing your 
thumb to rest on the back of his hand and 
the fingers on the palm. 



Lesson R. Position 2. — Raise his hand up, 
pressing firmly with your right thumb and use 
your right as shown above. 





Lesson S. Position 1. — Grasp your adver- 
sary's left hand with your left, so that the ball 
of your hand will rest on his. 



Lesson S. Position 2. — Quickly bring your 
right hand around his left arm and press 
down with the left, at the same time twisting 
his wrist. 



E. J. S. 





Lesson T. Position 1. — Seize your opponent's 
left hand with your left, the ball of your hand 
resting on the back of his. 



Lesson T. Position 2. — Raise his arm, twist- 
ing- inward. Place your right arm under his 
left. 




■ n T. Position 3. — Place the right at 
the back of his head. 



Lession T. Position 4. — Press his arm down 
with your left, twisting inwardly, and force 
his head down with your right. 



E. J. S. 






2 1 


4 Sk 



Lesson U. Position 1. — Grasp your opponent's 
left hand with your right, your thumb resting 
on the back and your fingers on the palm of 
his hand. Hold firmly with left and pass right 
under his arm. 



Lesson U. Position 2. — Grasp your right arm 
with your left hand and press upward. Seize 
his head with your right hand and twist. 








Lesson V. Position 1. — Should a person point 
a revolver in your face quickly seize his wrist 
with both hands, raising his arm, and twist 
to the right. 



Lesson V. Position 2. — "With your right 
hand. You can then take the revolver with 
your left or force him to drop it. 



E. J. S. 



^^ 


Wrm: 


1 


~5a 






'■■■'■■' • " : 




2 mH 


t /; '•■ ..-;•■'-:. ../;.';- : :-%::f 










a 




Lesson W. Position 1. — If a person grasps 
you by the throat, seize his index finger with 
your left hand, draw his hand up and to the 
left. 



Lesson "W. Position 2. — Run your right un- 
der his left arm. 





Lesson W. Position 3. — And grasp his right 
•wrist, pressing down firmly. 



Lesson W. — Showing friendly feeling existing 
between instructor and pupil, notwithstanding 
nervous tension to which pupil has been sub- 
jected. 



E. J. S. 



THE SCIENCE OF BREATH. 1699 

several times every day. Some people find it advantageous to retain the 
breath during a count of four steps, then exhaling in an eight step count 
as described. 

Morning Exercise. — Standing erect with head up, chin in, shoulders 
back, eyes front, hands at sides and knees stiff, raise the body slowly on 
the toes and while doing so steadily and slowly inhale a complete breath. 
Retain both breath and position for a few seconds and then slowly sink 
back to the first position, slowly exhaling through the nostrils while doing 
so. Repeat the exercise several times, varying it by standing on right leg 
alone and then on left leg alone. Follow with the cleansing breath. 

Stimulating Circulation — The object of this exercise is to stimulate 
the circulation by driving blood to the extremities through the arteries 
and drawing it back to the heart and lungs through the veins in order 
that the blood may receive an extra charge of oxygen through the quick- 
ened circulation. In cases of ansemia and poor circulation there may not 
be enough blood in the lungs to absorb the increased amount of oxygen 
inhaled in complete breathing, and such persons therefore do not enjoy 
the full benefits of complete breathing. The occasional practicing of this 
exercise with the regular complete breathing will aid in bringing about 
an absorption and assimilation of the increased oxygen. (1) Place a cane 
or stick on a low table, and standing erect in front of it, inhale and retain 
a complete breath, and while retaining bend slightly forward and firmly 
grasp the stick and gradually exert your full strength upon the grasp. 
Then relax the grasp and return to the first position, when slowly exhale. 
Repeat several times and follow with the cleansing breath. 

Rhythmic Breathing. — It is well known that there is great power in 
rhythm. A note on a violin sounded repeatedly and in rhythm will start 
vibrations which, if properly directed, would move ponderous bodies. 
When moving in body soldiers are supposed to keep step, but when cross- 
ing a bridge they invariably break the general body step, each soldier 
walking without regard to the stepping of the man around him, and the 
whole body thus marching without uniformity or rhythm. If this were 
not done the steady, rhythmic tramp of thousands of soldiers would set 
up such vibration that the bridge would collapse. Rhythmic breathing 
acts in this same way upon the human body and if it be brought into full 
rhythmic harmony with the will it can be directed to increase nerve cur- 
rents to different parts of the body by the will. It is first necessary to be 
thoroughly and practically familiar with and habitually accustomed to 
complete breathing, after which the full mental idea of rhythm must be 
107 



1700 THE SCIENCE OF BREATH. 

acquired. The measured counting in music: one, two, three, four; one, 
two, three, four, or the rhythmic step of the soldier: left, right; left, 
right, are symbolical of the idea. In breathing the rhythm must be with 
the heart-beat and as the heart-beat varies in different persons, the heart- 
beat unit of each individual must be his or her rhythmic standard. The 
heart-beat may be ascertained by placing a finger over the pulse on the 
wrist and counting: one, two, three, four, five, six; one, two, three, four, 
five, six, and continuing this until the measure or rhythm of the beats 
becomes thoroughly fixed in the mind. Very little practice will so posi- 
tively fix this rhythm in the mind that there need be no actual counting 
in making the breathing correspond to the heart-beat. The average be- 
ginner inhales in about six pulse units, but in some cases it may run to 
seven or eight, and these numbers with practice will gradually increase. 
The exact counting to a measure must depend upon the individual and 
must be decided by himself, but the idea is the same whether the measure 
or rhythm be covered by four or eight pulse units. The rhythmic units 
of inhalation and exhalation are the same, but the units for retention and 
the units between breaths should be one-half those of inhalation and 
exhalation— that is to say, if the rhythmic inhalation be eight pulse beats, 
the rhythmic retention will be four beats, the rhymic exhalation eight 
beats, and the rest until the next inhalation four beats. 

The Hindu Yogis claim wonderful psychic effects as possible with 
a full knowledge of rhythmic breathing, but without taking up this phase 
of the matter, which is foreign to our present discussion, and considering 
rhythmic breathing simply as respects its relation to the physical effects of 
complete breathing, the following exercise will be demonstrative of rhyth- 
mic effect: (1) Sitting erect, but in an easy position, yet with the chest, 
neck and head as nearly as possible in line, shoulders slightly thrown 
back and hands quietly reposing on the lap, slowly inhale a complete 
breath, counting six pulse units. (2) Retain this breath while counting 
three pulse units. (3) Exhale slowly through the nostrils during the 
time of six pulse units. (4) Count three pulse units and then again in- 
hale. Repeat this a number of times, but be careful not to do so to a point 
of fatigue. When you feel that the exercise has been sufficiently pro- 
longed follow with the cleansing breath, which will not only rest you, but 
cleanse the lungs. Gradually with practice, the duration of the inhala- 
tions and exhalations will increase until perhaps fifteen pulse units in- 
dicate a measure or rhythm and it is to be remembered that he units for 
retention and between the breaths increase in like proportion — that is, they 



THE SCIENCE OF BREATH. 



1701 



continue to be one-half of the units of inhalation and exhalation. Always 
avoid becoming tired in this exercise. Practice it frequently, but in no 
instance excessively continue any one exercise, but on each occasion pay 
all possible attention to acquiring the "rhythm," until the measured swing 
of the rhythm may be felt as a vibratory motion throughout the whole 
body. It will require time and much perseverance to accomplish this, but 
the gratification that will come as improvement is observed will make the 
task a pleasing one. 

SEVEN SIMPLE EXERCISES IN COMPLETE BREATHING. 

Being a Condensed Course in Physical Culture and Lung Development. 

1. Standing erect, with hands at sides, inhale a complete breath and 
retain it, raising the arms rigidly until they meet above the head; hold 
them there a moment and then lower the hands slowly to the sides, exhal- 
ing slowly at the same time. Follow with the cleansing breath. 

2. Standing erect with arms straight in front, inhale and retain a 
complete breath. Then swing the arms back as far as they will go, and 
still retaining the breath, bring them forward to the first position and 
repeat the whole movement several times without any exhalation. Then 
exhale vigorously through the mouth and follow with the cleansing breath. 

3. Standing erect with arms straight in front of you, inhale complete 
breath; swing the arms around a few times in a backward circle, then 
reverse the motion. The breath must be retained throughout all the mo- 
tions. Then exhale vigorously through the mouth and follow with the 
cleansing breath. 

4. Lying face downward on the floor with palms of hands flat upon 
the floor at the sides, inhale and retain complete breath. Then stiffen the 
body and raise it by the strength of the arms until the whole weight is 
upon the hands and toes. Then lower the body to its original position and 
exhale vigorously through the mouth. Follow Avith the cleansing breath. 

5. Standing erect with your palms against the wall, inhale and re- 
tain a complete breath, then with the weight of the body on the hands push 
the chest forward against the wall ; then, keeping the body still and using 
only the arm muscles push the body back to the original position; then 
exhale vigorously through the mouth and follow with the cleansing breath. 

G. Standing erect with the hands resting on the waist and the arms 
akimbo, inhale and retain a complete breath; then keeping the hips and 
legs stiff, bend well forward, slowly exhaling as the forward movement is 



1702 THE SCIENCE OF BREATH. 

made. Keturning to the first position inhale again and then bend back- 
ward, slowing exhaling ; resuming the first position and inhaling, bend to 
one side, exhaling, and then repeat by bending to the other side. Follow 
with the cleansing breath. 

7. Standing or sitting erect with straight back, inhale a complete 
breath, not in the usual continuous manner, but instead in a series of short 
quick breaths, adding one breath to the other without exhaling until the 
lung space is completely filled. After retaining this series of breaths for 
a few seconds, exhale through the nostrils in one long restful exhalation. 
Follow with the cleansing breath. 

The exercises which have been given are useful to all people of 
whichever sex. They may be brought into utilization in youth or old 
age, but they should be put into effect from early infancy. The 
mother should carefully guard all points of breathing. She should see 
that the child from its earliest days does not breathe through the mouth, 
she should take every precaution and use every endeavor to bring about 
breathing through the nostrils. As the child grow older and commences 
its infantile frolics this point still should be guarded and at a very early 
age instructions should be commenced as to the proper form of breathing. 
Very simple demonstrations will appeal to the little child in a way that 
will bring effects that could not be accomplished in later years. The 
great point is to make it become natural with the child from its earliest 
beginnings to breathe in the right way, so that it will not need to be a 
lesson to be learned, but something that is naturally done. It is not ad- 
vocated that the whole series of breathing exercises set forth in this 
chapter should be taught, but that the natural art or system of nature as 
it exists and is demonstrated by complete breathing should be instilled into 
the child in its early, plastic age, so that there may be no thought nor 
effort in later years as to how or why this particular form of breathing 
should be performed, but that it comes as a natural part of existence. 

There is one point in connection with complete breathing which must 
not be lost sight of, and it is this — there should be no straining of the 
lungs nor muscles in endeavors to carry out the exercises which have been 
outlined. This is to be especially noted in respect of those whose lungs 
are weak and still more especially when there has been indication of 
hemorrhage. Where tendency to hemorrhage exists it is evident that the 
minute blood-vessels of the lungs have become deteriorated and are suscep- 
tible to strain of any kind and should complete breathing be exercised 
with straining effort it follows that there must be danger of rupture of 



REMEDIAL EXERCISES. 



1703 



the vesicles and hemorrhage may ensue. This does not mean to say that 
complete breathing should not be adopted by people with weak lungs, but 
simply that there should be no undue straining. With one whose lungs 
are strong and in healthy condition, vigorous and even strained effort may 
be employed, but with those whose lungs are weak it must be matter of 
quietly endeavoring to reach the extremities of the lungs to an extent 
that never before has been reached, yet without strain. In other words, 
do not attempt to completely fill each and every cell of the lungs by 
strenuous effort, but quietly reach the entrance to all the cells by the 
complete breath inhaled and exhaled without undue effort, and gradually 
these entrance cells will open the way to the deeper parts and permit the 
entry of oxygen or life-giving source to cells which have become dormant. 



REMEDIAL EXERCISES 



By Eemedial Exercises, we mean particularly a scientific series of 
movements bringing into play and developing those muscles that hold, 
encase or control, the great vital organs : the heart, lungs, kidneys, liver, 
intestines and female organs of generation. 

These exercises have proven beneficial to an extraordinary degree, 
as they increase bodily vigor, and help all organs to perform their func- 
tions properly. They are suggested as a natural method of treatment in 
certain common disorders. 

We hold that prevention as a successful factor in the attainment of 
health is not possible under certain conditions. The arm with weakened 
muscles could not prevent or ward off a blow. That entire organ that 
has dropped out of normal place, because the supporting muscles are not 
strong enough to hold it properly, cannot perform its functions and pre- 
vent or ward off disease. 

While the exponent of the natural method seeks no quarrel with 
the drug practitioner, yet he believes that there are many cases where 
the use of drugs cannot possibly benefit, and is more than likely to prove 
very harmful. 

The muscles of the weakened arm need to be exercised properly— 



1704 REMEDIAL EXERCISES. 

soon the blood courses through each artery and vein, waste and diseased 
tissue is carried away, while the nascent oxygen and hlood corpuscles re- 
pair everything that need attention. 

In like manner, the muscles and supporting tissue sorrounding the 
internal organs can he strengthened, and the organs brought to a normal 
condition. l\ow, their corrected action quickly brings about perfect 
health. While the masseur, chiropractic and the osteopath obtain some 
excellent results along these lines by purely mechanical methods, the 
results are more beneficial and permanent when the muscles are worked 
naturally instead of artificially. 

The following are selected as a thorough series of Remedial Exer- 
cises ; any one of which, if persisted in regularly over a reasonable period 
of time, will bring results. 

Care should be taken at the start not to exercise too hard. For the 
first few days merely go through the motions and become accustomed to 
what you are doing, and why. Put your mind thoroughly on each move- 
ment, as exercise of a certain amount of your will power is helpful in any 
method of treatment, but particularly so in this method, where the object 
is to build up and strengthen all important organs naturally from within. 
Centering the mind on the organ to be benefited directs the blood to that 
place. 

FIRST EXERCISE (For Men and Women) . 

Object. — To tone up and strengthen heart, lungs, stomach, spleen, 
liver and intestines. 

Place the hands, closed, on chest with knuckles touching the elbows 
raised until forearms are horizontal. Completely fill the lungs, then close 
throat as if swallowing; holding the throat closed, lower chest and force 
air fully into the lower lungs by distending the abdomen. Still holding 
throat closed, contract abdomen and inhale in upper lungs, spreading 
eliest as fully as possible. Be careful to hold the throat closed, not allowing 
aii- to escape while distending abdomen and chest. Repeat five to ten 
times. Relax chest and exhale slowly. 



SECOND EXERCISE (For Women). 

Object. — To strengthen kidneys and ovaries. 

Lie on floor or bed ; clasp hands over head. Stretch downward with 



KEMEDIAL EXERCISES. 1705 



right leg, reaching far as possible with the leg, until the right hip is drawn 
so that a line from the armpit to the hip is straight. Center jour thought 
on the muscles of the hips and buttocks. While holding right hip and leg 
tense, reach up with the left hip, drawing same as high as possible. The 
left hip bone in this exercise may be brought as much as four inches 
higher than the right. Change, stretching left and raising right hip. 
Repeat twenty times, alternating ten times with each hip. 



THIRD EXERCISE (For Women). 

Object. — To bring weakened organs back to normal strength and 
proper position in the body. Beneficial in kidney trouble, ovarian dis- 
orders and prolapsus of the uterus. 

Lie on the back with hands folded under the head. Bend knees, 
bringing feet close to body. Raise heels, supporting body on head and 
shoulders, and raise thighs slowly until body curves upward from knees 
to neck. Xow draw feet still closer and contract muscles of abdomen, 
hips and back, making them rigid. Lower body nearly to floor and raise 
again while keeping abdominal muscles tense. Raise and lower five 
times ; rest ; repeat five times. 

FOURTH EXERCISE (For Men and Women). 

Object. — To check and prevent cold, catarrh, hay fever, asthma, 
bronchitis and similar ailments. 

Lie on back with arms and legs relaxed. (1) Distend muscles of the 
abdomen; relax. Repeat five times. (2) Distend muscles over stomach; 
relax. Repeat five times. (3) Lift chest upward, trying to make it touch 
chin, but do not raise small of back too far from floor. The abdomen in 
this movement draws in tensely. Xow relax chest. Repeat five times. 
Distend and relax as in (1) ; follow directly with (2). Continue this 
movement to (3), abdomen tense. This creates a surging movement af- 
fecting many important muscles. Repeat the movement five times. Take 
every night on retiring ; follow by ten deep full strong breaths. 

FIFTH EXERCISE (For Men and Women) . 

Object. — To correct catarrhal condition of the nose and throat. 
Distend muscles over diaphragm with strong, quick movement. This 



1706 REMEDIAL EXERCISES. 

is done by keeping mouth closed, inhaling quickly through the nostrils, 
which will close quickly as the muscles contract. This exercise should be 
done vigorously, and will cause a loud sniffling sound, both in inhaling 
and exhaling. Distend muscles to the fullest extent, contracting quickly 
and repeating in rapid succession ten times. 



BOOK XIX 

Treats of Jiu-jitsu, the great Japanese system of 
self-defense. 



Adam's Apple Blow 1711 

Constipation, Jiu-jitsu for 1710 

Death-producing Grips and Blows 1710 

Dyspepsia, Jiu-jitsu for 1710 

Breathing in Jiu-jitsu 1710 

Indigestion, Jiu-jitsu for 1710 

Insomnia, Jiu-jitsu for 1710 

Jiu-jitsu 1709 



Jiu-jitsu as Functional Structure .1710 

Deep Breathing in 1710 

Effect of on Muscles 1710 

History of 1709 

Varieties of 1710 

Obesity, Jiu-jitsu a cure for 171 1 

Pulmonary Troubles, Jiu-jitsu for...i7io 
Self-Defense, Japanese System of . . . . 1709 



ILLUSTRATIONS 

Twenty-four Exercises in Jiu-Jitsu, illustrated by fifty-four photo- 
graphs, with a full explanation of each photograph 



1707 



Book XIX 



JIU-JITSU 

JAPANESE SYSTEM OF SELF-DEFENSE 



Jiu-Jitsu, the much-talked of Japanese system of self-defense, has 
attracted so much attention throughout the English-speaking countries of 
the world that its acceptance in this country as a meritorious branch of 
combative athletics causes not the slightest surprise among broad-minded 
people. 

Like all innovations, especially foreign ones, Jiu-Jitsu was at first 
disparaged by scores of people. Some of them still hold to their original 
opinion, but many, who have made a thorough study of the subject, have 
found that the science contains much of value. 

Jiu-Jitsu is the most wonderful system of physical training the 
world has ever known. It is a science. It is muscle dominated and di- 
rected in every detail by the brain. 

Jiu-Jitsu is one of the oldest known branches of self-defense. Au- 
thentic records of its existence before the Christian era are now in pos- 
session of the Mikado of Japan. History relates that so far back as 200 
years before Christ the supporters of the Japanese emperor of that time 
fought unarmed against hostile tribes, and, aided by Jiu-Jitsu, completely 
defeated them. The tribes in question carried the arms of the day, but 
this availed them nothing against the disconcerting and often deadly tricks 
of the Jiu-Jitsu experts. 

A large proportion of the tricks temporarily paralyze nerves and 
nerve-centers, and others stop the circulation of the blood in various parts 
of the body. Many holds consist of twisting the hand, arm, leg, ankle 
or the neck, and many more depend for success on the obtaining of pow- 
erful leverage on the arm or leg on various joints. There are some Jiu- 
Jitsu manoeuvres which have never been explained to Europeans or 
Americans and probably never will be. Especially reticent are the Jap- 

1709 



17 1Q jiu-jitsu. 

anese regarding the dozen or so of death-producing grips and blows. 
Several of them have been described in detail by them at various times, 
but others are only hinted at. These blows are remarkable. Jiu-Jitsu 
experts execute a trick which is very much like the boxer's solar plexus 
punch. It consists of a blow delivered violently into the solar plexus 
and twisted in a peculiar manner, completely paralyzing this nerve 
center. The blow also produces breathlessness, and, in cases of poorly 
trained men, nausea. 

Jiu-Jitsu comprises three different systems or branches and up- 
wards of 250 manoeuvres. One branch, the most common, calls for the 
use of the hands only, another, a piece of rope, and the third, a club. 
However, only the first named is considered here, for it is the one most 
frequently used. Japanese experts are, of course, proficient in all three 
branches. The Japanese are the hardiest race of people in the world to- 
day, and they attribute their wonderful strength and power of endur- 
ance to the persistent practice of their national system of physical de- 
velopment. Jiu-Jitsu develops every muscle and strengthens every or- 
gan in the human body. It affects the minute muscles which are not 
reached by any other system. It strengthens the heart action, renews and 
invigorates every tissue, and helps every organ to properly 'perform its 
functions. The man or woman who will devote ten minutes daily to the 
practice of Jiu-Jitsu will enjoy a degree of health and strength that will 
make him or her thoroughly alive and fully conscious of the possession of 
perfect manhood or womanhood. As a system of physical culture Jiu- 
Jitsu is superior to most methods. It results in a very fine all-round 
development, and the peculiarity of the Japanese system is that the mus- 
cles never become hard like those of an ordinary athlete, but remain 
perfectly soft and pliable to the touch and are apparently coated with a 
layer of fat as the muscles of the Greek athletes were said to have been 
in the days of the Olympian Games. 

The exertion of pressure on muscles and ligaments is the idea of 
Jiu-Jitsu, and a thorough knowledge of the parts of the human body thus 
vulnerable is essential to expert practice of the system. On the strength 
of the stomach a great deal depends. Next in importance is the train- 
ing of the heart and lungs by deep breathing, with which every lesson in 
Jiu-Jitsu begins and ends. Fresh air is, of course, an absolute necessity. 

Jiu-Jitsu is also a natural and positive cure for constipation, indi- 
gestion and all other forms of dyspepsia, insomnia, pulmonary troubles 
and lack of vitality. Its practice improves the appetite, accelerates cir- 



jiu-jitsu. 1711 

dilation and aids digestion. To the increased vigor and tone of the system 
the brain responds, and the mental capacity, as well as the physical is 
improved. The Japanese enjoy better health than any other nationality. 
With them consumption is very rare ; the word dyspepsia has no meaning, 
and physical weakness is an affliction with which only the aged are beset. 
Extreme leanness is regarded by them much the same as Americans re- 
gard physical deformity and extreme corpulency is unknown. There is 
a reason for all this and it is found in Jiu-Jitsu. 

Owing to the wide-spread eagerness for information regarding Jiu- 
Jitsu, many erroneous ideas have been formed regarding it. 

Scores of holds and tricks purporting to be Jiu-Jitsu manoeuvres 
have been exploited, but here are illustrated only such holds, etc., as are 
included in Jiu-Jitsu, omitting unauthoritative holds and those not con- 
sidered practical. The so-called "Adam's apple blow" is one which is 
omitted, simply because in its execution the victim has one hand free, 
which a clever man would use in effectually blocking the movement. 

The secret of Jiu-Jitsu consists in the knowledge of how to grasp an 
opponent in such a manner that he must either submit to be thrown or 
have the limb which is grasped ruthlessly broken. An expert Jiu-Jitsu 
wrestler can throw his adversary in practically any direction he wishes. 
In explaining and illustrating Jiu-Jitsu we have endeavored to give 
briefly the most important points of this valuable science. 



Book XX 



DICTIONARY OF DRUGS 



Latin 
Absinthium 
Acacia 
Aceta 

Acetanilidum 
Acetum 
Ace turn opii 
Acetum scillce 
Acidum aceticum 
Acidum arseniosum 
Acidum benzoicum 
Acidum boricum 
Acidum carbolicum 
Acidum chromicum 
Acidum citricum 
Acidum gallicum 
Acidum hydrobromicum 

dilutum 
Acidum hydro chloricum 
Acidum hydrocyanicum 

dilutum 
Acidum lacticum 
Acidum nitricum 
Acidum nitro-hydro- 

chloricum 
Acidum oleicum 
Acidum oxalicum 
Acidum phosphoricum 
Acidum salicylicum 
Acidum sulphuricum 
Acidum sulphurosum 
Acidum tannicum 
Acidum tartaricum 
Aconitina 
Aconiti folia 
Aconitum 
Adeps 

Adeps lana hydrosus 
Aether 
Alcohol 
A Ilium 
Aloe 

Aloe barbadensis 
Aloin 



English 
Absinthium 
Acacia (Gum-arabic) 
Vinegars 
Acetanilide 
Br. Vinegar 
Vinegar of opium 
Vinegar of squill 
Acetic acid 
Arsenious acid 
Benzoic acid 
Boric acid 
Carbolic acid 
Chromic acid 
Citric acid 
Gallic acid 
Diluted hydrobromic 

acid 
Hydrochloric acid 
Diluted hydrocyanic 

acid. Prussic acid 
Lactic acid 
Nitric Acid 
Nitro-hydrochloric 

acid 
Oleic acid 
Oxalic acid 
Phosphoric acid 
Salicylic acid 
Sulphuric acid 
Sulphurous acid 
Tannic acid 
Tartaric acid 
Aconitine 
Aconite leaves 
Aconite 
Lard 
Lanoline 
Ether 
Alcohol 
Garlic 
Aloes 

Barbadoes aloes 
Aloin 

171 



Latin 

Althcea 
Alumen 
Aluminii sulphas 

Ammoniacum 
Ammonii benzoas 

Ammonii bromidum 

Ammonii carbonas 

Ammonii chloridum 

A m m o nii io didu m 
Ammonii nitras 
Ammonii phosphas 

Ammonii sulphas 

Ammonii valcrianas 

Amygdala amara 
Amygdala dulcis 
Amy I nit r is 
Amylum 

Amylum io datum 
Anisum 
Anthemis 
Antimonium 
Antimonii et potassii tar 
tras 

Apocynum 

Apomorphincc hydro- 

chloras 
Aqua 

Aqua chlori 
Aqua aurantiHor. 
Aqua ammonia 
Aqua calcis 
Argent urn 
Argenti nitras 



English 

Althaea, marshmallow 

Alum 

Sulphate of alu- 
minum 

Ammoniac 

Benzoate of ammon- 
ium 

Bromide of ammon- 
ium 

Carbonate of ammon- 
ium 

Chloride of ammon- 
ium 

Iodide of ammonium 

Nitrate of ammonium 

Phosphate of ammon- 
ium 

Sulphate of ammon- 
ium 

Valerianate of am- 
monium 

Bitter almond 

Sweet almond 

Nitrite of amyl 

Starch 

Iodized starch 

Anise 

Anthemis chamomile 

Antimony 
- Tartar emetic. Tar- 
trate of antimony 
and potassium 

Apocynum. Cana- 
dian Hemp 

Hydrochlorate of 
apomorphine 

Water- 
Chlorine water 

Orange flower water 

Hartshorn 

Lime water 

Silver 

Nitrate of silver 



1714 



DICTIONARY OF DRUGS. 



Latin 
Aristolochia serpentaria 
Armoracece radix 
Arnica Hores 
Arnica radix 
Ar senium 
Asafcetida 
Asclepias 

Aspidium 

Aspidosperma 
Atropa belladonna 
Aurantii amara 
Auranti cortex 
Aurantii dulcis 
Auri et sodii chloridum 

Avence farina 
Avena sativa 
Balsa mum peruvianum 
Balsamum tolutanum 
Barium 

Berbince sulphas 
Belladonnas folia 
Belladonna radix 
Benzinum 
Benzoinum 
Bismuthi citras 
Bismuthi et ammonii 

citras 
Bismuthum 
Br o mum 
Bryonia 
Buchu 
Butyrum 
Caffea 
Caffeina 

Calamina praparata 
Calamus 
Calcis chloridum 
Calcium carbonas precip. 
Calendula 

Calumba 

Calx 

Cambogia 

Camphora 

Cannabis 

Cantharis 

Capsicum 

Carbo 

Carbo animalis 

Carbo ligni 

Cardamomum 

Carutn 

Caryophyllus 

C as car ilia 

Cassia fistula 

Castanea 

Cotaplasmata 

Catechu 



English 
Snakeroot 
Horse-radish root 
Arnica flowers 
Arnica root 
Arsenic 
Asafetida 
Asclepias (Pleurisy 

Root) 
Aspidium (Male 

fern) 
Quebracho 
Deadly nightshade 
Bitter orange 
Orange peel 
Sweet orange 
Chloride of gold and 

sodium 
Oatmeal 
Oats 

Balsam Peru 
Balsam Tolu 
Barium 

Sulphate of berbine 
Belladonna leaves 
Belladonna root 
Benzine 
Benzoin 

Citrate of bismuth 
Citrate of bismuth 

and ammonium 
Bismuth 
Bromine 

Bryonia (Bryony) 
Buchu 
Butter 
Coffee 
Caffeine 

Prepared calamine 
Calamus (sweet flag) 
Chloride of lime 
Precipitate of chalk 
Calendula 

(Marigold) 
Calumba (Columbo) 
Lime 
Gamboge 
Camphor 
Hemp 
Cantharides (Spanish 

flies) 
Capsicum 
Carbon 

Animal charcoal 
Charcoal 
Cardamomum 
Caraway 
Cloves 
Cascarilla 
Cassia (Senna) 
Chestnut 
Cataplasms 
Catechu 



Latin 

Caulophyllum 

Cephcelis ipecacuanha 

Cera alba 

Cera Hava 

Cerata 

Cerevisice fermentum 

Cerii ox alas 

Cetaceum 

Cetraria 

Chelidonium 

Cheno podium 

Chimaphila 

Chinoidinum 

Chloral 

Chloroformi 

Chondrus 

Chrysarobinum 

Cimicifuga 

Cinchona 

Cinchonina 

Cinnamomum 
Cocaines hydrochloras 

Coccus 
Codeina 
Colchisi radix 
Colchisi semen 
Collodium 
Colocynthis 
Co mum 

Convolvulus jalap a 
Copaiba 

Coriandrum 

Cornus 

Creosotum 

Creta 

Crocus 

Cubeba 

Cuprum 

Cupri sul f has 

Cydonium 

Cypripedium 

Datura stramonium 

Digitalis 

Dulcamara 

Elaterinum 

Elaterium 

Ergot a 

Erythroxylon 

Eucalyptus 

Euonymus 

Eupatorium 

Farina tritici 
Eel bovis 
Ferri citras 
Ferri et quinia citras 



English 
Blue cohosh 
Ipecac 
White wax 
Yellow wax 
Cerates 
Bur yeast 
Oxalate of Cerium 
Spermaceti 
Iceland moss 
Celandine 

American wormseed 
Pipsissewa 
Chinoidin 

(Quinoidin) 
Chloral (Hydrate of 

chloral) 
Chloroform 
Irish moss 
Chrysarobin 
Black snakeroot 
Peruvian bark 
Cinchonine 

(Cinchonia) 
Cinnamon 
Hydrochlorate of 

cocaine 
Cochineal 
Codeine (Codeia) 
Colchicum root 
Colchicum seed 
Collodion 
Colocynth 
Hemlock 
Jalap 
Copaiba (Balsam of 

Copaiba) 
Coriander 
Dogwood 
Creosote 
Chalk 
Saffron 
Cubebs 
Copper 
Bluestone 
Quince seed 
Ladies' slipper 
Thorn apple 
Foxglove 
Bitter sweet 
Elaterin 
Elaterium 

Ergot (Ergot of rye) 
Coca 

Eucalyptus 
Wahoo 
Thoroughwort 

(Boneset) 
Wheaten flour 
Ox gall 
Citrate of iron 
Citrate of iron and 

quinine 



DICTIONARY OF DRUGS. 



1715 



Latin 
Ferri ferrocyanuretum 

Ferri sulphas 

Ferrum 

Ficus 

Foeniculum 

Frangula 

Galbanum 

Galla 

Gaultheria 

Gelsemium 

Gentiana 

Geranium 

Glycerinum 

Glycyrrhiza 

Gossypii radicis cortex 

Gossypium 



Granatum 
Grind 'elia robust a 
Guaiaci lignum 
Guaiaci resina 
Guarana 
Gutta-percha 
Hcematoxylon 
Hamamelis 
Hedeoma 

Hordium decortication 
Humulus 

Hydrargyri chloridum 
corrosivum 



Hydrargyri chloridum 
mite 



Hydrargyri cyanidum 
Hydrargyri iodidum 

rub rum 
Hydrargyri iodidum 

viride 
Hydrargyri oxidum 

Havum 
Hydrargyri oxidum 

rubrum 
Hydrargyri persulphas 

Hydrargyri subsulphas 

Havus 
Hydrargyri sulphidion 

ruprum 
Hydrargyrum 

Hydra rgyru m ammoni- 
atum 



Hydrargyrum cum creta 
Hydrastis 
Hxoscvamus 
108 



English 

Prussian blue 

Green vitriol 

Iron 

Fig 

Fennel 

Buckthorn 

Galbanum 

Nutgall (Galls) 

Wintergreen 

Yellow jasmine 

Gentian 

Cranesbill 

Glycerin 

Liquorice root 

Cotton root bark 

Cotton (Purified cot- 
ton. Absorbent cot- 
ton) 

Pomegranate 

Grindelia 

Guaiacum wood 

Guaiac 

Guarana 

Gutta percha 

Logwood 

Witchhazel 

Pennyroyal 

Pearl barley 

Hops 

Corrosive chloride of 
mercury (Corrosive 
sublimate. Mercuric 
chloride) 

Mild chloride of mer- 
cury (Calomel. 
Mercurous chlor- 
ide) 

Cyanide of mercury 

Red iodide of mer- 
cury 

Green iodide of mer- 
cury 

Yellow oxide of mer- 
cury 

Red oxide of mer- 
cury 

Persulphate of mer- 
cury 

Yellow subsulphate of 

mercury 

Red sulphide of mer- 
cury 

Mercury (quick- 
silver 

Ammoniated mercury 

White precipitate 
M e r c u r a mmonium 

chloride 
Mercury with chalk 
Golden seal 
Henbane 



Latin 
Ichthyocolla 
Ignatia 
Illicium 
Inula 

Iodoformum 
Iodum 
Ipicacuanha 
Iris 
Jalapa 
Juglaus 
Juniperus 
Kamala 
Kino 
Krameria 
Lac 

Lactuca 
Lactucarium 
Lappa 

Laricis cortix 
Lauro-cerasi folia 
Laurus camphora 
Lavandula 
Leptandra 
Limonis 
Limonis cortex 
Limonis succus 
Linum 
Lini farina 

Linium Usita tissimum 
Liquor calcis 
Liquor plumbi subacetate 
Lithii bencoas 
Lithii bro nudum 
Lithii carbonas 
Lithii citras 
Lithii salicylas 
Lobelia 

Lotio hydrargyri nigra 
Lupulinum 

Lycopodiu?. 
Ma cis 
Magnesia 

Magnesia sulphas 
Magnolia 
Ma Hum 
Mangani oxidum 

nigrum 
Mangani sulphas 

Manna 

Maranta arundinacea 

Marrubiitm 

Massa hydrargyri 

Mastiche 

Matico 

Matricaria 

Mel 

Melissa 

Menispermum 

Mentha piperita 



English 

Isinglass 

Bean of St. Ignatius 

Star anise 

Elicampane 

Iodoform 

Iodine 

Ipecac 

Blue flag 

Jalap 

Butternut 

Juniper 

Kamala 

Kino 

Rhatany 

Milk 

Lettuce 

Lactucarium 

Burdock 

Larch bark 

Cherry laurel leaves 

Camphor - 

Lavendar 

Culver's root 

Lemons 

Lemon peel 

Lemon juice 

Flaxseed 

Flaxseed meal 

Flaxseed 

Lime water 

Lead water 

Benzoate of lithium 

Bromide of lithium 

Carbonate of lithium 

Citrate of lithium 

Salicylate of lithium 

Lobelia 

Black wash 

Lupulin (lupulinic 
glands) 

Lycopodium 

Mace 

Magnesia (light mag- 
nesia) 

Epsom salts 

Magnolia 

Malt 

Black oxide of man- 
ganese 

Sulphate of mangan- 
ese 

Manna 

Arrow root 

Horehound 

Blue mass pill 

Mastic 

Matico 

German chamomile 

Honey 

Balm" 

Canadian moousecd 

Peppermint 



1716 



DICTIONARY OF DRUGS. 



Latin 

Mentha puligium 

Mentha viridis 

Menthol 

Menthol salicylis 

Mezereum 

Mica panis 

Mist ura creta 

Mori succus 

Morphina 

Moschus 

Myristica 

Myrrha 

Narthex asafoetida 

Nectandrae cortex 

Nux vomica 

Oleum a dip is 

Oleum amygdalae 

Oleum caryophylli 

Oleum cubebae 

Oleum gaultheria 

Oleum morrhuae 

Oleum olivae 

Oleum ricini 

Oleum terebinthinae 

Oleum tiglium 

Opium 

Origanum 

Os usturn 

Ovi albumina 

Ovi vitellus 

Papaveris capsula 

Papaveris somniferum 

Parafferium durum 

Pareira 

Pepo 

Pepsinum sac char atum 

Petrolatum 

Phosphorus 

Physostigma 

Physostigmina 

Phytolaccae 

Phytolaccae radix 

Picrotoxinum 

Pigmentum indicum 

Pilocarpus 

Pilulac masse hydrargyri 

Pimenta 

Piper 

Piperina 

Pix 

fix liquida 

Plumbiacetas 

Plumbum 

Podophyllum 

Potassii bitartras 

Potassii nitras 

Potassium 

Potassa 

F'rinos 

Prunum 



English 
Pennyroyal 
Spearmint 
Menthol 

Menthol Salicylate 
Mezereum 
Crumb of bread 
Chalk mixture 
Mulberry juice 
Morphine 
Musk 
Nutmeg 
Myrrh 
Asafetida 
Nectandra, b e e b eru 

bark 
Nux vomica 
Lard oil 
Oil of almonds 
Oil of cloves 
Oil of cubebs 
Oil of wintergreen 
Cod-liver oil 
Sweet oil 
Castor oil 
Turpentine 
Croton oil 
Opium 

Wild marjoram 
Bone ash 
Egg albumin 
Yolk of eggs 
Poppy capsules 
Poppy-heads 
Hard paraffin 
Pareira brava 
Pumpkin seed 
Saccharated pepsin 
Petroleum ointment 
Phosphorus 
Calabar bean 
Physostigmine 
Poke berry 
Poke root 
Picrotoxin 
Indigo 
Jaborandi 
Blue-mass pill 
Allspice 
Pepper (black 

pepper) 
Piperine 
Pitch 
Tar 

Sugar of Lead 
Lead 

May-apple 
Cream of tartar 
Saltpetre 
Potassium 
Potassa 
Black alder 
Prune 



Latin 

Prunus virginiana 
Pulsatilla 
Pulv. Ipecac et opii 
Pyrethrum 
Pyroxylinum 
Quassia 
Quercus alba 
Quercus cortex 
Quercus infect oria 
Quillaia 

Quinidinae sulphas 
Quinina 
Resina 

Rhamni purshiani 
cortex 

Rhus 

Rhus glabra 

Rhus toxicodendron 

Rosa centifolia 

Rosa gallica 

Rosmarinus 

Rubus 

Rubus I dams 

Rumex 

Sabadilla 

Sab in a 

Saccharum 

Saccharum albe 

Saccharum lactis 

Sagus rumphii 

Salicinum 

Salix 

Salvia 

Sambucus 

Sanguinaria 

Santalum rubrum 

Santonica 

Santoninum 

Soap 

Sarsaparilla 

Sassafi'as 

Sassafras medulla 

Sc ammonium 

Scilla 

Scoparius 

Scutellaria 

Senega 

Senna 

Serpentaria 

Sevum 

Si nap is 

Sinapis alba 

Sinapis nigra 

Smilax Officinale 

Sodii biboras 

Sodii bicarbonas 

Soda 

Solanium dulcamara 

Spigelia 

Spiritus frumenti 

Spiritus vini gallici 



English 

Wild-cherry 

Pulsatilla 

Dover's powders 

Pellitory 

Soluble gun cotton 

Quassia 

White oak 

Oak bark 

Nutgalls 

Soap bark 

Sulphate of quinidine 

Quinine 

Resin 

Sacred bark 
Chittim bark 
Cascara sagrada 

Rhubarb 

Rhus glabra ; oak 

Rhus toxicodendron 

Pale rose 

Red rose 

Rosemary 

Blackberry 

Raspberry 

Rumex 

Cevadilla 

Savine 

Sugar 

White sugar 

Sugar of milk 

Saco 

Salicin 

Salix 

Salvia 

Elder 

Bloodroot 

Red saunders 

Levant wormseed 

Santonin 

Soap 

Sarsaparilla 

Sassafrass 

Sassafrass pith 

Scammony 

Squill 

Broom 

Scullcap 

Senega 

Senna 

Virginia snakeroot 

Suet 

Mustard 

White mustard 

Black mustard 

Sarsaparilla 

Borax 

Baking soda 

Soda 

Bitter sweet 

Pinkroot 

Whiskey 

Brandy 



DICTIONARY Otf DRUGS. 



1717 



Latin 
Staphisagria 
Stillingia 
Stramonii folia 
Sodii chloridum 
Sodii et Potassi tartras 
Sodii phosphas 
Sodii sulphas 
Stramonii semen 
Strychina 
Sty rax 

Sulphuris iodidam 
Sulphur lotum 
Sulphur praecipitatum 
Sulphur rotundum 
Sulphur sublimatum 
Sumbul 

Syrupus acaciae 
Syrupus acidi citrici 



English 
Stavesacre 
Queen's root 
Stramonium leaves 
Salts 

Rochelle salts 
Phosphate of soda 
Glauber salts 
Stramonium seed 
Strychnine 
Styrax 

Iodide of sulphur 
Washed sulphur 
Precipitated sulphur 
Brimstone 
Sublimed sulphur 
Sumbul 

Syrup of gum arabic 
Syrup of citric acid 



Syrupus acidi hydriodici Syrup of hydriodic 

acid 
Syrupus allii Syrup of garlic 

j Syrupus althceae Syrup of althaea 

Syrupus amygdala Syrup of almond 

Syrup of orgeat 
Syrupus aurantii Syrup of orange 

Syrupus aurantiiHorum Syrup of orange 

flowers 
Syrupus calcii lacto- Syrup of Lactophos- 

phosphatis-. phate of calcium 

Syrupus ferri bromidi Syrup of bromide of 

iron 
Syrupus ferri iodidi Syrup of iodide of 

iron 
Syrupus ferri phosphatis Syrup of phosphate of 

iron 
Syrupus ferri quininae Syrup of the phos- 
phates of iron 
Quinina et strychinae Quinine and strych- 

phosphatum nine 

Syrupus hypophosphitum Syrup of hypophos- 

phites 
Syrupus hypophosphitum Syrup of hypophos- 

cumferro phites with iron 

Syrupus ferri quininae Syrup of the phos- 
et strychinae phos- phates of iron, qui- 

phatum nine and strychnine 

Syrupus ipecacuanhae Syrup of ipecac 
Syrupus krameriae Syrup of krameria 

Syrupus lactucarii Syrup of lactucarium 

Syrupus limonis Syrup of lemons ^ 

Syrupus mori Syrup of mulberries 

Syrupus papaveris Syrup of poppies 

Syrupus picis liquidae Syrup of tar 



Latin 
Syrupus pruni 

Virginianae 
Syrupus rhus 
Syrupus rhus 

aromaticus 
Syrupus rosae 
Syrupus rubi 
Syrupus rubi idaei 
Syrupus sarsaparilla 

compositus 
Syrupus scillae 



English 
Syrup of wild-cherry 

Syrup of rhubarb 
Aromatic Syrup of 

rhubarb 
Syrup of rose 
'Syrup of blackberry 
Syrup of raspberry 
Compound syrup of 
sarsaparilla 
Syrup of squill 
Syrup scillae compositus Compound syrup of 

squill 
Syrupus senegae Syrup of senega 

Syrupus sennae Syrup of senna 

Syrupus tolutanus Syrup of tolu 

Syrupus zingiberis Syrup of ginger 

Tabacum Tobacco 

Tamarindus Tamarind 

Tanacetum Tansy 

Taraxacum Dandelion 

Tcrcbinthina Turpentine 

Theobroma cacao Chocolate 

Theriaca Treacle (molasses) 

Thuja Arbor vitae 

Thymol Thymol 

Tinctura opii Laudanum 

Tinctura opii camphor ata Paregoric 
Tragacantha Tragacanth 

Triticum Couch-grass 

Ulmus E!m (slippery elm) 

Ustilago Corn smut 

Uvae Raisins 

Uva ursi Bearberry 

Valeriana Valerian 

Vanilla Vanilla 

_ Veratrina Veratrine 

! Veratrum viride American hellebore 

Viburnum Black haw 

Viburnum opulus Cramp bark 

Vinum album White wine 

Vinum rubruni Red wine 

Vina medicata Medicated wines 

Viola tricolor Pansy 

Vitellus Yolk of egg 

Xanthoxylum Prickly ash 

Zincum Zinc 

Zinci acctas Acetate of zinc 

Zinci Chloridum Chloride of zinc 

Zinci iodidum Iodide of zinc 

Zinci oxidum Oxide of zinc 

Zinci sulphas Sulphate of zinc 

Zingiber Ginger 



TABLE OF MEDICINES AND DOSES 



Xo fixed rule can be applied to dosage for various reasons. Primarily 
because one individual may be more readily affected by drugs than another, 
or the drugs may be so antagonized by the disease process as to render 
very large doses necessary. Therefore, dosage must be varied to suit the 
case, and taking into consideration age and sex. 

The following table gives a full list of medicines ordinarily used, with 
their properties and the doses suitable for adults. The dose for a child 
may be determined, excepting in a few dangerous medicines, by this rule : 
Add twelve to the child's age in years and divide the sum by the child's 
age. The quotient shows what proportion of the dose for an adult is to 
be used. Thus : 

Child's age in years 6 

Add 12 

Divide by child's age 6) 18(3 

and the dose for a child of six years is found to be one-third of the dose for 
an adult. This rule is not a law, however, for of narcotics children should 
receive less than this (one-half), and of purgatives or laxatives more than 
this (say two or three times). 

Medicines and Properties. Doses. 

Acetanilid ; febrifuge, anodyne 1 to 5 grains 

Aconite root, tincture of; narcotic, sedative and nauseant. . .1 to 3 drops 3 times a day 

Aloes socotrine, powdered ; purgative 5 to 10 grains 

Aloes socotrine, pills of ; purgative .2 to 3 pills at bedtime 

Aloes socotrine, tincture of ; purgative 1 to 3 drams at bedtime 

Aloes and myrrh, tincture of; emmenagogue 1 to 2 teaspoonfuls 2 or 3 times a day 

Aloes and myrrh, pills of ; emmenagogue 3 or 4 pills twice a day 

Alum, powdered ; astringent and emetic 3 to 30 grains 

Alum, burned; escharotic 10 to 15 grains moistened with water applied externally 

Ammonia, carbonate of; stimulant 5 to 6 grains every 2 to 4 hours 

Ammonia, water of (spirits of hartshorn); stimu. and caustic. 8 to 12 drops diluted 
with water. 

Ammonia aromatic, spirits of ; stimulant 10 to 20 drops diluted in water 

Ammonia liniment (volatile) ; rubefacient applied externally 

(1719) 



1720 TABLE OF MEDICINES AND DOSES. 

Medicines and Properties. Doses. 

Ammoniac mixture ; expectorant tablespoonful 3 or 4 times a day 

Ammonium chloride ; expectorant 5 to 10 grains 

Angelica root, fluid extract of; stimulant and aromatic, .teaspoonful 3 or 4 times a day 
Angelica root, decoction of; stimulant and aromatic. . .wineglassful 2 to 4 times a day 

Anise-seed, essence of; aromatic and carminative 1 to 2 teaspoonfuls 

Antimonial wine; emetic 2 to 3 teaspoonfuls 

Antipyrine ; febrifuge " 3 to 5 grains 

Arrowroot, Bermuda ; nutritive and tonic as a gruel 

Arsenic, Donovan's compound solution of; alternative 5 to 10 drops 3 times a day 

Arsenic, Fowler's solution of; alternative and febric, 1 to 5 drops 3 times a day 

Asafetida, pills of ; anti-spasmodic 1 to 2 pills 

Asafetida, milk of; anti-spasmodic 1 to 2 teaspoonfuls 

Asafetida, tincture of; anti-spasmodic 25 to 40 drops 

Balsam of copaiva ; diuretic, laxative and stimulant 20 to 30 drops 3 times a day 

Balsam of fir; diuretic 10 to 15 drops 

Balsam of Peru ; stimulant and tonic 5 or 10 drops twice a day 

Balsam of tolu, tincture of; stimulant and tonic 20 to 40 drops 

Belladonna, tincture of; diaphoretic, diuretic and narcotic 3 to 5 drops 

Belladonna, plaster of; anodyne and diaphoretic applied externally 

Belladonna, ointment of ; anodyne applied externally 

Bismuth, subnitrate of; anti-spasmodic, absorbent, sedatives to 10 grains 3 times a day 

Bitter sweet, fluid extract of; emetic and narcotic 30 to 40 drops 3 times a day 

Black drop (vinegar of opium) ; narcotic 10 to 12 drops 

Black cohosh, decoction of; narcotic, diaphoretic and diuretic. .. .wineglassful 3 

times a day. 
Black cohosh, tincture of; narcotic, diaphoretic and diuretic. .. .teaspoonful 3 

or 4 times a day. 
Blackberry root, decoction of; astringent and tonic. . .wineglassful 3 or 4 times a day 

Blackberry root, fluid extract of; astringent and tonic teaspoonful 3 times a day 

Blackberry root, syrup of; astringent tablespoonful 3 to 6 times a day 

Blue vitriol ; emetic 1 to 3 grains 

Blue mass pills; alterative and sialagogue 1 or 2 pills (5 grains each) 

Boneset, infusion of; stimulant, sudorific and emmenagogue. . . 1 to 2 tablespoon- 

fuls 3 or 4 times a day. 
Boneset, fluid extract of; stimulant, sudorific and emmenagogue 30 to 40 drops 

3 or 4 times a day. 

Borax, powdered ; nephitic and deterient 15 to 25 grains 

Buchu, infusion of; diaphoretic and diuretic tablespoonful 4 or 5 times a day 

Buchu, fluid extract of; diaphoretic and diuretic teaspoonful 3 or 4 times a day 

Buckthorn, fluid extract of; hydragogue cathartic teaspoonful at bedtime 

Burdock, fluid extract of ; herpetic anti-scorbutic tablespoonful 

Calomel ; alterative and laxative % to 5 grains 

Camphor, gum ; anti-spasmodic and sedative 2 to 5 grains 

Camphor, spirits of; anti-spasmodic and sedative 10 to 25 drops 

Camphor, water of ; anodyne and sedative 2 to 4 teaspoonfuls 

Calamus root, fluid extract of; aromatic, stimulant and stomachic teaspoonful 

Caraway seed, infusion of ; aromatic and carminative tablespoonful 

Cardamom seed, tincture of; aromatic and stimulant 1 to 2 teaspoonfuls 

Cardamom, compound tincture of ; stomachic 1 to 2 teaspoonfuls 



TABLE OF MEDICINES AND DOSES. 1721 

Medicines and Properties. Doses. 

Cascar'a sagrada, fluid extract of; tonic laxative 10 to 30 drops 

Catechu, powdered ; astringent 15 to 30 grains 

Catechu, tincture of ; astringent 10 to 30 drops 

Catnip, decoction of; diaphoretic, stomachic and corrective tablespoonful 

Cayenne pepper, powdered ; stimulant 3 or 6 grains 

Cayenne pepper, tincture of; stimulant 10 to 15 drops 

Castor oil ; purgative. 1 to 2 tablespoonfuls 

Chamomile flowers, cold infusion of; tonic and stomachic. . 1 to 2 tablespoonfuls 3 times 
a day. 

Chalk, prepared; antacid and astringent 10 to 30 grains in mucilage 

Chalk mixture ; antacid and astringent 2 or 3 teaspoonfuls 

Chloroform ; narcotic and sedative 10 to 60 drops in mucilage 

Chloroform, liniment of ; anesthetic and anodyne applied externally 

Cinnamon, powdered ; astringent and stomachic 5 to 15 grains 

Cinnamon, oil of; astringent and stomachic 2 to 4 drops 

Cinnamon, essence of; astringent and stomachic 20 to 25 drops 

Cloves, powdered; aromatic, carminative and stimulant 10 to 15 grains 

Cloves, oil of; stimulant, aromatic and carminative 1 to 5 drops 

Colombo root, decoction of; tonic tablespoonful 3 times a day 

Colchicum root, wine of; narcotic, diuretic and sedative.. 10 to 30 drops 3 times a day 
Colchicum seed, tincture of; narcotic, diuretic and sedative. ... 10 to 30 drops 
3 times a day. 

Corrosive sublimate ; antisyphilitic 1-60 to % grain 2 or 3 times a day 

Cotton root, fluid extract of; emmenagogue, parturient and abortive. . .20 to 30 drops 

Cream tartar ; aperient and refrigerant teaspoonful in water 

Cubebs, powdered ; stimulant and diuretic 20 to 30 grains 

Cubebs, fluid extract of; stimulant and diuretic 20 to 30 drops 

Cubebs, tincture of; stimulant and diuretic 1 to 2 teaspoonfuls 

Cubebs, oil of ; stimulant and diuretic 10 to 12 drops on sugar 

Dandelion, fluid extract of; alterative, aperient, tonic and diuretic. 1 to 2 teaspoonfuls 
Dogwood bark, decoction of; tonic, astringent and stimulant, .wineglassful 2 or 3 times 
a day. 

Dover's powder ; diaphoretic 5 to 15 grains at bed-time 

Elder flower, decoction of; alterative, diaphoretic and diuretic... 1 to 2 tablespoonfuls 

Elm bark, infusion of; demulcent and diuretic wineglassful 

Epsom salts ; cathartic 2 or 3 teaspoonfuls before breakfast 

Ergot, powdered (fresh) ; astringent 15 to 30 grains 

Ergot, fluid extract of ; astringent 15 to 60 drops 

Ergot, tincture of ; astringent 1 teaspoonful 

Ergot, wine of ; astringent 1 teaspoonful 

Fennel seed, infusion of; aromatic and carminative tablespoonful 

Fennel seed, oil of; aromatic and carminative 3 to 6 drops 

Fever-root, decoction of; diuretic, cathartic and emetic tablespoonful 

Flaxseed, infusion of; demulcent wineglassful every 3 or 4 hours 

Flaxseed, poultice of ; astringent excellent for drawing 

Flaxseed, oil and lime-water ; astringent applied to scalds and burns 

Foxglove, powdered (digitalis) ; diuretic, narcotic and sedative .... % to 1 grain 2 or 3 

times a day. 
Foxglove, tincture of; diuretic, narcotic and sedative. .5 to 15 drops 2 or 3 times a day 



1722 TABLE OF MEDICINES AND DOSES. 

Medicines and Properties. Doses. 

Garlic, syrup of ; expectorant I to 2 teaspoonf uls 

Gaultheria, oil of (wintergreen) ; antirheumatic 2 to 10 drops 

Gentian, tincture of ; tonic 1 teaspoonf ul 

Ginger, powdered ; stimulant and carminative 20 to 30 grains 

Ginger, tincture of ; stimulant and carminative 15 to 30 drops 

Glauber salts; aperient and cathartic 1 to 2 teaspoonf uls before breakfast 

Gelsemium, fluid extract of; narcotic, sedative, diaphoretic and febrifuge.. 2 to 5 drops 
Gelsemium, tincture of; narcotic, sedative, diaphoretic and febrifuge. .5 to 10 drops 

Gum arabic, mucilage of; demulcent tablespoonful every 3 or 4 hours 

Guaiacum, tincture of; diaphoretic and diuretic teaspoonful 2 or 3 times a day 

Henbane, tincture of; narcotic and anodyne 15 to 30 drops 

Henbane, fluid extract of; narcotic and anodyne 5 to 15 drops 

Hoarhound, decoction of; sudorific, pectoral, aperient and tonic... tablespoonful 

Hoarhound, syrup of ; sudorific and pectoral tablespoonful 

Hops, tincture of; nerve tonic and sedative 1 to 2 teaspoonfuls every 4 hours 

Hydrastine (active principle of yellow root) ; astringent, tonic, stomachic, anti- 
bilious....! to 2 grains. 

Hypophosphites, syrup of; tonic Vi to 1 teaspoonful 3 times a day 

Iodine, tincture of; alterative and discutient applied to scrofulous tumors 

Iodine, ointment of ; discutient applied to scrofulous tumors 

Iron, carbonate (rust) of; tonic 5 to 10 grains 

Iron, syrup of iodine of; alterative, diuretic and tonic 5 to 10 drops twice a day 

Iron tincture, muriate of ; tonic 10 to 30 drops 

Irish moss, infusion of ; nutritive, demulcent and expectorant tablespoonful 

Ipecac, powdered ; emetic and diaphoretic 20 grains 

Ipecac, fluid extract of ; emetic and diaphoretic 20 to 25 drops 

Ipecac, wine of; emetic and diaphoretic '. 1 to 2 teaspoonfuls 

Ipecac, syrup of, emetic and diaphoretic teaspoonful repeated 

Jalap, powdered, cathartic 15 to 30 grains 

Juniper berries, infusion of; diuretic wineglassful 3 or 4 times a day 

Lactucarium ; anodyne 5 to 10 grains 

Lady's-slipper root, decoction of ; nervine tablespoonful 

Laudanum ; narcotic 5 to 20 drops 

Lead, acetate (sugar) of; astringent and sedative. ... 1 to 3 grains every 3 or 4 hours 
Lead, Goulard's extract of; anodyne and sedative.. 1 ounce diluted with 1 pint of 

water; applied externally to reduce inflammation. 

Licorice root, decoction of; demulcent and expectorant wineglassful 

Life-everlasting, decoction of; astringent, diaphoretic, stomachic. 1 to 2 tablespoonfuls 
Liverwort, decoction of; astringent, demulcent and pectoral. ... 1 to 2 tablespoonfuls 

Lobelia herb, infusion of; emetic and diaphoretic 2 teaspoonfuls 

Lobelia herb, powdered ; emetic and diaphoretic 10 to 15 grains 

Lobelia seed, tincture of; diaphoretic, emetic and expectorant 20 to 40 drops 

Magnesia, carbonate ; antacid and laxative 15 to 60 grains 

Magnesia, calcined ; antacid and laxative 15 to 60 grains 

May-apple root, powdered; cathartic, hydragogue and emetic. 15 to 20 grains at 

bedtime. 
May-apple root, powdered; cathartic, hydragogue and emetic 15 to 20 grains at 

bedtime. 
Manna ; laxative 1 to 2 drachms before breakfast 



TABLE OF MEDICINES AND DOSES. 1723 

Medicines and Properties. Dosbs. 

Manna, syrup of; laxative i to 2 tablespoonfuls before breakfast 

Mercury with chalk ; alterative 2 to 10 grains 

Mercury, mass of (blue pill); cathartic 3 to 10 grains 

Mercury, red precipitate ointment ; stimulant applied externally 

Mercurial ointment (blue) ; resolvent, antiparasitic applied externally 

Morphine, sulphate of ; anodyne and soporific Ys to Y± grain 

Mustard seed (black), ground; diuretic, emetic and stimulant 1 2 to 1 teaspoonful 

Mustard. seed (white), ground; diuretic, emetic and stimulant wineglassful 

Nitrate of silver (crystals); astringent, antispasmodic. . 1-6 to % grain 2 or 3 times 

a day. 

Nitrate of silver, lunar caustic (sticks); escharotic applied externally 

Nut-galls, tincture of ; astringent 1 to 2 teaspoonfuls 

Nut-galls, ointment of ; astringent 1 to 2 teaspoonfuls 

Nux vomica, tincture of; diuretic, excrement, stimulant and tonic. 15 drops 3 times 

a day. 
Nux vomica, fluid extract of; diuretic, excrement, stimulant and tonic. 1 to 5 drops 

2 or 3 times a day. 

Opium, powdered ; narcotic and stimulant ._. 1 grain at bedtime 

Opium, tincture of. (See Laudanum.) 

Opium, camphorated tincture of. (See Paregoric.) 

Paregoric ; anodyne 1 to 2 teaspoonfuls 

Pennyroyal, infusion of; diaphoretic, emmenagogue, stimulant, .wineglassful every hour 
Peppermint, infusion of; stimulant and carminative. . .wineglassful 2 or 3 times a day 

Peruvian bark, powdered ; febrifuge and tonic 1 drachm 2 or 3 times a day 

Peruvian bark, decoction of; febrifuge and tonic wineglassful 3 or 4 times a day 

Peruvian bark, fluid extract of; tonic and febrifuge. .. .30 to 60 drops 3 times a day 

Pepsin, pure ; digestant 15 to 60 grains 

Pepsin, saccharated ; digestant 30 grains to 1{ 2 ounce 

Pepsin, liquor ; digestant 2 to 4 teaspoonfuls 

Phenacetine ; antipyretic, antineuralgic 2 to 5 grains 

Pinkroot, infusion of; anthelmintic tablespoonful before meals 

Pinkroot, fluid extract of; anthelmintic Vi to 1 teaspoonful before meals 

Pinkroot and senna, fluid extract of; anthelmintic, purgative, .teaspoonful before meals 
Podophyllin (active principle of mandrake); diuretic, purgative.. 1 to 3 grains at 

bedtime. 

Potash, chlorate 10 to 15 grains dissolved in water 

Potash, citrate ; refrigerant and diaphoretic jo to 25 grains 

Potash, nitrate (saltpetre); refrigerant and diaphoretic 6 to 12 grains 

Potassium, bromide of; antiscorbutic, nerve sedative 5 to 60 grains 

Potassium, iodide of; alterative and antisyphilitic 5 to 15 grains 3 times a day 

Rochelle salts ; aperient 2 to 3 drachms before breakfast 

Rhatany root, decoction of ; astringent and tonic tablespoonful 

Rhatany root, tincture of ; astringent and tonic teaspoonful 

Rhubarb, powdered ; astringent and cathartic 20 to 30 grains 

Rhubarb, tincture of; astringent and cathartic 1 to 2 teaspoonfuls 

Rhubarb, fluid extract of; cathartic and astringent 25 to 40 drops 

Rhubarb, syrup of; cathartic and astringent 2 or 3 teaspoonfuls 

Rue herb, decoction of; tonic, anthelmintic and emmenagogue tablespoonful 

Saffron (American), infusion of; diaphoretic 2 to 3 teaspoonfuls 



1724: TABLE OF MEDICINES AND DOSES. 

Medicines and Properties. Doses. 

Saffron (Spanish), infusion of ; diaphoretic i to 2 teaspoonfuls 

Sage, infusion of; sudorific and stomachic * wineglassful 

Sassafras pith, infusion of; demulcent and anodyne.. 1 or 2 teaspoonfuls; also applied 

to sore eyes. 
Sassafras bark, infusion of; diaphoretic and stimulant, .wineglassful every 2 or 3 hours 

Sarsaparilla, decoction of; alterative and deobstruent teacup ful 3 times a day 

Sarsaparilla, fluid extract of; alterative and deobstruent. .teaspoonful 3 times a day 
Sarsaparilla, compound syrup of; alterative, deobstruent. .tablespoonful 4 to 6 times 
a day. 

Scammony ; cathartic 5 to 15 grains at bedtime 

Senega (snakeroot), fluid extract of; expectorant, stimulant and diuretic. 5 to 20 drops 

Senna, decoction of ; cathartic 1 to 2 tablespoonfuls 

Senna, fluid extract of ; cathartic 1 to 4 teaspoonfuls 

Stramonium leaves, tincture of; narcotic, sedative, antispasmodic. .10 to 20 drops 2 or 
3 times a day. 

Stramonium leaves, ointment of ; sedative applied externally 

Soda, bicarbonate ; antacid , 15 to 30 grains 

Seidlitz powders ; aperient 1 powder before breakfast 

Sweet spirits of nitre ; diaphoretic, diuretic and febrifuge : . . .30 to 60 drops 

Tansy (double), decoction of; sudorific, emmenagogue, anthelmintic. .1 to 2 table- 
spoonfuls. 

Thyme, infusion of; aromatic and stomachic wineglassful 

Uva ursa leaves, decoction of; diuretic and tonic wineglassful 3 or 4 times a day 

Uva ursa, fluid extract of; diuretic and tonic. . . .V2 to 1 teaspoonful 3 or 4 times a day 

Waterpepper herb, tincture of; stimulant, diuretic and emmenagogue teaspoonful 

Wild cherry bark, cold infusion of; tonic, astringent, sedative, .tablespoonful 3 times 
a day. 

Wild cherry bark, syrup of; sedative tablespoonful 3 times a day 

Witch-hazel; anodyne, astringent, sedative, styptic. 1 to 2 teaspoonfuls; also, ex- 
ternallv to reduce inflammation. 



GLOSSARY 

Giving definitions of all medical and technical 
terms contained in this work. 



Abdomen (ab-do'men). The belly; the cavity in 
the body betwen the thorax and the 
pelvis. 

Abdominal (ab-dom'in-al). Pertaining to the 
abdomen. 

Aberration (ab-er-a'shun). Deviation from the 
normal. 

Abirritant (ab-ir'it-ant). Allaying irritation. 

Ablution (ab-lu'shun). The process of cleansing 
the body. 

Abnormal (ab-norm'al). Contrary to the na- 
tural law. 

Abolition (ab-o-lish'un). Complete suspension, 
as of a function. 

Abort (ab-orf). To miscarry; to arrest the de- 
velopment of a disease. 

Abortion (ab-or'shun). Premature expulsion of 
a foetus. 

Abortive (ab-ort'iv). Prematurely born. 

Abrasion _ (a-bra'shun). A wearing off of the 
skin or mucous membrane. 

Absinthe (ab'sinth). A cordial containing oil of 
wormwood and aromatics. 

Absinthium (ab-sinth'um). Wormwood; car- 
diac stimulant and stomachic tonic. 

Absorbent (ab-sorb'ent). Taking up by suction; 
a drug that produces absorption of dis- 
eased tissue. 

Absorption (ab-sorp'shun). The inhibition of 
one body by another, as of the lens after 
rupture of the capsule. 

Abstemious (ab-ste'me-ous). Moderate in mat- 
ters of diet. 

Abstinence (ab'stin-ence). Voluntary privation 
of self-denial in diet. 

Abstract (ab'strakt). A preparation containing 
the soluble principles of a drug evapo- 
rated and mixed with sugar of milk. 

Abstraction (ab-strak'shun). Blood letting. 

Acacia (ah-ka'she-ah). A genus of shrubs and 
trees. Gum arabic. 

Accelerate (ak-sel'er-ate). To hasten; to quick- 
en action. 

Accentuate (ak-sen'tu-ate). To emphasize. 

Accentuation (ak-sen-tu-a'shun). Increased dis- 
tinctness. 

Access (ak'ses). The beginning or onset of a 
disease. 

Accession (ak-sesh'un). The same as access. 

Accouchement (ak-koosh'ment). Delivery in 
child-bed. 

Acetate (as'et-at). A salt of acetic acid. 

Achorion (ah-ko're-on). A genus of fungous 
organisms in the skin. 

Acid (as'id). A sour substance. 

Acidity (as-id'it-e). Sourness; tartness; sharp 
to the taste. 

Acme (ak'me). The crisis or height of a dis- 
ease. 

Acne (ak'ne). Inflammation of the sebaceous 
glands from retained secretion. 

Acne Rosacea (ak'ne ro-za'she-ah). Chronic 
congestion of the skin of the face. 

Aconite (ak'o-nit). Same as aconitum. 

17 



ip; a synonym ot 
of acute ery- 



Acomtum (ak-on-i'tum). A genus of herbs and 
also the poisonous roots and leaves of 
monk's hood; cardiac sedative. 

Acrid (ak'rid). Burning; pungent. 

Acute (a-kut'j. Rapid; severe; sharp; keen. 

Adaptation (a-dap-ta'shun). The adjustment of 
the pupil to light variations. 

Adenitis (ad-en-i'tis). Inflammation of a gland. 

Adenoid (ad'e-noid). Resembling a gland. 

Adenoma (ad-en'o-mah). A glandular tumor. 

Adenosis (ad-en-o'sis). Any chronic abnormal- 
ity of the glands. 

Adeps (ad'eps). Lard. 

Adequate (ad'e-quate). Equal; proportionate; 
fully sufficient. 

Adipose (ad'i-pos). Fatty. 

Adipose Arteries (ad'i-pos ar'ter-ez). Arterial 
branches, supplying the renal fat. 

Adipose _ Tissue (ad'i-pos tish'u). Fat cells 
united by connective tissue. 

Adiposis (ad-i-po'sis). Corpulence; fatty de- 
generation. 

Adult (a-dulf). Having arrived at mature 
years; of full size and strength. 

Adynamia (ad-in-a'me-ah). A deficiency or loss 
of vital power. 

Aeration (a-er-a'shun). Admixture or impreg- 
nation with air. 

Aerial (a-er'e-al). Pertaining to the air. 

Affinity (afin'i-te). Relationship; a synonvi 
attraction. 

Afflatus _ (a-fla'tus). A variety 
sipelas. A current of air. 

Affusion (a-fu'shun). A pouring upon, as water 
on the body. 

Agaricus (a-gar'i-kus). A genus of fungi. 

Agenesia (ah-jen-e'ze-ah). Abnormal or imper- 
fect development. 

Agenesis (ah-jen'e-sis). The same as agenesia. 

Agent (a'jent). A substance that produces 
changes in the body. 

Agglutinative (a-glu'ti-na-tiv). Adhesive; a sub- 
stance with adhesive properties. 

Agglutinin (a-glu'ti-nin)^ A substance in the 
blood-serum or immunized individuals 
which has the property of agglutinating 
bacteria. 

Agility (a-gil'i-te). The power of moving the 
limbs quickly. Activity. 

Agitation (aj-i-ta'shun). Violent excitement; a 
shaking. 

Akimbo (a-kim'bo). At an acute angle; said of 
the arms when the hands rest on the hips 
and the elbows project outward. 

Albumen (al-bu'men). The white of an egg. 
Food material in a seed between the em- 
bryo and seed-coats. 

Albumin (al-bu'min). A proteid animal or 
vegetable which is soluble in water and 
coagulated by heat. 

Albumin Acid (al-bu'min as'id). That changed 
by the action of acid. 

Albuminate (al-bu'min-ate). A basic compound 
of albumin. 

Albuminoid (al-bu'min-oid). Resembling albu- 
men. _ A substance resembling true pro- 
teids in origin and composition. 



1726 



GLOSSARY. 



Albuminuria (al-bu-min-u're-ah). Presence of 
albumin in the urine. 

Albumon (al-bu'mon). A protein found in the 
blood; it cannot be coagulated by heat. 

Alchemy (al'kem-e). The supposed art of chang- 
ing base metals into gold and of discov- 
ering the elixir of life. 

Aliment (al'i-ment). Nourishment; food. 

Alimentary (al-i-men'ta-re). Having the quality 
of nourishing. 

Alimentary Canal (al-i-men'ta-re ka-nal'). The 
whole digestive tube from the mouth to 
the anus. 

Alimentation (al-imen-ta'shun). The process of 
nourishment. 

Alimentation, Rectal (al-i-men-ta'shun rec'tal). 
Nourishing by injection of food into the 
rectum. 

Alkali (al'ka-li). An electropositive substance 
combining with an acid to form a neutral 
salt. 

Alkaline (al'ka-lin). Having the properties of 
an alkali. 

Alkanet (al'kan-et). The herb alkanna tinc- 
toria; the root yields a red dye. 

Allay (al-la'). To abate; to assuage; to sub- 
side. 

Alleviate (al-e'vi-ate). To ease; to mitigate; to 
make more bearable. 

Allium (.al'e-um). A genus of plants. 

Allium Cepa (al'e-um ce'pa). Common onion. 

Allium Sativum (al'e-um sa-ti'vum). Garlic; a 
diuretic and stimulant. 

Allot ropy (a-lot'ro-pe). A variation of physical 
properties without a change in chemic 
composition. 

Alluvial (al-lu've-al). Belonging to soil formed 
by deposits of mud. 

Alopecia (al-o-pe'se-ah). Loss of the hair. 

Alterative (al'ter-a-tiv). A medicine that alters 
the processes of nutrition and excretion, 
restoring the normal body functions. 

Alternately (al-ter'nate-le). In a reciprocal suc- 
cession; by turns; as night follows day 
and day follows night. 

Alternation of Generation (al-ter-na'shun _ of 
jen-e-ra'shun). A form of reproduction 
in which members can produce new be- 
ings non-sexually, while in the final stage 
reproduction is always sexual. 

Alveole (al-ve-ol). A small cell, cavity or de- 
pression in a surface; a tooth socket. 

Alvine (al-vin). Pertaining to the belly or in- 
testines. 

Alvine Concretion (al-vin kon-kre'shun). In- 
testinal calculus. 

Alvine Discharges (al'vin dis-charg'ez). The 
discharge of the bowels. 

Alvin Flux (al'vin fluks). Diarrhoea. 

Alius (al'vus). The belly or its contents. 

Amalgam (a-mal'gam). An alloy containing 
mercury. 

Amaurosis (am-au-ro'sis). Partial or total 
blindness. 

Ambiguity (am-bi-gu'i-te). Uncertain; doubtful; 
of double meaning. 

Amblyopia (am-ble-o'pe-ah). Dimness of vision. 

Ameba (am-e'bah). A genus of rhizo pods; an 
individual in the above genus. 

Ameboid (a-me'boid). Having the movements 
of an ameba. 

Amelia (ah-me'le-ah). Absence of the limbs, 
from birth or atrophic. 

Amelioration (a-mel-i-o-ra'shun). Becoming bet- 
ter; improvement. 

Amenorrhea (a-men-o-re'a). Irregularity or 
suppression of the menses. 

Ammonium (am-mo'ne-um). A hypothetic alka- 
line base existing only in combination. 

Amnesia (am-ne'ze-ah.) A loss of memory for 
words. 

Amoeba (am-e'bah). See ameba. 

Amputation (am-pu-ta'shun). The operation of 
cutting off a limb or part of a limb. 



A mygdalitis (am-ig-dal-it'tis) . 
Amylaceous (am-il-a'se-us). 



Tonsillitis. 
Containing starch. 
Converting starch 



body 



Amylolytic (am-il-o-lit'ik). 
into sugar. 

Analog or Analogue (an'a-log). A part or or- 
gan similar in function to another but 
different in structure. 

Analogous _ (an-al'a-gus). Conforming or an- 
swering to; bearing resemblance. 

Analysis (an-al'i-sis). The resolution of a 
into its elements. 

Analysis Gasometric (an-al'i-sis gas-o-met'ric). 
That of gaseous compounds. 

Anam Ulcer (an'am ul'sur). A form of pha- 
gedena common in the tropics. 

Anamnesis (an-am-ne'sis). The past history of 
a disease. 

Anaphia (an-a'fe-ah). A deficient sense of 
touch. 

Anaphoresis (an-af-or-e'sis). Insufficient pers- 
piration. 

Anasarca (an-as-ar'kah). General dropsy. 

Anastomosis (an-as-to-mo'sis). The junction of 
vesels or hollow organs. 

Anatomically (an-a-tom'i-cal-e). In an anatom- 
ical manner; by means of dissection; ac- 
cording to anatomy. 

Anatomy (an-at'o-me). The science of organic 
structure. 

Anchylosis (an-kil-o'sis). See ankylosis. 

Anemia (an-e'me-ah). A deficiency of blood or 
of red corpuscles. 

Anemic (an-em'ik). Pertaining to anemia. 

Aneroid (an'er-oid). Dispensing with fluid. 

Anesthesia (an-es-the'ze-ah). A state of insen- 
sibility. 

Anesthetic (an-es-thet'ik). A substance produc- 
ing anesthesia. 

Aneurism (an'u-rizm). A dilatation of an ar- 
tery. 

Angina (an-ji'nah). A sense of suffocation. 

Anginose (an'jin-oz). Affected with angina. 

Angioleucitis (an-je-o-lu-si'tis). Inflammation of 
the lymphatics. 

Animation (an-i-ma'shun). The act of infus- 
ing life; the state of being animated. 

Ankylosis (an-kil-o'sis). Union of the bones 
forming a joint resulting in a stiff joint. 

Annular (an'ti-lar).- Ring-like. 

Annular Ligament (an'u-lar lig'a-ment). The 
ligament around the wrist and ankle. 

Anodyne (an'o-din). A medicine relieving pain. 

Antacid (ant-as'id). An alkali; neutralizing 
acidity. 

Antagonist (an-tag'o-nist). A drug neutraliz- 
ing the effects of another, or a muscle 
opposing the action of another. 

Antaphrodisiac (ant-af-ro-dis'i-ak). A medicine 
which cools the animal passion. 

Antecedent (an-te-ced'ent). A person or thing 
that goes before, with reference to time, 
place, position, etc. 

Anterior (an-ter'e-or). Situated before or in 
front of. 

Anteroposterior (an-ter-o-pos-te're-or). From 
before; backward. 

Anthelmintic (an-thel-min'tik). A remedy ex- 
pelling worms. 

Antibilious (an-te-bil'yus). Opposing bilious- 
ness. 

Antidote (an'ti-dot). An agent counteracting 
the action of a poison. 

Antifcrmcntativc (an-te-fer-men'ta-tiv). Arrest- 
ing fermentation. 

Antimorbific (an-te-mor-bif'ic). That which 
opposes disease. 

Antiperiodic (an-te-per-i-od'ik). A remedy for 
periodical disease. 

Antiphlogistic (an-te-flo-jist'ik). An agent re- 
ducing inflammation or fever. 

Antipruritic (an-te-pru-rit'ik). Relieving itch- 
ing. 



GLOSSARY. 



1727 



Antipyretic (an-ti-pi-ret'ik). Reducing tempera- 

Antiscorbutic (an-te-skor-bu'tik). A remedy for 
scurvy. J 

Antiseptic .(an-te-sep'tik). Preventing or de- 
stroying the germs of putrefaction or 
suppuration. 

Antispasmodic (an-te-spas-mod'ik). Counteract- 
ing or curing spasm. 

Antisyphilitic (an-te-sif-i-lit'ik). A remedy for 
the relief of syphilis. 

Antitoxin (an-te-toks'ine). Virus used to neu- 
trahze the action of toxin. 

Anuria (an-u're-ah). An absence or deficiency 
of urine. 

Aniis^ (a'nus). The extremity of the rectum 

Aperient (ah-pe're-ent). Laxative; opening.' 

Aperture (a'per-tur). An opening or orifice. 

The tip, point or summit of 



power of 



Apex (a'peks). 
anything. 
Aphasia (ah-fa'se-ah). A loss of 

speech from cortical lesion. 
Aphasia Amnesic (ah-fe'se-ah am-ne'sik). A 

want of memory for words. 
Aphasia Ataxic (ah-fe'se-ah a-taks'ik). An in- 
ability to articulate words. 
Aphonia (ah-fo'ne-ah). A loss of voice, due to 

peripheral lesion. 
Aphonia Clericorum (ah-fo'ne-ah cler-i-co'rum). 

Clergymen's sore throat. 
Aphthae (af'the). Small white ulcers of the 

mouth; thrush. 
Aphthous (af'thus). Marked by aphthae. 
Apis Mellifica (ap'is mel-if'ik-a). The honey- 
bee. 
Apnea (ap-ne'ah). Temporary absence of 

breathing. 
Apoplexy (ap'o-pleks-e). Paralysis from rup- 
ture of a cerebral vessel. 
Apoplexy, Bulbar (ap'o-pleks-e bulb'ar). Due to 
the rupture of a blood vessel in the 
medulla oblongata. 
Apothecary (a-poth'e-ka-re). A druggist; a sel- 
ler of drugs. 
Apparatus (ap-a-ra'tus). Instruments; a num- 
ber of organs which act together in the 
performance of a definite function. 
Appendage (ap-pen'dage). That which is at- 
tached to an organ as a part of it. 
Appendicitis (ap-pen-dis-i'tis). Inflammation of 

the appendix vermiformis. 
Appendix (ap-pen'diks). An appendage; an ad- 
junct. 
Approximate (ap-proks'i-mate). To come near 

to; approaching; closely resembling. 
Arabinose (ar'ab-in-os). A pentose; gum sugar 

from arabic acid. 
Arachnitis (ar-ak-ni'tis). Inflammation of the 

arachnoid membrane. 
Arachnoid (ar-ak'noid). Resembling a web. 
Arcanum (ar-ka'num). A sweet medicine o 

nostrum. 
Area (a're-ah). Any space with boundaries. 
Areola (a-re'o-lah). A ring-like discoloration 

colored ring around the nipple. 
Areolae (a-re'o-le). The interstices in connec 

tive tissue. 
Areolar (ar-e'o-lar). Pertaining to the areola 

full of interstices. 
Aroma (a-rom'ah). Intense perfume; odor. 
Aromatic^ (a-ro-mat'ik). Spicy; fragrant; a 

spicy, stimulating drug. 
Aromatic Powder (a-ro-mat'ik pow'der) 

mixture of nutmeg, ginger, cinnamon and 
cardamona. 
Aromatic Tincture (a-ro-mat'ik tinc'ture). An 

alcoholic solution of aromatic powder. 
Arteritis (ar-te-ri'tis). Inflammation of an ar- 
tery. 
Artery (ar'ter-e). A vessel carrying blood from 

the heart. 
Arthritic (ar-thrikt'ik). Relating to inflamma- 
tion of the joints. 
Articulated (ar-tik'u-la-ted). Jointed. 



A 



Articulation (ar-tik-u-la'shun). A joint or an 
a'~h~ f T } hrosis ; The enunciation . of words. 
^^""a^tiPula/ion? 1 ' 11 - 13 - 10 -^- Pertai ™* to 
Artificial^ (ar-ti-fish'al). Made or imitated by 

Aryten gi pe ^-^oid). Cup-shaped or ladle- 

ASCa %o a r S m k s* V '' 1S) - A genuS ° f P arasitic round- 

Ascending (as-send-ing). Rising. 

Ascending Degeneration (as-sand-ing de-jen-er- 
a'shun). A degeneration of nerve fibre, 
progressing from the periphery ^ the 

Ascites (as-si'tez). Droosv of tk« ~>ua 

Aspermous (ah-sper'mus). Without seed. 
Asphyxia (as-fiks'e-ah). The condition caused 
by the nonoxygenation of the blood Sus- 
pended animation. Ub 

Aspirate (as'pi-rate). To breathe roughly 

P lion. (aS - pi " ra ' shun )- Inspiration; y inbibi- 

Aspirat ° } - Cas'pir-a-tor). An instrument for ex- 
. tractmg fluids from cavities 

' 2m 'simflate a d" im ' il ' a " bl) - Capable ' ° f being ^s- 

Assimilate (as-Vi-late). To become similar. 

To perform the act of converting food to 

. the substance of the body. 

Assimilation (as-im-il-a'shun). The act of ah 

sorting nutriment. A state of rtem-" 

Assumption (as-sump'shun.) The act of taking 
to oneself; adoption. living 

Asthenia s (as-the'ne-ah) . A loss of strength 
Asthenopia (as-then-o'pe-ah). Weak or painful 
vision. ' u 

Asthma (az'mah). Paroxysmal difficult breath- 
ing with oppression. 
Asthma, cardiac (az'mah kar'di-ak). Difficult 

breathing due to heart disease. 
Asthmatic (az-mafik). Subject to asthma. 
Astringent (as-trin'jent). An agent producing 
contraction of organic tissues or the arm- 
rest of a discharge. 
Atmosphere (at'mus-fer). The air or gaseous 
mixture surrounding the earth, fifteen 
pounds to the square inch 
Atomizer (afo-mi-zer). An instrument for re- 
a* ,., ■ Cl , ng a J et of hc J uid t0 a spray. 
Atrophia (at-ro'fe-ah). See atrophy. ' 
Atrophy (at'ro-fe). A wasting of a part from 

a lack of nutrition. 
Atropina (afro-pin). The active principle of 

belladonna. 
Attar of Rose (ofar). Oil of rose 
Attenuated (a-ten'u-a-ted). Wasted; thinned 
Attenuation (a-ten-u-a'shun). A thinning 'or 

weakening. 
Attic (afik). The portion of the tympanum 

above the atrium. 
Auditory (aw'di-to-re.). Pertaining to the act 

or organs of hearing. 
Augment (aug'ment). The increase of a dis- 
ease or the period intervening between it ; 
attack and its height. 
Auricle (au'rik-1). The external ear. One of 

§ the upper cavities of the heart. 
Auricular (aw'rik-u-lar). Pertaining to the ear 

or cardiac auricle. 
Auriculoventricular (aw-rik-u-lo-ven-trik'n-lar) 
Pertaining to both the auricle and ven- 
tricle. 
Auscultation (aws-kul-ta'shun). A method of 
determining the condition of an organ bv 
listening to the sounds produced by it.' 
Autecic (aw-te'sik). Living absolutely on the 
same organism. 



1728 



GLOSSARY. 



Autopsy (aw'top-se). Examination of a corpse. 
Auxilary (awks-il'e-a-re). Aiding; assisting. 
Axilla (aks-il'ah). The armpit. 
Axillary (aks-il'a-re). Relating to the armpit. 

B 

Bacillus (bas-il'us). A genus of schizomycetes, 
the most important group of- bacteria. 

Bacteria (bak-te're-ah). Micro-organisms; mi- 
crobes; schizomycetes. 

Bacterial (bak-te're-al). Relating to or caused 
by bacteria. 

Bactericidal (bak-te-ris-i'dal). Destroying bac- 
teria. 

Bactericide (bak-te'ris-id). See germicide. 

Bacteremia (bak-te-re-e'me-ah). The presence 
of bacteria in the blood. 

Bacterin (bak'ter-in). Any vaccine prepared 
from a specific bacterium. 

Bacterium (bak-te're-um). A genus of fission 
fungi. 

Balsam (bawl'sam). A compound of resin and 
evaporative oils, fragrant and aromatic. 

Balsamic (bawl'sam-ik). Resembling balsam; 
pertaining to balsam. 

Balsamic Tincture (bawi'sam-ik tink-ture). Com- 
pound tincture of benzoin. 

Barley (bar'le). A cereal used for food. 

Barley-water (bar'le-wa'ter). A nutritious drink 
made of an infusion of barley. 

Belladonna (bel-ah-don'ah). A poisonous plant, 
used as an anodyne; an antispasmodic. 

Benignant (be-nig'nant). Not malignant; mild. 

Benzoin (be'zoin). An antiseptic resin from 
styrax benzoin. 

Bergamot Camphor,^ Oil of (ber'gam-ot kam'fer). 
An evaporative oil from rind of citrus 
bergamia. 

Bergaptene (ber-gap'tene). An oily substance 
* from bergamot oil. 

Beriberi (ber'e-ber'e). An East Indian micro- 
bic disease characterized by weakness, 
anemia, dropsy, dyspnea and paraplegia. 

Bibulous (bib u-lus). Having the quality of ab- 
sorbing water. 

Bicapiiate (bi-kap'it-at). Having two heads. 

Bicapsular (bi-kap'su-lar). Having two capsules. 

Bicarbonate (bi-kar'bo-nat). A compound of 
two equivalents of carbonic acid and one 
of a base. 

Bicaudate (bi-kaw'date). Having two tails. 

Bicellular (bi-sel'u-lar). Composed of two cells. 

Biceps (bi'seps). Two-headed; applied to mus- 
cles. 

Bichlorid (bi-klo'rid). A chloridwith twice as 
much chlorin as proto-chlorid. 

Biennial (bi-en'e-al). Occurring ev«ry two "ears. 

Bif orate (bi-fo'rat). Having two aperatures or 
pores. 

Bifurcate (bi-fer'kat). Divided into two bran- 
ches. , 

Bile (bil). A yellow, bitter liquid secreted by 
the liver. 

Biliary (bil'e-a-re). Pertaining to the bile; con- 
veying the bile. 

Bilious (bil'yus). Pertaiping to bile; having a 
disordered liver. 

Binary (bi'na-re). Compounded of two ele- 
ments. 

Biogenesis (bi-o-gen'e-sis). The genesis of liv- 
ing beings from living beings. 

Biologist (bi-ol'o-jist). One versed in biology. 

Biology (bi-ol'o-je). The science of life and 

living things. 
Biolysis (bi-ol'i-sis). The destruction of life; 
death. 

B ; nlytic (bi-o-lit'ik). Tending to destroy life. 

Biomcter (bi-om'et-er). An instrument for 

measurng life sounds. 
Biometry (bi-om'et-re). The measure of life. 
Bioscopy (bi-os'ko-pe). Examination of the 

body to see if life is extinct. 
Bismuth (biz'muth). A pinkish-white crystal- 
line metal. 
Blackheads (blak'heds). See comedo. 



Bland (bland). Mild; nonirritating. 

Blepharal (blef'ar-al). Relating to the eyelids. 

Blepharism (blef'ar-ism). Spasm of the eyelid. 

Blepharitis (blef-ar-i'tis). Inflammation of the 
edges of the eyelids. 

Blister (blis'ter). A vesicle containing serum. 

Blood (blud). The nutritive fluid circulating in 
the arteries and veins. 

Bloodless (blud'les). Without blood. 

Bloodless Operation (blud'less op-er-a'shun). 
One in which the blood is expelled by 
compresses from the part to be operated 
on. 

Blue Baby (blu ba'be). A color; a baby with 
blue disease. 

Blue Blindness (blu blind'ness). Inability to 
distinguish a blue color. 

Blue Disease (blu dis-ez'). See cyanopathy. 

Blue Flag (blu flag). See iris. 

Blue Alass (blue mas). A compound pill of 
mercury. 

Blue Ointment (blu oint'ment). Mercurial 
ointment. 

Blue Stone (blu stone). See blue vitriol. 

Blue Vision (blu vizh'un). See cyanopia. 

Blue Vitriol (blu vit'ri-ol). Sulphate of cop- 
per; bluestone. 

Body (bod'e). The animal frame with its or- 
gans. 

Boil (boil). A localized abscess of the skin. 

Bole (bol). Fine clay, formerly used as an 
astringment. 

Bolus (bo'lus). A mass of masticated food 
ready to swallow. 

Borax (bor'ax). Sodium diborate used as an 
antiseptic. 

Bovine (bo'vin). Pertaining to or derived from 
the ox or cow. 

Bowel (bow'el). The intestines. 

Bowel Complaint (bow'el kom-plant') . Diar- 
rhoea. 

Brachia (brak'e-ah). See brachium. 

Brachial (brak'e-al). Pertaining to the arm. 

Brachium (brak'e-um). The arm from the 
shoulder to the elbow. 

Bronchi (bron'ki). See bronchus. 

Bronchia (bron'ke-ah). A branch of the wind- 
pipe. 

Bronchiole (bron'ke-ol). A minute bronchial 
tube. 

Bronchitis (bron-ki'tis). Inflammation of the 
bronchial tubes. 

Bronchopathy (bron-kop'a-the). Any disease of 
the bronchi. 

Bronchopneumonia (bron-ko-nu-mo'ne-ah). In- 
flammation of the lungs beginning at 
the bronchi. 

Bronchotomy (bron-kot'o-me). Incision of the 
bronchus. 

Bronchus (bron'kus). One of the main 
branches of the trachea. 

Bruit (bru'e). An abnormal sound in ausculta- 
tion. 

Bubo (bu'bo). An inflammation and a swelling 
of the lymphatic glands of the groin. 

Bugleweed (bu'gl-weed). The herb hycopus vir- 
ginicus used as a narcotic and as an as- 
tringent. 

Bulb (bulb). The expansion of a canal or ves- 
sel; the oblongata and pons. 

Bulimia (bu-lim'e-ah). Excessive, morbid hun- 
ger. 

Bullate (bul-late). Blistered; inflated. 

Bullation (bul-a'shun). Inflation; division into 
small compartments. 

Bursa (bur'sah). A small sac interposed be- 
tween movable parts. 

Bursal (hur'sal). Pertaining to a bursa or sac. 

Bursalis (hur-sa'lis). The obturator internus 
muscle. 

Bursitis (bur-si'tis). Inflammation of a bursa. 

Butane (bu'tan). An anesthetic substance from 
petroleum. 

Buttock Cbut'ok). One of the rounded parts 
of the gluteal region; the rump. 



GLOSSARY. 



1729 



c 

Cacao (ka-ka'o). See theobroma. 

Cacao Butter (ka-ka'o but'ter). The oil of theo- 
broma. 

Cachexia (ka-keks'e-ah). A depraved condition 
of nutrition. 

Calcareous _ (kal-ka're-us). Having the nature 
of lime. 

Calcination (kal-sin-a'shun). The process of ex- 
pelling by heat the evaporative elements 
of a substance. 

Calcined (kal'sind). Subjected to calcination. 

Calcium (kal'se-um). A metal; the basis of 
lime. 

Calculi (kal'ku-li). Plural of calculus. 

Calculus (kal'ku-lus). A stone-like concretion 
formed in the body. 

Calf (kaf). The fleshy part of the leg below 
the knee. 

Calisthenics (kal-is-then'iks). A system of light 
gymnastics. 

C alio sum (kal-lo'sum). The bridge of white 
nerve substance joining the hemisphere 
of the brain. 

Callous (kal'us). Hard; indurated. 

Callus (kal'us). A callosity; a new bony de- 
posit about a fracture. 

Cancelli (kan-sel'li). The divisions of the in- 
terior of bone. 

Cancer (kan'ser). See carcinoma. 

Canker (kan'ker). A cancerous or gangrenous 
sore. 

Cannabis (kan'na-bis). Hemp; a genus of nar- 
cotic, antispasmodic and aphrodisiac 
plants. 

Cantharides (kan-thar'i-dez). The plural of 
cantharis. 

Cantharis (kan'thar-is). Spanish fly; dried and 
powdered beetle cantharis vesicatoria. 

Canthus (kan'thus). A cavity at the extremi- 
ties of the eyelids; ari angle of the eye. 

Capillary (kap'il-ar-e). A minute blood vessel, 
like a hair. 

Capsicum (kap'si-kum). Cayenne pepper; a 
powerful stimulant. 

Capsular Ligament (kap'su-lar lig'a-ment). A 
ligament around a movable joint. 

Capsule (kap'sul). A membranous sac inclos- 
ing a part. 

Carbo Hydrate (kar'bo hi'drate). A compound 
of carbon with hydrogen and oxygen, the 
latter being in the proportion to form 
water. 

Carbon (kar'bon). A nonmetal occurring in 
the forms of diamond, graphite and 
charcoal, the latter only being used in 
medicine. 

Carbonated (kar'bon-at-ed). Containing or im- 
pregnated with carbonic acid. 

Carbuncle (kar'kunk-1). A large circumscribed 
inflammation of the subcutaneous tissite. 

Carcinoma (kar-sin-o'mah). A malignant tumor 
with the production of epithelioid cells; 
cancer. 

Cardia (kar'de-ah). The heart; an orifice of 
the stomach. 

Cardiac (kar'de-ak). Pertaining to the heart 
or cardia. 

Cardiagra (kar-de-a'grah). Gout of the heart. 

Cardialgia (kar-de-al'je-ah). Heartburn; pain 
in the heart. 

Cardiocele (kar'de-o-sel). Hernia of the heart. 

Cardiology (kar-de-ol'o-je). The science of the 
heart. 

Carminative (kar-min'a-tiv). A medicine expell- 
ing flatus. 

Carotid (kar-ot'id). The principal artery of the 
neck. 

Carpal (kar'pal). Pertaining to the carpus or 
wrist. 

Carpus (kar'pus). The wrist. 

Cartilage (kar'ti-laj). Gristle; a nonvascular 
elastic tissue, softer than bone. 



Cartilaginous (kar-til-aj'in-us). Of the nature 
of cartilage. 

Caruncle (kar'un-kl). A small, fleshy growth. 

Catalysis (ka-tal'i-sis). A chemic reaction pro- 
moted by the presence of a third unaf- 
fected substance. Dissolution; decay; de- 
terioration. 

Catamenia (kat-a-me'ne-ah). The menses. 

Cataplasm (kat'a-plazm). A poultice. 

Catarrh (ka-tar'). Inflammation of the mucous 
membrane. 

Cathartic (ka-thar'tik). A purgative medicine; 
a medicine which opens the bowels freely. 

Catheter (kath'e-ter). A tube for introduction 
through a narrow canal into a cavity, 
usually the bladder. 

Catheterism (kath'et-er-ism). The use of the 
catheter. 

Cathalicon (kath-ol'i-kon). A panacea; a uni- 
versal medicine. 

Caudate (kaw'dat). Having a tail. 

Caudate Lobe (kaw'dat lob). The tail-like pro- 
cess of the liver. 

Causalgia (kaw-zal'ge-ah). An intense burning 
neuralgia. 

Causation (kaw-za'shun). The act of causing 
or producing. 

Caustic (kaws'tik). A substance which burns 
living tissues. 

Caustic _ Arrows (kaws'tik ar'rows). Conic 
sticks charged with caustic material. 

Caustic, Lunar (kaws'tik, lu'nar). Silver nitrate 

cast into sticks. 

Caustic, Mitigated (kaws'tik, mit'i-ga-ted). Sil- 
ver nitrate fused with potassium nitrate. 

Caustic Potash (kaws'tik pot'ash). Potassium 
hydrate; a powerful potash used in medi- 
cine and the arts for cauterizing and 
cleansing purposes, and in the manufac- 
ture of soft soap. 

Caustic Soda (kaws'tik so'da). Sodium hydrate; 
similar in properties and uses to caustic 
potash, the soaps made with it, however, 
being hard. 

Cauterization (kaw-ter-i-za'shun). The applica- 
tion of a cautery. 

Cautery (kaw'ter-e). A substance or instru- 
ment for burning or disorganizing a part. 

Cavitary (kav'it-a-re). Hollow; having a body- 
cavity or intestinal tract. 

Cecum (se'kum). The blind pouch at the head 
of the large intestine. 

Cellular (sel'u-lar). Composed of cells. 

Cellulose (sel'u-los). The supporting structure 
or frame work of plant tissue. 

Cephalalgia (sef-al-al'je-ah). Pain in the head. 

Cephalic (sef-al'ik). Pertaining to the head. 

Cera (se'rah). Wax. 

Cerate (se'rate). A composition having wax for 
a basis. 

Ceratum (se-ra'tum). A cerate. 

Cerebellum (ser-e-bel'lum). The lower part of 
the brain. 

Cerebral (ser'e-bral). Relating to the brain. 

Cerebritis (ser-e-bri'tis). Cerebral inflamma- 
tion. 

Cerebrosid (ser'e-bro-sid). Any one of the 
group of chemic substances containing 
nitrogen but no phosphorus, found in 
nerve tissue. 

Cerebrospinal (ser-e-bro-spi'nal). Relating to 
the brain and spine. 

Cerebrum (ser'e-brum). The chief part of the 

brain; the center of reasoning faculties. 

Cerumen (se-ru'men). The wax or yellow mat- 
ter secreted by the ear. 

Cervical (ser'vi-kal). Pertaining to the neck or 
to a cervix. 

Cervix (ser'viks"). The neck; any neck-like part. 

Cessation (ces-sa'shun). To stop; to rest; to 
pause; ceasing from action. 

Cesspool (ses'pool). A hole sunk in the earth 
to receive drainage. 



1730 



GLOSSARY. 



An alkaloid from saba- 

Any water or liquid 

The primary or hard 

Resembling a chan- 



Cevadin (sev'ad-in), 
dilla. 

Chalybeate (ka-lib'e-at), 
containing iron. 

Chancre (shang'ker). 
syphilitic ulcer. 

Chancroid (shang'kroid) 
ere. 

Chancrous (shang'krous). Of the nature of a 
chancre. 

Charcoal (char'kol). Coal produced from wood 
by smothered combustion. 

Charlatan (shar'la-tan). A quack. 

Charlatanry (shar'lat-an-re). Quackery. 

Chemical (kem'i-kal). Pertaining to chemistry. 
See chemistry. 

Chemistry (kem'is-tre). The science of the 
molecular and atomic structure of bodies. 

Chilblain (chil'blan). Cutaneous inflammation 
due to cold. 

Chloretone (klo're-ton). A white crystalline 
substance used as a hypnotic and local 
anesthetic. 

Chlorin (klo'rin). A nonmetallic gaseous ele- 
ment. 

Chlorinated (klo'rin-a-ted). Charged with 
chlorin. See chlorin. 

Chlorite (klo'rit). A salt of chlorous acid. 

Cholagog (kol'ag-og). A medicine that pro- 
motes the flow of bile. 

Cholagogue (kol'ag-og). Same as cholagog. _ 

Choleric (kol'er-ic). Abounding with bile. 
Easily irritated. 

Chondroma (kon-dro'mah). A cartilaginous 
tumor. 

Chorea (ko-re'ah). Saint Vitus's dance; in- 
voluntary muscular twitchings. 

Choreoid (ko're-oid). Pertaining or similar to 
chorea. 

Chorioid (ko're-oid). See choroid. 

Choroid (ko'roid). The second or vascular 
tunic of the eye. 

Choroiditis (ko-roid-i'tis). Inflammation of the 
choroid. 

Chromium (kro'me-um). A hard, gray, metallic 
element. 

Chronic (kron'ik). Long continued; the reverse 
of acute. 

Chyle (kil). The milky fluid found in the mes- 
enteric lymph-vessels during absorption. 

Chylopoietic (ki-lo-poi-et'ik). Chyle-producing. 

Chyme (kim). The food that has undergone 
gastric but not intestinal digestion. 

Cicatrix (se-ka'trix). A scar from a wound. 

Cicatrization (sik-a-triz-a'shun). The process of 
healing. 

Cicatrize (sik'a-triz). To heal. 

Cilia (sil'e-ah). The eyelashes; hair-like pro- 
cesses of certain cells. 

Ciliary (sil'e-a-re). Pertaining to the cilia. 

Ciliary Body (sil'e-a-re bod'e). The ciliary 
muscle and processes. 

Cinchona (sin-ko'nah). A genus of trees and 
their bark yielding quinin. 

Cinchonism (sin'kon-ism). The systemic effects 
of quinin in overdose. 

Circumscribed (ser'kum-skribed). Clearly de- 
fined, as an abscess. 

Citrate (si'trate). A salt of citric acid. 

Citrus (sit'rus). A genus of trees yielding 
lemons, limes, and oranges. 

Clarificant (klar'if-ik-ant). A substance for 
clearing a solution. 

Clarified (klar'i-fied). To purify; to make clear. 

Clavicle (klav'i-kel). The collar-bone joining 
the sternum and scapula. 

Climacteric (kli-mak'ter-ik). A critical period in 
human life or a period in which some 
great change is supposed to take place in 
the human constitution. 

Clinic (klin'ik). Bedside instruction. 

Clinical (klin'ik-al). Pertaining to a sick-bed 
or clinic. 



Clonic (klon'ik). Shaking; convulsive; irregu- 
lar. 

Clyster (klis'ter). A rectal injection; an enema. 

Coagulate (ko-ag'u-late). To change from a 
liquid to a denser state. 

Coagulation (ko-ag-u-la'shun). A clotting. 

Coagulum (ko-ag'u-lum). A clot or mass of 
thickened blood. 

Coalesce (ko-a-les'). To grow together; to unite 
as separate bodies, or separate parts into 
one body. 

Coalescence (ko-al-es'ens). The union of two 
or more parts. 

Coaptation (ko-ap-ta'shun). The adjustment of 
the edges of fractures. 

Cocain (ko'kan). An alkaloid from coca; it is 
a powerful local anesthetic and internally 
is used as a narcotic. 

Coccus (kok'us). A cell or capsule. 

Coccyx (kok'siks). The last bone of the spinal 
column. 

Cochineal (coch'i-neal). Coccus cacti; dried in- 
sects used as coloring matter. 

Cocoa (ko'ko). See cacao. A name given to 
a simple preparation of the ground ker- 
nels of the cacao or chocolate-tree. 

Coco-nut Oil (ko'ko-nut oil). The oil from the 
fruit of the palm. 

Codein (ko'de-in). One of the alkaloids de- 
rived from opium. 

Coil (koil). A # spiral. 

Coil Gland (koil gland). A sweat gland. 

Colchicum Autumnale (kol'chick-um au-tum'nal). 
Meadow saffron. It is an emetic and 
drastic cathartic. It is used in gout and 
in rheumatic affections. 

Cold (kold). Coryza; catarrh of the respira- 
tory tract. 

Collapse (kol-laps'). A marked depression of 
the vital activities of the body. 

Colliquative (kol-lik'wa-tiv). Profuse or ex- 
cessive, so as to cause exhaustion; said 
of the discharges, as a colliquative sweat. 

Collision (kol-li'shun). The coming together of 
two bodies; a concussion. 

Collodion (kol-o'de-on). Same as collodium. 

Collodium (kol-o'de-om). A dressing for 
wounds, made by dissolving gun-cotton 
in ether and alcohol. 

Colloid (kol'oid). Glue-like; a noncrystallizable 
organic substance. 

Colloid Cancer (kol'oid kan'ser). Carcinoma 
with colloid degeneration. 

Colloid Cyst (kol'oid cist). A cyst with jelly- 
like contents. 

Colloma (kol-o'mah). A cyst containing colloid 
matter. 

Collum (kol'um). The neck. 

Collutorium (kol-u-to're-um). A mouth wash; 
a gargle. 

Colly Hum (kol-ir'e-um). A medical lotion for 
the eyes. 

Coloboma (kol-o-bo'mah). A fissure, especially 
of parts of the eye. 

Colocentesis (ko-lo-sen-ti'sis). Surgical punc- 
ture of the colon. 

Coloenteritis (ko-lo-en-ter-i'tis). Inflammation 
of the small and large intestines. 

Colon (ko'lon). The part of the large intestine 
from the cecum to the rectum. 

Coma (ko'mah). An abnormally deep sleep; 
stupor. 

Comatose (ko'ma-tos). In a condition of coma. 

Combustion (kom-bus'chun). The state or op- 
eration of burning. 

Comedo (kom'e-do). Blackhead; a worm-like 
mass in an obstructed sebaceous duct. 

Comminution (kom-min-u'shun). The process 
of breaking into pieces. 

Commiphora (kom-if'o-rah). The genus of 
trees furnishing myrrh and balm of 
Gilead. 



GLOSSARY. 



1731 



Commissure (kom'mis-ur). A joining or unit- 
ing. 

Compensation (kom-pen-sa'shun). The state of 
counterbalancing a defect of structure or 
function. 

Complemental Air (kom-ple-men'tal air). That 
inhaled after ordinary breathing. 

Complexus (kom-pleks'us). The totality of the 
symptom6 of a disease. 

Complication (kom-pli-ka'shun). A combina- 
tion of diseases or morbid conditions. 

Compress (kom'pres). Folded cloths for local 
pressure. 

Compression (kom-presh'un). The forcing to- 
gether of a substance. 

Conarium (ko-na're-um). The pineal gland of 
the brain. 

Concave (kon'kav). Presenting a hollowing in- 
curvation. 

Concavity (kon-kav'i-te). A depression or fossa. 

Concentrated (kon'sen-tra-ted). Made stronger 
or purer. 

Concentric (kon-sen'trik). Having a common 
center. 

Conception (kon-sep'shun). The fecundation 
of the ovum. 

Conception Imperative _ (kon-sep'shun im-per'a- 
tiv). A false idea dominating an in- 
sane person's actions. 

Concoction (kon-kok'shun). The boiling of two 
substances together. 

Concomitant (kom-kom'it-ant). Accompanying, 
as symptoms. 

Concrete (kon-kref). Solidified or condensed. 

Concretion (kon-kre'shun). A calculus; an os- 
seous deposit; abnormal union of adja- 
cent parts. 

Concussion (kon-kush'un). A shaking. 

Concussion of the Brain (kon-kush-un). Shock 
or agitation of the brain caused by im- 
pact with another body. 

Condiment (kon'di-ment). Seasoning; sauce; 
that which is used to give relish to meat 
or other food. 

Conductive (kon-duk'tiv). Having the power 
to conduct. 

Conductivity (kon-duk-tiv'i-te). The capacity 
for conducting. 

Conductor (kon-duk'tor). An instrument di- 
recting a surgical knife. 

Conduit (kon'dit). Any medium of transmis- 
sion as the nerves and blood vessels. 

Condyle (kon'dil). Any rounded prominence, 
such as occurs in the joints of many 
bones especially the femur, humerus and 
lower jaw. 

Confection (kon-fek'shun). A sweet excipient 
in pharmacy. 

Confinement (kon-fin'ment). The period of par- 
turition. 

Congelation (kon-jel'a-shun). A freezing; frost- 
bite. 

Congenital (kon-jen'i-tal). Existing from birth, 
innate. 

Congestion (kon-jes'chun). An excessive ac- 
cumulation of blood in an organ with 
disorder of its functions. 

Conium Maculatum (kon-i'um mak-u-la'tum). 
Poison hemlock. The leaves and seeds 
are sedative and narcotic. 
Conjugation (kon-ju-ga'shun). A form of re- 
production or cell division. 
Conjugation Nucleus (kon-ju-ga'shun nu'kle-us). 

The segmentation-nucleus. 
Conjunctiva (kon-junk-ti'vah). The mucous 

membrane of the eye. 
Conjunctivitis (kon-junk-tiv-i'tis). Inflamma- 
tion of the conjunctiva. 
Conserve (kon-serv'). A confection. 
Consistence (kon-sis'tens). The degree of den- 
sity or hardness. 
Constipation (kon-sti-pa'shun). A sluggish ac- 
tion of the bowels. 

109 



Constitution (kon-sti-tu'shun). Composition; 
the general temperament of the body. 

Constrict (kon-strikt'). To draw together in 
one part. 

Constrictor (kon-strik'tor.) A contracting or 
compressing muscle. 

Contagion (kon-ta'jun). The process of trans- 
fer of specific diseases. The act of tak- 
ing a disease by contact. 

Contagious (kon-ta'jus). Having the character 
of contagion. 

Contagium (kon-ta'je-um). Germs of specific 
diseases. Contagion. 

Contamination (kon-tam-i-na'shun). The act of 
polluting; pollution; defilement; taint. 

Contiguity (kon-tig-u'i-te). AcUial contact. 

Continuity (kon-tin-u'i-te). Uninterrupted con- 
nection. 

Contorted (kon-tor'tad). Twisted. 

Contortion (kon-tor'shun). A twisting or wrest- 
ing of a limb or member of the body 
out of its natural situation. 

Contract (kon-trakt'). To draw the parts to- 
gether; to shrink; to acquire by con- 
tagion. 

Contractile (kon-trak'til). Having the power to 
contract. 

Contraction (kon-trak'shun). Decrease of 

volume; shortening. 

Contracture (kon-trak'chur). A state of per- 
manent rigidity. 

Contuse (kon-tuz'). To bruise. 

Contusion (kon-tu'zhun). A bruise. 

Convalescence (kon-va-les'ence). The period of 
recovery after a disease. 

Convergence (kon-ver'gens). A coming together. 

Convex (kon'veks). Curved outward on the 
external surface. 

Convoluted (kon'vo-lu-ted). Rolled one part 
on another. 

Convolution (kon-vo-lu'shun). A fold, -twist or 
coil of any organ. 

Convulsion (kon-vul'shun). A violent involun- 
tary contraction; a spasm or tit. 

Co-ossify (ko-os'si-fi). To become united by 
ossification; to form one bone; as, sev- 
eral bony elements co-ossify in man to 
form the sphenoid bone. 

Copious (ko'pi-us). Abundant; plentiful; in 
great quantities. 

Coracoid (kor'ak-oid). Shaped like a crow's 
beak. 

Cordial (kor'jal). An aromatic, spirituous 
stimulant. 

Coriaceous (kor-ri-a'shus). Leather-like; elastic 
and tough. 

Corm (kormj. A bulb-like, solid, fleshy sub- 
teranean stem. A colony of persons. 

Com (korn). A local thickening and indura- 
tion of the skin, as on the toes. 

Cornea (kor'ne-ah). The transparent anterior 
part of the eyeball. 

Corneal (kor'ae-al). Pertaining to the cornea. 

Comeoritis (kor-ne-o-ri'tis). Inflammation of 
both cornea and iris. 

Comu (kor'nu). A horn-shaped structure. 

Coronary (kor'o-na-re). Encircling, as a ves- 
sel or nerve. 

Coroner (kor'o-ner). An officer who holds in- 
quests on those dead from violence. 

Corpora (kor'po-rah). Flural of corpus. Hu- 
man bodies, living or dead. 

Corporeal (kor-po're-al). Having a body; con- 
sisting of material substance. 

Corpulency (kor'pu-len-se). Obesity; largeness 
of the body; fleshiness. 

Corpus (kor'pus). A body; the human body. 

Corpuscle (kor'pus-1). A minute body; a cell. 
Corrective (kor-rek'tiv). A substance modify- 
ing the action of drugs. 

Correlation (kor-re-la'shun). Interdependence; 
reciprocal relation. 



1732 



GLOSSARY. 



Corroborant (kor-ob'o-rant). A tonic, invigor- 
ating remedy. 

Corroborative (kor-ob'o-ra-tiv). A medicine that 
strengthens; a corroborant. 

Corrosive (kor-o'siv). A substance that eats 
away or destroys. 

Cortex (kor'teks). The external gray layer of 
the brain. 

Cortical (kor'tik-al). Pertaining to the cortex. 

Cortical Cataract (kor'tik-al kat'a-ract). Opac- 
ity in the Cortex of the lens. 

Cosmetic (kos-met'ik). Making beautiful; a 
remedy for beautifying the skin. 

Cosmetic Operation (kos-met'ik op-er-a'shun). 
An operation for lessening unsightliness. 

Cosmolin (koz'mo-lin). See petrolatum. 

Costal (kos'tal). Pertaining to the ribs. 

Costal Cartilage (kos'tal kar'ti-laj). The ante- 
rior cartilaginous extremity of a rib. 

Costal Respiration (kos'tal res-pi-ra'shun). 
Respiration carried on chiefly by the chest 
muscles. 

Costive (koc'tiv). Affected with constipation. 

Costiveness (kos'tiv-nes). Abnormality of di- 
gestion marked by hardness and reten- 
tention of the discharge of the bowels. 

Counter-irritant (koun'ter-er'ri-tant). A medi- 
cine which relieves irritation in one or- 
gan by increasing it in another. 

Cranial (kra'ne-al). Pertaining to the skull. 

Cranium (kra'ne-um). The skull; the bony case 
of the brain. 

Crassamentum (kras-a-men'tum). A clot, as of 
blood. 

Crepitus Indux (krep'i-tus in'dux). The crack- 
ling rale heard at the beginning of croup- 
ous pneumonia. 

Crepitus Redux (krep'i-tus re'dux). A crack- 
ling rale indicating the recession of pneu- 
monia. 

Crescent (kres'ent). Having the shape of a 
new moon. 

Crescentic (kres-en'tik). Moon-shaped. 

Cresol (kre'sol). Cresylic acid, a coal-tar prod- 
uct. 

Cretin (kre'tin). One affected with cretinism. 

Cretinism (kre'tin-ism). The condition of a 
cretin. An endemic disease characterized 
by idiocy, goiter and a deficient develop- 
ment of the organism. 

Crisis (kri'sis). The turning point in a disease. 

Crude (krud). In the natural form; raw. 

Cms (krus). The leg; a leg-like structure. 

Crypt (kript). A small sac or follicle; a gland- 
ular cavity. 

Cryptogram (krip'to-gram). A flowerless plant. 

Crypt it us (krip-ti'tis). Inflammation of a 
crypt. 

Crystals (kris'tals). Solid substances of definite 
geometric form, resulting from the ac- 
tion of natural forces. 

Crystalline (kris'tal-en). Like a crystal. 

Curd (kurd). The coagulum of milk. 

Cutaneous (ku-ta'ne-us). Pertaining to the 
skin. 

Cuticle (ku'ti-kl). The epidermis or scarf skin. 

Cutis (ku'tis). The derma or true skin. 

Cutization (ku-tiz'a-shun). A change into der- 
mic tissue. 

Cyanopathy (si-an-op'a-the). See cyanosis. 

Cyanopia (si-an-o'pe-ah). A perverted state of 
the vision rendering all objects blue. 

Cyanopsia (si-an-op'se-ah). See cyanopia. 

Cyanosis (si-an-o'sis). Blue discoloration of 
skin from nonoxidation of blood. 

Cyanotic (si-an-ot'ik). Pertaining to cyanosis. 

Cyclotomy (si-klot'o-me). An operation for the 
relief of glaucoma consisting of an in- 
cision through the ciliary body. 

Cynancle (sin-an'ke). All inflammatory dis- 
ease of the throat. 
Cyst Csist). A membranous sac containing fluid. 



Cysticus (sis'tik-us). Any one member of a 
family of tapeworms which in the course 
of development form the cysticercus or 
bladder-worm. 

Cystitus (sis-ti'tis). Inflammation of the blad- 
der. 

D 

Debauch (de-boch'). Excess in eating or drink- 
ing. Intemperance. 

Debilitant (de-bil'it-ant). An agent allaying ex- 
citement. 

Debilitated (de-bil'i-tated). To weaken; to im- 
pair the strength of. 

Debility (de-bil'i-tej. Weakness; feebleness; 
languor of body. 

Deciduous (de-sid'u-us). Shedding; falling; not 
perennial or permanent. 

Decoction (de-kok'shun). Result obtained by 
boiling substances in a fluid. 

Decomposition (de-kom-po-zish'un). Putrefac- 
tion; the analysis of a body. 

Decrepitude (de-krep'i-tude). The broken state 
of the body, produced by decay and the 
infirmities of age. 

Decubital (de-ku'bit-al). Relating to a bed-sore 
or to decubitus. 

Defecation (def-e-ka'shun). The evacuation of 
the bowels. 

Defect (de-fekf). An imperfection; an absence 
of a part or organ. 

Defervescence (de-fer-ves'ens). Abatement or 
decrease of a fever. 

Deformity (de-for'mi-te). Physical malforma- 
tion or distortion. 

Degeneration (de-jen-er-a_'shun). Deterioration 
in structure of a tissue or an organ. 

Deglutition (deg-lu-tish'un). The act or power 
of swallowing. 

Dejection (de-jek'shun). Discharge of the bow- 
els. 

Deleterious (del-e-te'ri-ous). Injurious; per- 
nicious; unwholesome. 

Deliquescent (del-i-ques'ent). Liquefying from 
absorption of atmospheric moisture. 

Delirium (de-lir'e-um). Mental aberration due 
to disease; wandering of the mind. 

Delta Fornices (del'ta for'ni-ces). See lyra 
fornices. 

Deltoid (del'toid). Delta shaped; a muscle of 
the shoulder. 

Delusion (de-lu'shun). A false judgment of 
objective things. 

Demarcation (de-mar-ka'shun). The act of 
marking the limits of; separation, as into 
a class. 

Demented (de-men'ted). Deprived of reason. 

Dementia (de-men'she-ah). Profound mental 
incapacity. 

Demulcent (de-mul'sent). A medicine having 
a soothing effect. 

Dentin (den'tin). The bony structure of the 
teeth. 

Dentition (den-tish'un). The cutting of the 
teeth and the period of the same. 

Deobstruent (de-ob'stru-ent). A medicine hav- 
ing the power of removing obstructions 
from the passages of the body. 

Deplete (de-plef). To empty. 

Depression (de-presh'un). A hollow or fossa; 
a depressed condition. 

Deprivation (dep-ri-va'shun). The act of de- 
priving; a taking away. 

Depuration (dep-u-ra'shun). Cleansing from 

impurities. 
Derangement (de-ranj'ment). Disorder of in- 
tellect; insanity. 
Dcrmalgia (der-mal'je-ah). Neuralgia of the 

skin. 
Dermic (der'mik). Pertaining to the skin. 
Dcrmopathy (der-mop'a-the). Any disease of 
the skin. 



GLOSSARY. 



1733 



Desiccate (des'i-kate). To become dry. 
Despumation (des-pu-ma'shun). The formation 

of froth. 
Desquamation (des-kwam-a'shun) . Scaling of 

the cuticle. 
Detergent (de-ter'jent). Cleansing; purging. 
Deteriorate (de-te'ri-o-rate). To grow worse; 
to be impaired in quality; to degenerate. 
Deterioration (de-te-ri-o-ra'shun). The state of 

growing worse. 
Determination (de-ter-min-a'shun). Tendency 
to flow to; more plentiful than is normal. 
Detritus (de-tri'tus). Waste matter from disor- 
ganization. 
Dexter (deks'ter). Upon the right side. 
Dextral (deks'tral). Pertaining to the right 

side. 
Diabetes (di-a-be'tes). A disease characterized 

by an excessive flow of urine. 
Diabetic (di-a-bet'ik). One affected with dia- 
betes. 
Diabetid (di-a-be'ted). A cutaneous manifesta- 
tion of diabetes. 
Diacetate (di-as'et-at). A salt of diacetic acid. 
Diagnosis (di-ag-no'sis). The recognition of a 

disease from its symptoms. 
Diaphoresis (di-a-for-e'sis). The production of 

perspiration. 
Diaphoretic (di-a-fo-ret'ik). An agent produc- 
ing perspiration. 
Diaphragm (di'a-fram). The muscular wall be- 
tween the thorax and the abdomen. 
Diarrhea (di-a-re'ah). Frequent evacuation of 

the bowels. 
Diarrhoea (di-a-re'ah). See diarrhea. 
Diarthrosis (di-ar-thro'sis). A freely movable 

articulation. 
Diastase (di'a-stase). A nitrogenous ferment in 

malt. 
Diastole (di-as'tole). The period of dilatation 

of the heart. 
Diathesis (di-a-the'sis). A constitutional pre- 
disposition to disease. 
Dicrotic (di-krot'ik). Double-beating, as ob- 
served in certain pathologic conditions 
of the pulse. 
Diet (di'et). Food; a system of aliment. 
Dietetic (di-e-tet'ik). Pertaining to diet. 
Dietetical (di-e-tet'i-kal). _ Rules for regulating 
the kind and quantity of food to be eaten. 
Differentiate (dif-fer-en'shi-ate). To become 

specifically distinct and separate. 
Differentiation (dif-fer-en-shi-a'shun). A spe- 
cialization of tissues, organs or functions. 
Diffusible (dif-fu'zi-ble). Capable of rapid 

spreading. 
Diffuse (dif-fuze). To scatter or spread about. 
Digestion (di-jes'shun). Conversion of food 

into chyme and chyle. 
Dilatation (dil-a-ta'shun). An expansion of a 

vessel or an organ. 
Diluent (dil'u-ent). A medicine increasing the 

fluidity of secretions. 
Dilution (di-lu'shun). A weakening with water. 
Diminution (dim-i-nu'shun). The act of les- 
sening; a making smaller. 
Din us (di'nus). Vertigo or dizziness. 
Dioxid (di-oks'id). A compound containing two 

atoms of oxygen and one of a base. 
Diploe (dip'lo-e). The cellular bony tissue be- 
tween the cranial tables. 
Discharge (dis-charj'). A morbid secretion; an 

evacuation. 
Discrete (dis-kret'). Separate; distinct; op- 
posed to confluent. 
Discutient (dis-ku'shent). A medicine remov- 
ing a swelling or effusion. 
Disease (diz-ez')- A pathologic condition of 

any part or organ of the body. 
Disinfect (dis-in-fekt'). To free from infec- 
tiousness. 
Disinfectant (dis-in-fek'tant). An agent de- 
stroying germs. 



Disinfection (dis-in-fek'shun). Purification 

from that which infects. 

Disintegrate (dis-in'te-grate). To fail to pieces; 
to crumble. 

Dislocation (dis-lo-ka'shun). Throwing out of 
the natural position. 

Dispensation (dis-pen-sa'shun). Distribution; 
the act of dealing out to different per- 
sons or places. 

Disseminated (dis-sem'i-na-ted). Scattered. 

Dissemination (dis-sem-i-na'shun). A scatter- 
ing as of disease germs. 

Distal (dis'tal). Peripheral; away from the 
center. 

Distended (dis-tend'ed). A stretch or spread in 
all directions. 

Distension i^dis-ten'shun). A stretching and ex- 
panding. 

Distillate (dis'til-at). The substance distilled 
over. 

Distillation (dis-til-la'shun). The process of 
converting a fluid to a vapor and then re- 
ducing it again to its first form. 

Diuresis (di-u-re'sis). An excessive secretion 
of urine. 

Diuretic (di-u-ret'ik). A medicine increasing 
the flow of urine. 

Divergence (di-ver'gens). The act or state of 
receding from each other. 

Diverticulum (di-ver-tik'u-lum). A small cul- 
de-sac or pouch. 

Dolomite (dol'o-mite). A granular magnesian 
carbonite of lime. 

Dolomitic (dol-o-mit'ik). Pertaining to dolo- 
mite. 

Domestic (do-mes'tik). Belonging to the home. 

Dorsal (dor'sal). Pertaining to the back. 

Dosage (do-saj). The regulating of the doses 
of drugs. 

Douche (doosh). A stream of water directed 
against a part or one used to flush a 
cavity. 

Dover's Powder (do'vers pow'der). A powder 
containing ten per cent, each of opium 
and ipecac. 

Drachm or Dram (dram). A weight of sixty 
grains. 

Draft (draft). A quantity of liquid medicine 
taken at one time. 

Dram (dram). A weight of sixty grains. 

Drastic (dras'tik). A powerful and irritating 
purgative. 

Draught or Draft. See draft. 

Dropsical (drop'si-kal). Pertaining to dropsy. 

Dropsy (drop'si). An effusion of fluid into the 
tissues or cavities of the body. 

Duodenum (du-o-de'num). The first part of 
the small intestines. 

Dura or Dura Mater (du-rah ma'ter). The 
outer membrane of the brain and spinal 
cord. 

Duration (du-ra'shun). Continuance in time. 

Dysaphe (dis'a-fe). Disordered sense of touch. 

Dysbasia (dis-ba'ze-ah). Difficulty in walking. 

Dysecoia (dis-e-koi'ah). Subnormal acuteness 
of hearing. 

Dysentery (dis'en-ter-e). Inflammation and ul- 
ceration of the intestinal mucous mem- 
brane with bloody evacuations. 

Dysgraphia (dis-graf'e-ah). An inability to 
write properly. 

Dyslalia (dis-la'le-ah). A structural defecc of 
speech; stutlering. 

Dyslogia (dis-lo'je-ah). An inability to reason. 

Dysmcnorrlica (dis-men-o-re'ah). Painful men- 
struation. 

Dysncuiia (dis-nu're-ah) . An impairment of 

nerve function. 
Dysopia (dis-o'pe-alA. Same as dysopsia. 

Dysopsia (dis-op'se-ah). Painful or defective 

vision. 
Dyspepsia (dis-pep'se-ah). Impaired or imper- 
fect digestion. 



1734 



GLOSSARY. 



Dyspeptic (dis-pep'tik). Pertaining to or af- 
fected with dyspepsia. 

Dysphoria (dis-fo're-ah). Restlessness. 

D'xsphrasia (dis-fra'ze-ah). Imperfect speech. 

Dyspnea (disp-ne'ah). Difficult or labored 
breathing. 

Dxsuria (dis-u're-ah). Difficulty in discharg- 
ing the urine attended with pain and a 
sensation of heat. 



Ecchymosis (ek-che-mo'sis). A bruise showing 
on the skin; a black and blue spot. 

Echinococcus (e-ki-no-kok'kus). A parasitic 
larva to a tapeworm peculiar to the dog. 
but found in other animals and in man, 
where it produces fatal tumors in the 
lungs and liver. 

Ecstasy (eks'ta-se). Excessive excitement; loss 
of mental control. 

Ectoderm (ek'to-derm). An outer layer or 
membrane, as the epidermal layer of the 
skin. 

Ectopia (ek-to'pe-ah). An_ abnormality of posi- 
tion, usually congenital. 

Ectopic (ek-top'ik). Pertaining to ectopia. 

Eczema (ek'ze-mah). Inflammation of the skin 
with exudation of lymph. 

Edema (e-de'mah). Accumulation of serum in 
the cellular tissue. 

Edematous (e-dem'a-tus). Relating to or 
marked by edema. 

Effeminate (ef-fem'i-nate). Having the qual- 
ities of the female sex. 

Effervescent (ef-fer-ves'ent). Gently boiling or 
bubbling by means of the disengagement 
of gas. 

Effete (ef-fete'). Barren; not capable of pro- 
ducing, as an animal, soil, etc. 

Efficacious (ef-fi-ka'shush). Producing the ef- 
fect intended. 

Efflorescence (ef-flo-re'sens). Redness of the 
skin; rash. 

Effluvium (ef-flu've-um). Exhalation; vapor; 
odor. 

Effusion (ef-fu'shun). Escape of fluid into 
body tissues or cavities. 

Efflux (efflux). To run or flow away. 

Ejection (e-jek'shun). The process of casting 
out. 

Elaterium (el-a-te'ri-um). A cathartic sub- 
stance obtained from the fruit of the 
squirting cucumber. 

Electuary (e-lek'tu-a-re). A medicine whose in- 
gredients are mixed with a syrup. 

Elephantiasis (el-e-fan-ti'a-sis). A chronic ede- 
matous disease of the skin with hyper- 
trophy of the cellular tissue. 

Elimination (e-lim-i-na'shun). The act of dis- 
charging by the pores; excretion. 

Elongation (e-lon-ga'shun). An imperfect laxa- 
tion occasioned by the stretching or 
lengthening of the ligaments. 

Emaciation (e-ma-she-a'shun). A loss of flesh; 
leanness. 

Emanation (em-a-na'shun). An effluvium; that 
which proceeds from a body. 

Embolism (em'bol-ism). The obstruction of a 
blood vessel by an embolus. 

Embolus (em'bo-lus). A blood-clot or other 
body carried by the blood current and 
obstructing circulation at the point of 
lodgment. 

Emesis (em'e-sis). The act of vomiting. 

Emetic (e-met'ik). An agent causing vomiting. 

Eminence (em'i-nence). Elevation or height; a 
rising ground. 

Emmenagogue (em-men'a-gog). A medicine 
which promotes the menstrual flow. 

Emolhent (e-mol'yent). An agent that softens 
tissues. 



Emphysema (em-fi-se'mah). A swelling pro- 
duced by air in the tissues. 

Empirical (em-pir'ik-al). Known by experience; 
derived from experiment; used and ap- 
plied without science. 

Empyema (em-pi-e'mah). Pus in the pleural 
cavity. 

Empyreuma (em-pi-ru'ma). Burnt smell; the 
odor of animal or vegetable substances 
when burned in close vessels. 

Empyreumatic (em-pi-ru-mat'ik). Pertaining to 
empyreuma. 

Emulsion (e-mul'shun). A milky fluid obtained 
by suspending oil in water. 

Encephalic (en-se-fal'ik). Pertaining to the= 
brain. 

Encephalon (en-sef'a-lon). The brain. 

Endemic (en-dem'ik). A disease peculiar to a 
people or nation. 

Endermatic (en-der-mat'ik). Relating to a 
method of administering medicines 
through the skin by rubbing. 

Endermic (en-der'mik). See endermatic. 

Endocarditis (en-do-kar-di'tis). Inflammation of 
the lining membrane of the heart. 

Endocardium _ (en-do-kar'di-um). The transpar- 
ent lining membrane of the heart. 

Enema (en'e-mah). A rectal injection of medi- 
cine or food. 

Energetic (en-er-jet'ik). Forcible; powerful; 
efficacious. 

Energy (en'er-je). The power of doing work. 

Engender (en-jen'der). To produce; to cause 
to exist. 

Engorgement (en-gorj'ment). Vascular con- 
gestion. 

Enteric (en-ter'ik). Pertaining to the intestine. 

Enteritis (en-ter-i'tis). Inflammation of the in- 
testines. 

Environment (en-vi'ron-ment). The aggregate 
of surrounding influences. 

Ephemera (e-fem'e-rah). A fever of one day's 
continuance only. 

Epidemic (ep-i-dem'ik). A prevailing disease 
among a people or nation. 

Epidermis (ep-e-der'mis). The outer layer of 
the skin. 

Epigastrium (ep-e-gas'tre-um). The region over 
the stomach. 

Epiglottis (ep-e-glot'is). A thin cartilaginous 
plate over the larynx. 

Epiglottitis (ep-e-glot-i'tis). Inflammation of the 
epiglottis. 

Epilepsy (ep'il-ep-se). A nervous disease with 
loss of consciousness and tonic and clonic 
convulsions. 

Epileptiform (ep-il-ep'ti-form). Resembling ep- 
ilepsy. 

Epilose (ep'i-los). Without hair; bald. 

Epispastic (ep-i-spas'tik). A blister. 

Epistaxis (ep-is-taks'is). Hemorrhage from the 
nose. 

Epithelial (ep-ith-e'le-al). Pertaining to epithe- 
lium. 

Epithelium (ep-ith-e'le-um). The cells covering 
all cutaneous and mucous surfaces to- 
gether with the secreting cells of glands 
developed from ectoderm. 

Epizootic (ep-e-zo-ot'ik). An epidemic among 
animals. 

Epoch (ep'ock). Any fixed time or period. 

Epulis (ep-u'lis). A small, elastic tumor of the 
gums. 

Ergot (er'got). A fungus parasitic upon rye. 

Ergotin (er'go-tin). A name for various active 
extracts of ergot. 

Erigeron (e-rig'e-ron). A genus of herbs. 

Erosin (e-ro'shun). Ulceration; an eating or 
wearing away. 

Eructation (e-ruk-ta'shun). Belching. 

Eruption (e-rup'shun). A breaking out, as in 
3 skin disease. 



GLOSSARY. 



1735 



Eruptive (e-rup'tiv). Characterized by a rash 
or an eruption. 

Erysipelas (er-i-sip'e-las). An acute specific in- 
flammation of the skin and subcutaneous 
tissues, accompanied by fever and consti- 
tutional disturbances. 

Erysipelatous (er-i-si-pel'a-tus). Pertaining to 
erysipelas. 

Erythema (er-ith-e'mah). A superficial blush or 
redness of the skin. 

Eschar (es'kar). A dry slough or crust of dead 
tissue. 

Eschar otic (es-kar-ot'ik). A substance produc- 
ing an eschar. 

Esophagus (e-sof-a-gus). Canal from the 
pharynx to the stomach. 

Essence (es-ens). The inherent qualities of a 
drug. 

Ester (es'ter). A compound ether containing 
both an acid and an alcohol radicle. 

Ether (e'ther). The subtle fluid filling all 
space. It is an anesthetic. 

Etiology (et-e-ol'o-je). The science of the 
causes of disease. 

Eustachian Artery (u-sta'ke-an ar'ter-e). A 
branch of the vidian artery. 

Evacuant (e-vak'u-ant). A medicine which 
causes evacuations of the bowels. 

Evacuation (e-vak-u-a'shun). Defecation; the 
act of emptying or clearing the con- 
tents. 

Evaporate (e-vap'o-rate). To convert from a 
solid or liquid state into vapor. 

Evaporation (e-vap-o-ra'shun). A turning into 
vapor. 

Evince (e-vince')- To manifest; to make evi- 
dent. 

Evolution (ev-o-lu'shun). The process of de* 
veloping from a simple to a complex, 
specified, perfect form. 

Evulsion (e-vul'shun). A forcible tearing away 
of a part. 

Exacerbation (eks-as-er-ba'shun). Increased 

severity of symptoms. 

Exaggerated (eks-a'ger-a-ted). Enlarged; un- 
duly increased. 

Exanthem or Exanthema (eks-an'them). An 
eruption of the skin. 

Exanthematous (eks-an-them'a-tus). Pertaining 
to an exanthem. 

Excipient (eks-sip'e-ent). Any substance com- 
bined with an active drug to give the 
latter an agreeable or convenient form. 

Excitant (eks-si'tant). A medicine which 
arouses the vital activity of the body. 

Exclusion (eks-klu'shun). A shutting out; the 
state of being excluded. 

Excoriation (eks-ko-re-a'shun). A wound of the 
skin caused by rubbing. 

Excrement (eks'kre-ment). The feces. 

Excrementitious (eks-kre-men-tish'us). Pertain- 
ing to the feces. 

Excrescence (eks-kres'cence). An abnormal out- 
growth on the body; as a wart. 

Excreta (eks-kre'tah). The natural discharges 
of the body. 

Excrete (eks-kref). To throw off effete ma- 
terial. 

Excretion (eks-kre'shun). The discharge of the 
waste products of the body. 

Excretory (eks'kre-to-re). Pertaining to excre- 
tion. 

Excruciating (eks-kru'si-a-ting). _ Torturing; tor- 
menting; most severe pain. 

Exertion (ex-er'shun). The act of putting into 
motion; effort; a striving or struggling. 

Exfoliation (eks-fo-le-a'shun). The scaling off 
of dead tissue. 

Exhalation (eks-hal-a'shun). The vapor given 
off by the body. 

Exhaustion (eks-aws'chun). Great loss of vital 
power. 



Exhilarant (eks-il'a-rant). An agent enlivening 
the mind. 

Exhilarating (eks-il'a-rat-ing). Enlivening; giv- 
ing life and vigor to the spirit. 

Exhumation (eks-hu-ma'shun). Disinterment of 
a corpse. 

Exostosis (eks-os-to'sis). An abnormal out- 
growth of a bone. 

Expectorant (eks-pek'to-rant). A medicine pro- 
moting a secretion of bronchial mucous. 

Expectoration (eks-pek-to-ra'shun). The expul- 
sion of the secretions from the chest. 

Expiration (eks-pi-ra'shun). The act of breath- 
ing out; conclusion; end; close. 

Exsiccation (eks-sik-ka'shun). The process of 
drying by heat. 

Extensor (eks-ten'sor). A muscle which causes 
extension of a part. 

Exterminator (eks-ter'min-a-tor). That which 
destroys. 

External (eks-ter'nal). Outer. 

Extravasation (eks-tra-va-sa'shun). An effusion 
of fluid into the tissues. 

Extremity (eks-trem'i-te). A limb; an end or 
a termination. 

Exudation (eks-u-da'shun). A morbid oozing 
out of fluids; sweating. 



Facial (fa'shal). Pertaining to the face. 

Fades (fa'she-ez). The countenance. 

Facultative (fak'ul-ta-tive). Pertaining to func- 
tional or acquired power. 

Faculty (fak'ul-te). Specific power. The corps 
of professors in a college. 

Faradic (far-ad'ik). Pertaining to induced elec- 
tric currents. 

Faradization (far-a-di-za'shun). The treatment 
of a nerve with faradic or induced cur- 
rents of electricity. 

Farina (far-e'nah). The powdered starch of 
grain. 

Farinaceous (far-in-a'she-us). Having the na- 
ture of farina. 

Fascia (fash'e-a). A thin covering of the mus- 
cles. 

Fascination (fas-in-a'shun). Inexplicable or 
hypnotic influence. 

Faucet (faw'set). A fixture for drawing liquid 
from a vessel. 

Febricula (feb-rik'u-lah). A mild fever of 
short duration. 

Febrifacicnt (feb-ri-fa'shent). Producing fever. 

Febrifuge (feb're-fuj). An agent that lessens 
fever. 

Febrile (feb'ril). Pertaining to fever. 

Feces (fe'sez). Excrement; the discharge of the 
bowels. 

Feculent (fek'u-lent). Foul with impure sub- 
stances; abounding with sediment matter. 

Femoral (fem'or-al). Pertaining to the femur. 

Femur (fe'mur). The thigh-bone. 

Ferment (fer'ment). A substance which in 
small quantities is capable of setting up 
changes in another substance without 
itself undergoing much change. 

Ferruginous (fer-ru'ji-nus). Containing iron. 

Fetid (fet'id). Having an offensive smell. 

Fetor (fe'tor). Any strong, offensive smell. 

Fetus (fe'tus). The product of conception after 
the fourth month of gestation. 

Fiber (fi'ber). A filamentary or thread-like 
structure. 

Fibrin .(fi'brin). A nitrogenous proteid coagu- 
lating in exposed blood. 

Fibrinous (fi'brin-us). Composed of fibrin. 

Fibroid (fi'broid). Having a fibrous structure. 

Fibrosis (fi-bro'sis). The development of fibrous 
tissue in an organ. 



173G 



GLOSSARY. 



Fibrous (fi'brus). Consisting of or pertaining 
to fibers. 

Filtration (ril-tra'shun). The process of strain- 
ing or filtering. 

Filament (fil'a-ment). A thread-like structure. 

Fimbria (fim'bre-ahj. A fringe. 

Fissure (fish'urj. A grove or cleft. 

Fistula (fis'tu-lah). An abnormal tube-like pas- 
sage in the body. 

Flaccid (fiak'sidj. Soft, flabby and relaxed. 

Flagellation (flaj-el-a'shun). Flogging, recom- 
mended as a means of checking pospa.rtum 
hemorrhage. 

Flasliing-point (.flash'ing-point). The tempera- 
ture at which gas from an oil will ignite 
if brought into contact with a flame. 

Flatulence (flat'u-lence). The presence of gas 
n the digestive canal. 

Flatus (fla-tus). Gas in the alimentary canal. 

Fleet or (flek'tor). A flexor. 

Flexibilitas (fleks-i-bil'i-tas). Flexibility. 

Flexibilitas Cerea (fleks-i-bil'i-tas_ se're-a). A 
cataleptic condition in which the limbs 
remain fixed as they are placed. 

Flexible (fleks'i-ble). That which may be bent. 

Flexor (fleks'or). A muscle that bends or flexes 
a part. 

Flexura (fleks-u'rah). A bending or curve in 
an organ. 

Flocculent (flok'ku-lent). Containing shreds; 
flaky. 

Fluctuatio'.i (fluk-tu-a'shun). A wave-like mo- 
tion. 

Flushing (flush'ing). To cleanse by forcing 
water through. A glow of red in the 
face. 

Flux (fluks). Dysentery; a liquid flow or dis- 
charge. 

Foetus (fe'tus). Same as fetus. 

Follicle (fol'ik-1). A small secretory cavity or 
sac. 

Follicular (fol-ik'u-lar). Containing follicles. 

Fomentation (fo-men-ta'shun). The application 
of warm liquids to the body. 

Fontanel (f on-tan-el')- A membranous space at 
the junction of the cranial bones in an 
infant, due to incomplete ossification. 

Foramen (for-a'men). A passage or an opening. 

Forceps (for'seps). A two-bladed instrument 
for grasping objects firmly. 

Formication (for-mi-ka'shun). A creeping sen- 
sation. 

Formula (form'u-lah). A prescribed method; a 
recipe. 

Fornices (for'ni-ses). Plural of fornix. 

Fornicolum (for'ne-kol-um). Anterior pillar of 
fornix. 

Fornix (for'niksj. An arched portion of the 
brain composed of the two hippocampus 
and their respective fimbrias. 

Fortification Spectrum (for-ti-fi-ka'shun spek'- 
trumj. See teichopsia. 

Fracture (frak'chur). The breaking of a bone. 

Frenzy (fren'ze). Violent mania. 

F riable (fri'a-bl). Easily broken or pulverized. 

Friction (frik'shun). The act of rubbing. 

Frigid (frij'id). Cold; stiff; apathetic; distant; 
unfeeling; irresponsive. 

Fugacious (fu-ga'shush). Flying or fleeing 
away; volatile. 

Fulcrum (f ul'krum) . A prop or support. 

Fuming (fum'ing). Smoking; raging; fretting. 

Function (funk'sliun). The normal or special 
action of a part. 

Functional (fitnk'shun-al). Pertaining to func- 
tion. 

Fundament (fun'da-ment). The base; the anus. 

Fungi (fun'ji). A section of saprophytic cryp- 
tograms. 

Fungoid (fun'goid). Having the appearance or 
character of a fungus. 

Fungous (fun'gus). Pertaining to a fungus. 



Fungus (fun'gus). A spongy, morbid growth. 
Fusio)i (fu'shun). The process of liquefying a 

solid by heat. 
Fustigation (fus-ti-ga'shun). Flagellation, as in 

passage. 



Galvanic (gal-van'ik). Pertaining to galvanism. 

Galvanism (gal'van-ism). A form of electricity 
produced by chemic reaction. 

Galvanization (gal-van-i-za'shun). The trans- 
mission of a galvanic current through a 
part of the body. 

Ganglioma (gang-le-o'mah). A swelling of a 
lymphatic gland. 

Ganglion (gan'gli-on). A semi-independent ner- 
vous center. An enlarged lymphatic 
gland. 

Ganglionic (gang-le-on'ik). Pertaining to a 
ganglion. 

Gangrene (gang'gren). The mortification or 
death of soft tissue. 

Gargle (gar'gl). A wash for the throat. To 
wash the throat. 

Garlic (gar'lik). The plant Alium Sativum. It 
is a tonic. 

Gaseous (gas'e-us). Of the nature of gas. 

Gastric (gas'trik). Pertaining to the stomach. 

Gastricism (gas-tris'ism). Dyspepsia. 

Gastritis (gas-tri'tis). Inflammation of the 
stomach. 

Gastroenteric (gas-tro-en-ter'ik). Pertaining to 
both stomach and intestines. 

Gastroenteritis (gas-tro-en-ter-i'tis). ' Inflamma- 
tion of the stomach and bowels. 

Gastrointestinal (gas-tro-in-tes'tin-al). See gas- 
troenteric. 

Gelatin (jel'a-tin). A nitrogenous principle ob- 
tained by boiling certain animal tissues, 
as cartilage, ligaments, etc. 

Gelatinous (je-lat'i-nous). Resembling gelatin; 
jelly-like. 

Generation (jen-er-a'shun). The begetting of 
offspring. 

Generative (jen-er-a'tive). Pertaining to gen- 
eration. 

Genital (jen'i-tal). Pertaining to the organs of 
generation. 

Genitalia (jen-i-ta'li-ah). The organs of genera- 
tion. 

Genitourinary (jen-i-to-u'ri-na-re). Pertaining 
to both genital and urinary organs. 

Germicide (jer'mi-sid). An agent destroying 
germs. 

Germination (jer-min-a'shun). The develop- 
ment of a seed or germ. 

Gcromorphism (jer-o-morf'ism). The appear- 
ance of age in a young person. 

Gerontic (jer-on'tik). Pertaining to old age. 

Gestation (jes-ta'shun). The act of carrying 
young in the womb from conception to 
delivery. 

Giddiness (gid'e-nes). A sensation of whirling. 

Ginglymus (ging'glim-us). A hinge-joint. 

Glairy (glar'e). Slimy; albuminous. 

Gland (gland). An organ which secretes some 
fluid from the blood. 

Glandular (glan'du-lar). Pertaining to a gland. 

Glaucoma (glaw-ko'mah). A disease of the eye 
characterized by increased intraocular 
tension. 

Gleet (glete). A mucous discharge, especially 
from the urethra; a thin ichor running 
from a sore. 

Gleety (gle'te). Resembling or affected with a 
gleet. 

Glioma (gli-o'mah). Tumor composed of neu- 
roglia. 

Globular (glob'u-lar). Shaped like a globe. 

Globule (glob'ul). A small spheric body. 

Glossa (glos'ah). The tongue. 



GLOSSARY. 



173' 



Glossography (glos-og'ra-fe). A description of 
the tongue. 

Glossohyal (glos-o-hi'al). Pertaining to the 
tongue and hyoid bone. 

Glottis (glot'tis). Aperature between the aryte- 
noid cartilages of the larynx. 

Gluteal (glu'te-al). Pertaining to the buttocks. 

Glutinous (glu'ti-nus). Resembling or contain- 
ing glue. 

Glycerin (glis'er-in). The sweetish principle of 
oils and fats. 

Glycyrrhica (glis-er-i'zah). A genus of plants 
and also the demulcent root of licorice 
root. 

Gnatliitis (na-thi'tis). Inflammation of the jaw. 

Gnathoplasty (na'tho-plas-te). A plastic opera- 
tion; the jaw. 

Goiter or Goitre (goi'ter). An enlargement of 
the thyroid gland. 

Gonagra (gon-a'grah). Gout of the knee. 

Gu)iecystic (gon-e-sis'tik). Pertaining to the 
seminal vesicles. 

Gonecystitis (gon-e-sis-ti'tis). Inflammation of 
a seminal vesicle. 

Gonyalgia (gon-e-al'je-ah). Pain in the knee. 

Gonyocele (gon'e-o-sel). White swelling of the 
knee. 

Gout (gowt). A disease associated with joint 
inflammation, swelling, uric acid in the 
blood, etc. 

Granular (gran'u-lar). Composed of grains or 
granulations. 

Granulation (gran-u-la'shun). Formation of 
small elevations on a healing surface. 

Granule (gran'ul). A small rounded grain. A 
spore. 

Graphite (graf'ite). A native form of carbon. 

Gray Matter (gra mat'ter). The cortical sub- 
stance of the brain. 

Grip or Grippe (grip). See influenza. 

Groin (groin). The depression between thigh 
and trunk. 

Groove (groov). A furrow, channel, crease or 
fold. 

Grumous (gru'mus). Thick; viscid; clotted. 

Gullet (gul'et). See esophagus. 

Gutta-percha (gut'ah-per'cha). The flexible con- 
crete juice of an East India tree. It is 
used as a protective application. 

Gymnastics (jim-nas'tiks). Systematic bodily 
exercise. 

Gypsum (jip'sum). Native calcium sulphate. 

H 

Hallucination (hal-lu-si-na'shun). A false per- 
ception or image. 

Harmonia (har-mo'ne-ah). A suture between 
two bones in which the opposed surfaces 
are smooth. 

Harmonious (har-mo'ne-us). Having the parts 
proportioned to each other. 

Harmonizing (har'mo-niz-ing). See harmonia. 

Hartshorn (hartz'horn). Ammonia. 

Haschisch (hash'ish). A narcotic and intoxi- 
cating preparation of the plant called In- 
dian hemp. 

Hectic (hek'tik). The fever of advanced dis- 
ease. 

Hectic Flush (hek'tik flush). Reddening of the 
cheeks in tuberculosis. 

Helonin (hel-o'nin). An extract. It is diuretic 
and anthelmintic. 

Hcmatcmesis (hem-a-tem'e-sis). The vomiting 
of blood. 

Hematimeter fhem-a-ti-me'ter). See hematocy- 
ometer. 

Hematocytometer (hem-at-o-si-tom'et-or). A de- 
vice for counting the corpuscles in a 
given volume of blood. 

Hematoma (hem-a-to'mah). A tumor contain- 
ing blood. 



Hemicrania (hem-e-kra'ne-ah). Neuralgia of 
half of the head. Imperfect development 
of half of the skull. 

Hemiplegia (hem-e-ple'je-ah). Paralysis of ono 
side of the body. 

Hemoptysis (hem-op'ti-sis). The spitting of 
blood. 

Hemorrhage (hem'or-age). A flow of blood 
from the vessels. 

Hemorrhoid (hem'or-oid). A pile; a small blood 
tumor at the anus opening. 

Hepatic (he-pat'ik). Pertaining to the liver. 

Hepatica (he-pat'i-ka). Medicines affecting the 
liver. 

Hepatitis (hep-a-ti'tis). Inflammation of the 
liver. 

Herbivorous (her-biv'o-rus). Eating vegetation. 

Heredity (he-red'i-te). The influence of parents 
upon offspring. 

Hermetic (her-met'ik). Protected from air; air 
tight. 

Hernia (her'ne-ah). The protusion of a viscus 
from its normal position. 

Herpes (her'pez). A skin disease with patches 
of distinct blisters. 

Hiccough (hik'kup). A spasmodic inspiration 
suddenly arrested by an involuntary 
closure of the glottis. 

Hiccup (hik'kup). Same as hiccough. 

Hinge-joint (hinj '-joint). See diarthrosis. 

Hippocampus (hip-po-kam'pus). Either of two 
convolutions of the brain — hippocampus 
major being a large white curved bodk- 
in the inferior cornu of the lateral ven- 
tricles of the brain and hippocampus 
minor a small eminence of white sub- 
stance in the posterior cornu. 

Hippocratic (hip'po-krat'ik). Of or belonging 
to Hippocrates, a celebrated physician of 
Greece, regarded as the father of medi- 
cine. 

Homogenesis (ho-mo-jen'e-sis). The generation 
of offspring experiencing the same cycle 
of developmental changes as the parent. 

Homogenous (ho-moj'e-nus). With like off- 
spring. 

Homogeny (ho-moj'e-ne). With like off- 
spring. 

Hordeum (hor'de-um). Barley. 

Humanity (hu-man'i-te). The quality of being 
human. 

Humeral (hu'mer-al). Pertaining to the hu- 
merus. 

Humerus (hu'mer-us). The large bone of the 
upper arm. 

Humid (hu'mid). Moist; damp. 

Humor (hu'mor). Any fluid of the body. 

Humus (hu'mus). A dark material from de- 
caying vegetable matter. 

Hyaline (hi'a-lin). Glassy; crystalline; trans- 
parent. 

Hydracid (hi-dras'id). Any hydrogen acid con- 
taining no oxygen. 

Hydragog (hi'dra-gog). Purgative; causing 
watery discharges. 

Hydrocephalic (hy-dro-sef-a'lik). Pertaining to 
hydrocephalus. 

Hydrocephalus (hy-dro-sef'al-us). A collection 
of water in the head: dropsy of the brain. 

Hydrochloric (hi-dro-klo'rik). Consisting of 
hydrogen and chlorin. 

Hydrogen (hi'dro-jen). An elementary sub- 
stance existing at ordinary temperatures 
as a colorless, tasteless and inodorous 
gas. the lightest of all known substances. 
It forms one-ninth of the weight of water 
and is present in almost all organic com- 
pounds. 

Hydropathic (hi-dro-path'ik). Pertaining to hy- 
dropathy. 

Hydropathy (hi-drop'a-the). The treatment of 
disease by the use of water. 



173S 



GLOSSARY. 



Hydrothorax (hi-dro-tho'raks). Dropsy of the 
chest. 

Hygiene (hi'je-en). The science of health. 

Hygienic (hi-je-en'ik). Pertaining to hygiene. 

Hylic (hi'lik). Pertaining to the pulp tissues of 
the embryo. 

Hyloma (hi-lo'mah). Any tumor arising in 
hylic or pulp tissues. 

Hymen (hi'men). The membrane which covers 
the mouth of the vagina. 

Hyoid Bone (hi'oid bone). The bone at the 
root of the tongue. 

Hyperesthesia (hi-per-es-the'se-ah). Excessive 
sensibility. 

Hypermnesis (hi-perm-ne'sis). An abnormal 
power of memory. 

Hyperosmia (hi-per-oz'me-ah). A morbidly 
acute sense of smell. 

Hypertrophic (hi-per-tro'fik). Affected with 
hypertrophy. 

Hypertrophy (hi-per'tro-fe). Abnormal increase 
in the size of an organ or a part. 

Hypnotic (hip-not'ik). An agent causing sleep. 

Hypochrondrium (hi-po-kon'dre-um). The re- 
gion of the abdomen at each side of the 
epigastrium. 

Hypodermatomy (hi-po-der-mat'o-me). Subcu- 
taneous incision. 

Hypodermatic (hi-po-der-mat'ik). See hypoder- 
mic. 

Hypodermic (hi-po-der'mik). Subcutaneous; ap- 
plied to injections of medicines. 

Hypogastrium (hip-o-gas'tri-um). The lower 
part of the abdomen. 

Hypophosphite (hi-po : fos'fit). A salt of hypo- 
phosphorous acid. 

Hyposmia (hi-poz'me-ah). A diminution in the 
sense of smell. 

Hypothalamus (hi-po-thal'am-us). Name given 
to the structures of the fore-brain under 
the thalmus. 

Hypotrophy (hi-pot'ro-fe). Defective nutrition. 

Hysteria (his-ter'e-ah). A nervous affection in 
which the patient loses control of the 
emotions through loss of will-power. 

Hysterial (his-te're-al). Of the nature of hys- 
teria. 



Ichor (i'kor). A colorless matter flowing from 
an ulcer. 

Ichthyocolla (ik-the-o-kal'ah). Isinglass; fish- 
glue; a gelatin made from the air glad- 
ders of a fish. 

Ichthyol (ik'the-ol). A liquid prepared from 
mineral pitch and used in skin diseases. 

Icteroid (ik'ter-oid). Resembling jaundice. 

Idiocy (id'e-o-se). A condition of extreme 
mental deficiency. 

Idiopathic (id-e-o-path'ik). Spontaneous; pri- 
mary. 

Idiosyncrasy (id-e-o-sin'kra-se). Individual pe- 
culiarity. 

Idiot (id'e-ot). A person with defective mental 
development. 

Illuminant (il-lu'mi-nant). That which affords 
light. 

Imitable (im'i-ta-ble). Capable of being imi- 
tated or copied. 

Immersed (im-merst'). Covered by water or 
other fluid; plunged. 

Immersion (im-mer'shun). The plunging of a 
body into a liquid. 

Immune (im-mun'). Safe from attack; pro- 
tected by vaccination. 

Immunity (im-mu'ni-te). Freedom from risk of 
infection. 

Immunization (im-mu-ni-za'shun). The act of 
rendering immune. 

Impervious (im-per've-us). Not permitting a 
passage. 



Impetigo (im-pet'i-go). An acute pustular in- 
flammation of the skin. 

Impotence (im'po-tense). Want of strength or 
power, physical, intellectual, or moral; 
weakness; defect of power to perform 
anything. 

Impregnate (im-preg'nate). To fertilize or make 
pregnate. 

Impregnation (im-preg-na'shun). The act of im- 
pregnating; the state of becoming im- 
pregnated. 

Impressible (im-pres'-ible). Capable of being 
impressed. 

Impression (im-presh'un). A hollow or depres- 
sion. 

Impurity (im-pu'ri-te) . That which is impure; 
foul matter. 

Inanimate (in-an'i-mate). Destitute of life; 
dead; dull; inactive. 

Inanition (in-ah-nish'un). Emptiness; exhaus- 
tion from fasting. 

Inarticulate (in-ar-tik'u-late). Vocal sounds 
not arranged into syllables. 

Incoherent (in-ko-he'rent). Not connected or 
coherent. 

Incontinence (in-kon'ti-nense). Involuntary 
evacuation. 

Incubation (in-ku-ba'shun). The time elapsing 
from exposure to a disease until symp- 
toms appear. 

Incus (in'kus). The middle bone of the inner 
ear. 

Indigenous (in-dij'e-nus). Native; produced in 
a country. 

Indolent (in'do-lent). Sluggish; of slow growth. 

Indurated (in-du-ra'ted). Hardened. 

Induration (in-du-ra'shun). The hardening of 
a tissue or part. 

Indurative (in'du-ra-tiv). Pertaining to indu- 
ration. 

Inebriant (in-e'bre-ant). An intoxicating sub- 
stance. 

Inebriation (in-e-bre-a'shun). A drunken con- 
dition. 

Inertia (in-er'shah). Sluggishness; inactivity. 

Infant (in'fant). A baby, less than two years 
of age. 

Infantile (in'fan-til). Pertaining to infancy. 

Infantile Paralysis (in'fan-til pa-ral'i-sis). 
Acute inflammation of the anterior horns 
of the gray matter of the spinal cord. 

Infection (in-fek'shun). The communication of 
disease germs. 

Inferior (in-fe'ri-or). Lower. 

Infiltration (in-fil-tra'shun). A fluid effusion 
into an organ or a tissue. 

Infinite (in'fi-nite). Immeasurable, bound- 
less; vast; countless; unbounded. 

Infirm (in-ferm'). Weak or feeble. 

Inflammation (in-flam-ma'shun). A morbid con- 
dition with pain, heat, swelling and dis- 
ordered function. 

Inflammatory (in-flam-ma-to-re). Pertaining to 
inflammation. 

Inflation (in-fla'shun). Distended with air. 

Inflection (in-flek'shun). A bending inward. 

Influenza (in-flu-en'zah). A contagious epidemic 
catarrhal fever with great prostration and 
varying symptoms and sequels; grip. 

Influx (in'fluks). An inflow. 

Infusion (in-fu'shun). Extracting properties by 
steeping. The slow injection of liquid 
into a vein. 

Ingesta (in-jes'tah). Substances introduced into 
the body as food. 

Ingestion (in-jes'chun). The introduction of 
food into the body. 

Ingredient (in-gre'de-ent). Any part of a com- 
pound. 

Inguinal (in'gwin-al). Pertaining to the groin. 

Inhalation (in-ha-la'shun). The inbreathing of 
air. 



GLOSSARY. 



1739 



Inhaled (in-hald'). See inhalation. 

Injection (in-jek'shun). The forcing of a liquid 
into a cavity, part or vessel of the body. 

Innervation (in-ner-va'shun). A state of nerve- 
lessness; special activity excited in any 
part of the nervous system. 

Innominate (in-nom'i-nate). Nameless. A term 
applied to many parts of the body in 
place of more specific names. 

Inoculation (in-ok-u-la'shun). The introduction 
of specific virus into the system. 

Inodorous (in-o'dor-us). Having no smell. 

Inosculajing (in-os'ku-lat-ing). Directly join- 
ing. 

Insidious (in-sid'e-us). Xot manifest; hidden 
or stealthy. 

Insipid (in-sip'id). Wanting the qualities which 
affect the organs of taste; flat in taste. 

Insoluble (in-sol'u-ble;. Incapable of solution. 

Insomnia (in-som'ne-ah). Inability to sleep. 

Inspiration (in-spi-ra'shun). The inhalation of 
air into the lungs. 

Integument (in-teg'u-ment). A covering, espe- 
cially the skin. 

Intellect (in'tel-ekt). The mind or the reason- 
ing power. 

Intellection (in-tel-ek'shun). Mental activity. 

Intemperance (in-tem'per-ance). The immod- 
erate use of food or drink or both. 

Intensity (in-ten'si-te). A high degree of power 
or activity. 

Intercellular (in-ter-sel'u-lar). Between cells. 

Intercostal (in-ter-kos'tal). Between the ribs. 

Interglobular Spaces (in-ter-glob'u-lar spa'sez). 
Certain irregular areas near the outside 
of the teeth. 

Interlobular (in-ter-lob'u-lar). Between lobules. 

Interment (in-ter'ment). The burial of the 
dead. 

Intermittent (in-ter-mit'ent). Occurring at in- 
tervals. 

Internal (.in-ter'nal). On the inside. 

Interstices (in-ter'sti-sez). Spaces; intervals; 
pores. 

Interstitial (in-ter-stish'al). Lying or placed be- 
tween. 

Intestinal (in-tes'ti-nal). Pertaining to the in- 
testines of the animal body. 

Intestine (in-tes'tine). The digestive tube from 
the stomach to the anus. 

Intima (in'tim-ahj. The innermost coat of the 
vessels. 

Intimitis (in-tim-i'tis). Inflammation of an in- 
tima. 

Intraocular (in-trah-ok'u-lar). Within the globe 
of the eye. 

Intravenous (in-trah-ve'nus). Within a vein. 

Intrinsic (in-trin'sik). Inherent; inward. Pe- 
culiar to a part. 

Introversion (in-tro-ver'shun). A turning in- 
ward. 

Intuitively -(in-tu'i-tive-le). By immediate per- 
ception; without reasoning. 

Intussusception (in-tus-sus-sep'shun). The fall- 
ing of one part of an intestine into an- 
other. 

Inunction (in-ungk'shun). The act of rubbing 
in an ointment. 

Iodid (i'o-did). A compound of iodin. 

Iodin (i'o-din). A poisonous nonmetallic ele- 
ment with a metallic luster, used in medi- 
cine as an alterative. 

Iodoform (i-o'do-form). A yellow antiseptic 
powder used largely in medicine. 

Ipecac (ip'e-kak). See ipecacuanha. 

Ipecacuanha (ip-e-kak-u-an'ha). The roots of 
tropical herbs and shrubs used as an em- 
etic, expectorant and cholagog. 

Iridectomy (ir-id-ek'to-me). The cutting of part 
of the iris. 

Iris (i'ris). The colored membrane of the an- 
terior part of the eye. 



Iritis (i-ri'tis). Inflammation of the iris. 

Irrigate (ir'ri-gate) . To wash out. 

Irritable (ir'ri-ta-ble). Easily inflamed or ir- 
ritated. 

Irritation (ir-ri-ta'shun). Excitement; stimula- 
tion. 

Isinglass (i'zing-glas). A pure gelatin made 
chiefly from the air bladders of stur- 
geons. 

Isolation (i-so-la'shun). The seclusion of pa- 
tients with contagious diseases. 

J 

Jactitation (jak-ti-ta'shun). Restlessness; a 
moving to and fro. 

Jamaicin (Ja-ma'sin). Bitter cathartic sub- 
stance from the bark of the cabbage-tree. 

Jaundice (jawn'disj. A yellow coloration of 
the skin. 

Jaw (jaw). Either of the two maxilliary bones 
serving the purpose of seizing and mas- 
ticating the food. 

Jecur (je'ker). The liver. 

Jejunal (je-ju'nal). Pertaining to jejunum. 

Jejunitas (je-ju'ni-tas). Fasting. 

Jejunum (je-ju'num). The upper two-fifths of 
the small intestine. 

Jugal (ju'gal). Connecting or uniting. 

Jugular (ju'gu-lar). Pertaining to the throat. 

Jugulation (jug-u-la'shun). The swift arrest of 
disease by therapeutics. 

Julep (ju'lep). A sweetened liquid medicine. 



Kalium (ka'le-um). See potassium. 

Karyon (kar'e-on). The cell-nucleus. 

Karyoplasm (kar'e-o-plasm). The nuclear sub- 
stances of a cell. 

Kefir (ke'fer). See kephyr. 

Kenophobia (ken-o-fo'be-ah). A fear of large 
empty spaces. 

Kephyr (ke'fer). A variety of fermented milk. 

Kerasin (ker'a-sin). A cerebrosid occurring in 
brain-tissue. 

Keratitis (ker-a-ti'tis). Inflammation of the cor- 
nea. 

Kerion (ke're-on). A pustular scalp disease. 

Kidney (kid'ne). The organ secreting urine. 

Kinesipathy (kin-e-sip'a-the). The gymnastic 
treatment of disease. 

Kinesodic (kin-e-sod'ik). Pertaining to motor 
impulses. 

Kinesthesis (kin-es'the-sis). The sense by which 
muscular movement is appreciated. 

Kleptomania (klep-to-ma'ne-ah). A morbid de- 
sire to steal. 

Kola (ko'lah). The seeds of Cola Acuminata, 
used as a nervine and cardiac stimulant. 

Kumis (koo'mis). Fermented mare's milk. 



Labia (la'bi-ah). The lips. 

Lachrymal (lak'ri-mal). Pertaining to or secret- 
ing tears. 

Lactation (lak-ta'shun). The function of se- 
creting and excreting milk. 

Lacteal (lak'te-al). Pertaining to milk. One 
of the lymphatics of the small intestine 
that takes up chyle. 

Lactopcptine (lak-to-pep'tin). The proprietory 
name for a mixture of pepsin diastase and 
pancreatin with lactic and hydrochloric 
acid. 

Lamina (lam'in-ah). A thin layer or scale. 

Laminated (lam'i-na-ted). Arranged in layers. 

Lamination (lam-i-na'shun). Arrangement in 
plates or layers. 

Lancet (lan'set). A two-edged surgical knife. 



17±0 



GLOSSARY. 



Lancinating (lan'si-na-ting). Piercing; darting; 
as a pain. 

Languor (lan'gwer). Lassitude; feebleness; 
weakness. 

Larva (lar'vaj. An insect in its earliest form 
4 after leaving the egg. 

Laryngitis (lar-in-ji'tis). Inflammation of the 
larynx. 

Laryngophthisis (lar-in-gof-thi'sis). Tubercu- 
losis of the larynx. 

Laryngoplasty (lar-in'go-plas-te). Plastic sur- 
gery of the larynx. 

Laryngoscope (lar-in'go-skop). An instrument 
for the examination of the larynx. 

Laryngoscopy (lar-in-gos'ko-pe). Inspection of 
the larynx. 

Laryngospasm (lar-in-go-spasm). Spasmodic 

contracture of the glottis. 

Laryngotomy (lar-in-got'o-me). The operation 
of cutting into the larynx. 

Larynx (lar'ingksj. The upper part of the 
windpipe; organ of voice. 

Lassitude (las'si-tude). Weakness; exhaustion; 
dullness; weariness. 

Latent (la'tent). Concealed; not manifest. 

Lateral (lat'er-al). Pertaining to the side. 

Laudanum (lod'an-umj. Tincture of opium. 

Lavandula (lav-an'du-lah). A genus of plants. 

Laxative daks'a-tiv). A mild purgative. 

Leech (leech). A blood-sucking aquatic worm. 

Legume (leg'um). A pod or cod, as a pea-pod 
as a peascod. 

Legumin (leg-u'min;. A nitrogenous proteid 
from legumes., as peas, beans, etc. 

Leptandra (lep-tan'drah). The laxative root of 
veronica virginica. 

Leptandrin (lep-tan'drin). A purgative resinoid 
from leptandra. 

Lesion (le'zhun). Structure tissue-change from 
injury or disease; a hurt or wound. 

Lethargy (leth'ar-je). A condition of drowsi- 
ness. 

Leucorrhea (lu-ko-re'ah). A white discharge 
from the vagina. 

Lichen (li'ken). A papular inflammation of the 
skin. 

Licorice (lik'o-ris). The root and extract Gly- 
cyrrhiza glabra. 

Lienteric di-en-ter'ik). Pertaining to a special 
form of diarrhoea. 

Ligament (lig'a-mentj. A band of fibrous tis- 
sue binding parts together. 

Ligamentum (lig-a-men'tumj. A ligament. 

Ligation (li-ga'shun). The operation of tying, 
as of an artery. 

Ligature (lig'a-chur). 
tying. 

Lincture (link'ture). 



cine. 
Liniment (lin'i-ment). 

external use. 
Liquid (lik'widj. A 
Liquorice (lik'o-ris). 



The material used for 
A soothing cough medi- 
A liquid preparation for 



substance that flows. 
Same as licorice. 

I.ithontriptic dith-on-trip'tik). A medicine 
which destroys a stone in the bladder. 

Lithotomy (li-thot'o-me). The operation of cut- 
ting for stone in the bladder. 

Lithotrity (li-thot'ri-te). The operation of 
breaking a stone in the bladder into small 
pieces capable of being voided. 

Liz id (liv'id). Discolored from the effects of 
congestion or contusion; black and blue. 

Lobe (lob). A rounded division of an organ. 

Lobule (lob'ul). A small lobe. 

Lochia (lo-ki'ah). The evacuations which fol- 
low childbirth. 

Locomotion (lo-ko-mo'shun). Animal move- 
ment. 

Longevity Hon-jev'i-te). Long life. 

Lotion (lo'shun). Any medicinal solution for 
external use. 

Lumbago (lum-ba'go). Pain in the loins. 



Lumbar (lum'bar). Pertaining to the loins. 

Lunar Caustic (lu'nar kaws'tik). Silver nitrate. 

Lung (lung). One of the two organs of respira- 
tion. 

Lymph (limf). A colorless alkaline fluid in the 
lymphatics. 

Lymphatics (lim-fat'iks). The lymph-tubes of 
the body; vessels which carry lymph. 

Lyra of the Fornix (li'rah for'niks). The harp- 
like portion of the fornix formed by 
cross-lying fibers running from one crus 
fornices to the other as they come to- 
gether. 

Lysis (li'sis). Gradual decline of a disease, 
especially a fever. 

M 

Maceration (mas-er-a'shun). Steeping 'in fluid; 

softening. 
Magnesia (mag-ne'ze-ah). Magnesium oxid; a 

laxative. 
Malady (mal'a-de). An illness or disease. 
Malaise (ma-laz'). A feeling of uneasiness or 

discomfort. 
Malaria (ma-la'ri-a). An infectious disease 

caused by a blood-parasite. 
Malarial Fever (ma-la're-al fe'ver). The pe- 
riodic fever of malaria. 
Malassimilation (mal-as-sim-i-la'shun). Imper- 
fect assimilation or nutrition; faulty di- 
gestion, conversion and appropriation of 
nutriment. 
Malformation (mal-for-ma'shun). Ill or wrong 
formation. An abnormal shape' or struc- 
ture. 
Malignant (ma-lig'nant). Virulent; fatal. 
Malleolus (mal-le'o-lus). A projection of either 
bone of the lower leg where it joins the 
ankle. 
Malleus (mal'e-us). A small bone of the inter- 
nal ear. 
Mamma (mam'ah). The breast; an organ for 

secreting milk. 
Mammary (mam'a-re). Pertaining to the mam- 
mas. 
Maniacal (man-ni'a-kal). Having the nature of 

madness. 
Manikin (man'i-kin). A model of a human be- 
ing. 
Manipulation (ma-nip-u-la'shun). Manual treat- 
ment; handling. 
Manipulus (ma-nip'u-lus). A handful. 
Marginal (mar'jin-al). Pertaining to, or at, the 

border of. 
Marsh-fever (marsh-fe'ver). Malarial fever. 
Marvelous (mar've-lus). Wonderful; strange; 
exciting wonder or some degree of sur- 
prise. 
Massage (mas-sazh'). Manipulation; methodic 
pressure; friction and kneading of the 
body. 
Mastication (mas-ti-ka'shun). The act or oper- 
ation of masticating or chewing food. 
Masticatory (mas'ti-ka-to-re). Chewing; adapted 

to perform the office of chewing food. 
Mastitis (mas-ti'tis). Inflammation of the 

breast. 
Matrix (ma'triks). A producing or containing 
substance; intercellular tissue, as of car- 
tilage. The womb. 
Mature (ma-chur'). Ripe; fully developed. 
Maturity (ma-tu'ri-te). Ripeness; the state or 

quality of being mature. 
Matzoon (mat'zun). Milk treated with a pe- 
culiar ferment. 
Maxilla (maks-il'ah). One of the upper or 

lower jawbones. 
Maxillary (maks'il-a-re). Pertaining to the 

jaws. 
Maximum (maks'i-mumj. The height of a dis- 
ease. The largest quantity. 



GLOSSARY. 



1741 



Meatus (me-a'tus). A passage or opening. 

Meconium (me-ko'ni-um). The first fecal dis- 
charges of a new-born infant. 

Medulla (me-dul'lah). The marrow in various 
cavities or any fatty substance resembling 
marrow. The spinal cord. 

Medullary (med'ul-la-re). Pertaining to, con- 
sisting of, or resembling marrow. 

Membrane (mem'bran). A thin enveloping or 
lining substance. 

Membranous (mem'bran-us). Having the na- 
ture of a membrane. 

Meningeal (men-in'je-al). Pertaining to the 
meninges. 

Meninges (men-in'jez). The membrane of the 
brain and cord. 

Meningitis (men-in-ji'tis). Inflammation of the 
meninges. 

Menopause (men'o-pauz). The end of the men- 
strual life. 

Menses (men'ses). The monthly flow of fe- 
males. 

Menstrual (men'stru-al). Pertaining to men- 
struation. 

Menstruation (men-stru-a'shun). Function of 
the female producing menstrual flow. 

Menstruum (men'stru-um). A salvent. 

Mesenteric (mes-en-ter'ik). Pertaining to the 
mesentery. 

Mesentery (mes'en-ter-e). The peritoneal at- 
tachment of the small intestine. 

Metabolism (met-ab'o-lism). A change in the 
intimate condition of cells, constructve or 
destructive. 

Metamorphism (met-a-mor'fizm). See metamor- 
phosis. 

Metamorphopsia (met-a-mor-fop'se-ah). A vis- 
ual defect with an apparent distortion of 
objects. 

Metamorphosis (met-a-mor'fo-sis). Transforma- 
tion; structural change. 

Metastasis (me-tas'ta-sis). A change in the 
seat of a disease. 

Meteorology (me-te-or-ol'o-je). _ The science 
which treats of atmospheric phenomena. 

Meter (me'ter). The unit of linear measure of 
the metric system. 

Miasm (mi'azm). See miasma. 

Miasma (mi-as'ma). Infection floating in the 
air. 

Microbic (mi-kro'bik). Pertaining to microbes. 

Micrococcus (mi-kro-kok'kus). A genus of fis- 
sion-fungi in which the cells are spher- 
ical or oval. 

Micrology (mi-krol'o-je). The science of micro- 
scopic objects. 

Microorganism (mi-kro-or'gan-izm). A minute 
living body. 

Microscopic (mi-kro-skop'ik). Minute; very 
small; visible only by the aid of a micro- 
scope. 

Microscopist (mi-kro'skop-ist). One skilled in 
microscopy. 

Microscopy (mi-kros'ko-pe). The vise of the 
microscope. 

Micturition (mik-tu-rish'un). The act of void- 
ing urine. 

Midwife (mid'wif). A woman who assists wo- 
men in childbirth. 

Migraine (mi-gran'.)- A headache characterized 
by a vehement pain confined to one side 
of the head. 

Mildew (mil'du). The common name for any 
one of a number of small fungi destruc- 
tive to living plants and dead vegetable 
substances. 

Miliaria (mil-e-a're-ah). Sudamina; a disorder 
of the sweat-glands with obstruction of 
their ducts. 

Minim (min'im). The smallest liquid measure; 
about equal to a drop. 

Minimum (min'i-mum). The smallest amount. 



Miscarriage (mis-kar'age). The expulsion of 
the fetus between the fourth and sixth 
months of pregnancy. Abortion. 

Mitigated (mit'i-ga-ted). Made milder. 

Mitral (mi'tral). Miter-like; applied to the left 
auriculoventricular valve of the heart. 

Mitral Valves (mi'tral valves). The valves of 
the heart. 

Mobile (mo'bil). Movable. 

Mobile spasm (mo'bile spazm). A form of tonic 
spasm with slow and irregular move- 
ments of the limbs. 

Mobility (mo-bil'i-te). The property of being 
easily moved. 

Molecular (mo-lek'u-lar). Pertaining to mole- 
cules. 

Molecule (mol'e-kul). The smallest quantity of 
a substance that may exist and preserve 
its characteristic qualities. 

Molluscum (mol-lus'kum). A chronic skin dis- 
ease with pulpy tumors. 

Momentous (mo-men'tus). Very important; 
weighty; of the greatest consequence. 

Monogamous (mo-nog'a-mus). Upholding the 
practice of marrying only one. 

Mono.vid (mon-oks'id). An oxid with one oxy- 
gen atom. 

Monster (mon'ster). An organism of abnormal 
development, especially one in which 
parts or organs are duplicated; a prodigy; 
a marvel. 

Monstrosity (mon-stros'i-te). The condition of 
a monster; a monster. 

Monstrous (mon'strus). Unnatural in form; 
out of the common course of nature; 
frightful; horrible. 

Morbid (mor'bid). Diseased; sickly; not sound 
and healthful. 

Morbidity (mor-bid'i-te). The proportion of 
disease to health in a community. 

Morbific (mor-bif'ik). Causing disease. 

Morphea (mor-fe'ah). A skin disease in which 
pinkish patches show in firm lesions often 
leaving a scar-like marking upon their 
disappearance. 

Mortal (mor'tal). Liable to death; deadly. 

Mortality (mor-tal'i-te). The death rate. The 
state of being mortal. 

Mortification (mor-ti-fi-ka'shun). See gang- 
rene. 

Mortify (mor'ti-fi). To lose vitality and or- 
ganic structure while yet a portion of a 
living body; to gangrene. 

Motile (mo'til). Capable of spontaneous mo- 
tion. 

Mucopurulent (mu-ko-pur'u-lent). Containing 
mucus and pus. 

Mucous Membrane (mu'cus mem'bran). The 
membrane lining all the cavities of the 
body which open externally. 

Mucus (mu'kus). The viscid liquid secretion of 
mucous membrane. 

Mullein (mul'in). See verbascum. 

Muscarin (mus'ka-rin). An alkaloid from fly- 
fungus. 

Musculomembranous (mus-ku-lo-mem'bran-us). 
Composed of muscle and membrane. 

Mutilation (mu-ti-la'shun). The loss of a mem- 
ber of an organ. 

Myalgia (mi-al'ie-ah). Pain in the muscles. 

Myelitis (mi-el-i'tis). Inflammation of the 
spinal cord. 

Myelon (mi'el-on). The spinal cord. 

Myopia (mi-o'pe-ah). Near-sightedness; a vis- 
ual defect from focalization of the image 
in front of the retina. 

Myopic (mi-op'ik). Pertaining to myopia. 

My rrli (mur). A gum resin from Commiphora 
Myrrha; it is a stimulant tonic. 



1742 



GLOSSARY. 



N 

Nanism ^nan'izm). Dwarfishness; the state of 
being undersized. 

Nanous (nan'us). Dwarfed. 

Nape (nap.). The back of the neck; the nucha. 

Narcotic (nar-kot'ik). A hypnotic allaying pain. 

Nares (na'rez). Plural of naris. 

Naris (na'riz). The nostril. 

Nasal (na'sal). Pertaining to the nose. 

Nasal Bones (na'sal bones). Two small bones 
forming the arch of the nose. 

Nasitis (na-zi'tis). Inflammation of the nose. 

Nausea (naw'se-ah). Sickness at the stomach; 
a desire to vomit. 

Nauseant (naw'se-ant) . A substance which pro- 
duces nausea. 

Necrosis (ne-kro'sis). The death of a circum- 
scribed piece of tissue. 

Nematoid (nem'a-toid). Resembling a thread. 
A thread-worm. 

Nephritic (ne-frit'ik). Pertaining to the kid- 
neys. 

Nephritis (ne-fri'tis). Inflammation of the kid- 
neys. 

Nervine (nerv'ine). A medicine which soothes 
nervous excitement. 

Neuralgia (nu-ral'je-ah). Pain in a nerve. 

Neurilemma (hu-ril-em'ah). The sheath incas- 
ing a nerve. 

Neuroglia (nu-rog'le-ah). The reticulated 

framework of the substance of the brain 
and spinal cord. 

Neurolemma (nu-rol-em'ah). See neurilemma. 

Neuroma (nu-ro'mah). A nerve-tumor. 

Neurosis (nii-ro'sis). Any disease of the nerves 
in which no structural change is appar- 
ent. 

Nevus (ne'vus). A birth-mark. 

Nidus (ni'dus). A nest. A cluster. A focus 
of infection. 

Nitre (ni'ter). Saltpeter; nitrate of potash. 

Nitrogen (ni'tro-jenj. A colorless nonmetallic, 
gaseous element. A main constituent of 
air. 

Nitrogenous (ni-troj'e-nus). Containing nitro- 
gen. 

Nitroglycerin (ni-tro-glis'er-in). An oily, toxic, 
explosive liquid. 

Noctambulation (nok-tam-bu-la'shun). Sleep- 
walking. 

Nocturnal (nok-ter'nal). Pertaining to the 
night. 

Nodal (no'dal). Relating to a node. 

Node (nod). An indurated swelling on a ten- 
don or a bone. 

Nodular (nod'u-lar). Covered with nodes. 

Nonviable (non-vi'a-ble). Not able to live. , 

Normal (nor'mal). Healthy; natural. 

Normoblast (nor'mo-blast). A blood corpusle 
of normal size. 

Nosography (no-sog'ra-fe). A description of 
disease. 

Nosology (no-sol'o-je). The science of dis- 
eases; the scientific classification of dis- 
eases. 

Nostalgia (nos-tal'je-ah). Homesickness. 

Nostrum (nos'trum). A quack or patent medi- 
cine. 

Noxious (nok'shus). Harmful; poisonous. 

Nucha (nu'kah). See nape. 

Nuclear (nu'kle-ar). Pertaining to the nu- 
cleus. 

Nucleus (nu'kle-us). The controlling center of 
a muscle or organ. The central element 
in a compound. 

Nutriment (nu'tri-ment). Anything that nour- 
ishes. 

Nutritious (nu-trish'us). Yielding nourishment. 

Nutritive (nu'tri-tiv). Affording nutrition. 



Obese (o-bes'). Extremely fat; corpulent. 

Obesity (o-bes'i-te). Fatness; corpulence. 

Object-blindness (ob'jekt blind'nes). An in- 
ability to comprehend objects seen. 

Oblique (ob-lek'). Slanting; inclined. 

Oblongata (ob-lon-ga'tah). The medulla oblon- 
gata. 

Obstetrician (ob-ste-trish'an). One who prac- 
tises obstetrics. • 

Obstetrics (ob-stet'riks). The science of the 
care of women during pregnancy, child- 
birth and the puerperium. 

Obstinate (ob'ste-nate). Not yielding to treat- 
ment; not easily subdued. 

Occipital (ok-sip'i-tal). Pertaining to the oc- 
ciput. 

Occiput (ok'si-put). The back part of the head. 

Occlusion (ok-klu'shun). The blocking up of 
an opening. 

Ocher or Ochre (o'ker). Yellow colored clay. 

Odorant (o'dor-ant). Odorous; fragrant; a per- 
fume. 

Odoriferous (o-dor-if'er-us). Yielding an odor; 
sweet of scent. 

Officinal (off-is'in-al). For sale by pharmacists. 

Ointment (oint'ment). A soft, greasy substance 
or compound used for smearing over any 
surface, particularly the body or a dis- 
eased part. 

Oleaginous (o-le-aj'in-us). Having the nature 
of oil. 

Olfactioh (ol-fak'shun). The sense of smell. 

Olfactory (ol-fak'to-re). The organ of smell; 
pertaining to smelling; having the sense 
of smell. 

Opacity (o-pas'i-te). Nontransparency; dark- 
ness; obscurity. 

Opalisin (o-pal-is'in). A proteid in human milk. 

Ophthalmic (off-thal'mik). Pertaining to the 
eye. 

Ophthalmoscope (of-thal'mo-skope). A perfor- 
ated mirror used in inspecting the inte- 
rior of the eye. 

Opiate (o'pe-ate). An opium preparation; a 
hypnotic. 

Optic (op'tik). Pertaining to the eye. 

Orbicular (or-bik'u-lar). Circular; spheric. 

Orbicular Bone (or-bik'u-lar bone). The round 
prominence at the end of the incus. 

Orbicular Ligament (or-bik'u-lar lig'a-ment). 
The circular ligament surrounding the 
head of the radius. 

Orbicularis (or-bik-u-la'ris). A name given to 
muscles whose fibres encircle an orifice. 

Orbit (or'bit). The bony cavity for the eyeball. 

Orbital (or'bit-al). Pertaining to the orbit. 

Organic (or-gan'ik). Pertaining to or having 
organs. 

Organism (or'gan-ism). A living, organized be- 
ing. 

Orifice (or'i-fis). The mouth or aperture of a 
tube, pipe or other cavity. 

Orolingual (o-ro-ling'gwal). Pertaining to the 
mouth and tongue. 

Orthopnea (or-thop'ne-a). A disease in _ which 
a person can breathe only when sitting up. 

Oscheitis (os-ke-i'tis). Inflammation of the 
scrotum. 

Oscillation (os-sil-la'shun). A swinging or vi- 
bration. 

Oscitation (os-si-ta'shun). The act of yawning 
or gaping. 

Osculation (os-ku-la'shun). Anastomosis; the 
act of kissing. 

Osseous (os'e-us). Bony; resembling bone. 

Ossification (os-si-fi-ka'shun). The change or 
process of change of flesh or other mat- 
ter of animal bodies into bony substances. 

Otoscope (o'to-skope). An instrument for in- 
specting the ear. 



GLOSSARY. 



1743 



Ovary (o'va-re). The organ of the female in 
which ova are formed in animals. 

Ovariotomy (o-va-ri-ot'o-me). A surgical op- 
eration in which _ an ovary is taken out. 

Ovule (o'vul). The unimpregnated ovum. Any 
small egglike structure. 

Ovum (o'vumj. The female reproductive cell 
of an animal or vegetable; an egg. 

Oxid (oks'id). Any binary combination of oxy- 
gen. 

Oxidation (oks-i-da'shun). The conversion into 
an oxid. 

Oxygen (oks'i-jen). One of the gaseous ele- 
ments; the supporter of life and combus- 
tion. 

Oxygenation (oks-i-jen-a'shun). Saturation with 
oxygen. 

Oxyuris (oks-i-u'ris). A genus of nematoid 
worms. 

Ozent (o-ze'nah). A fetid nasal ulceration and 
discharge. 

Ozone (o'zon). An allotropic form of oxygen 
used as an antiseptic and oxidizing agent. 



Pabulum (pab'u-lum). Food; anything nutri- 
tive. 

Palatableness (pal'a-ta-ble-nes). The quality of 
being agreeable to the taste. 

Palate (pal'ate). The roof of the mouth and 
floor of the nose. 

Palatitis (pal-a-ti'tis). Inflammation of the 
palate. 

Palliate (pal'e-ate). To soothe or mitigate. 

Palliative (pal'e-a-tiv). Mitigating; relieving. 

Pallor (pal'or). Paleness. 

Palpable (pal'pa-ble). Easily perceived and de- 
tected; unmistakable; plain. 

Palpitation (pal-pi-ta'shun). Violent pulsation, 
as of the heart. 

Palsy (pawl'se). See paralysis. 

Panacea (pan-a-se'ah). A remedy for all dis- 
eases. 

Panada (pa-na'da). A food made by pouring 
boiling water over toasted bread, sweet- 
ening and flavoring with mace, nutmeg 
or wine. 

Pancreas (pan'kre-us). A racemose gland in 
the abdomen; the sweetbread. 

Pancreatic (pan-kre-at'ik). Relating to the 
pancreas. 

Pancreatin (pan'kre-a-tin). A ferment from the 
juice of the pancreas. 

Papillae (pa-pil'la). A _ nipple of the breast. 
The minute elevations on the surface of 
the skin, as on the tongue. 

Papular (pap'u-lar). Consisting of papules. 

Papule (pap'ul). A small elevation of the skin. 

Paralysis (pa-ral'i-sis). Loss of sensation or 
voluntary motion. 

Paralytic (par-ah-lit'ik). A person affected with 
paralysis. 

Paraplegia (par-ah-ple'je-ah). Paralysis of the 
legs. 

Parasite (par'a-site). An organism that in- 
habits another organism and obtains nour- 
ishment from it. 

Parasiticide (par-a-sit'i-side). A substance de- 
stroying parasites. 

Paregoric (par-e-gor'ik). A camphorated tinc- 
ture of opium. 

Parenchyma (pa-ren'ki-mah). The tissue out- 
side the .blood vessels and derived from 
the blood; the cellular and fibrous sub- 
stance of the glands and other solid or- 
gans. 

Parenchymatitis (par-en-kim-a-ti'tis). Inflamma- 
tion of the paremchyma. 

Parietal (pah-ri'e-tal). Pertaining to a wall. 

Parietal Bones (pah-ri'e-tal bones). The bones 
forming the cranial sides and roof. 



Parotid (pa-rot'id). Situated near the ear. 
Parotid Glands (pa-rot'id glands). The glands 

of the cheeks which secrete the saliva. 
Paroxysm (par'oks-izm). A period of increase 

or crisis of a disease. 
Paroxysmal (par-oks-is'mal). Pertaining to par- 
oxysm. 
Parturition (par-tu-rish'un). The act of giving 
birth to young. 

Pasteurism (pas-ter'ism). Vaccination. 

Pasteurization (pas-ter-i-za'shun). The destruc- 
tion by heating of microbic life in a 
substance. 

Patella (pa-tel'lah). The kneepan or cap of the 
knee. 

Patency (pa'ten-se). The condition of being 
open. 

Pathetic (path-et'ik). That which appeals to or 
stirs the passions. 

Pathogenic (path-o-gen'ik). Causing disease. 

Pathognomonic (path-og-no-mon'ik). Character- 
istic; peculiar to. 

Patliognomy (path-og'no-me). The science of 
the signs by which disease is recognized. 

Pathologic (path-o-loj'ik). Pertaining to path- 
ology. 

Pathologist (pa-thol'o-jist). A specialist in 
pathology. 

Pathology (pa-thol'o-je). The science of dis- 
eases. 

Peat (peet). Partially carbonized vegetable ma- 
terial in bogs. 

Pectoral (pek'to-ral). Pertaining to the breast. 
A remedy for chest diseases. 

Pect oralis (pek-tor-a'lis). A muscle of the 
breast. 

Pedicle (ped'ik-1). The stalk or attachment of 
a tumor. 

Pediculus (pe-dik'u-lus). The lice that infest 
man. 

Peduncle (pe'dung-kl). A supporting part. 

Pedunculated (pe-dung'ku-lat-ted). Having a 
peduncle. 

Pelvis (pel'vis). The bony basin of the trunk 
formed by the innominate bones and 
the sacrum. 

Pemphigus (pem'fig-us). A skin disease with 
an eruption of blisters. 

Pendulous (pen'du-lus). Hanging or drooping. 

Pepsin (pep'sin). A ferment found in gastric 
juice. 

Peptone (pep'tone). A proteid derived from 
any native proteid through the action of 
hydralizing agents. 

Peptonized (pep'ton-izd). Converted into pep- 
tones. 

Peptonoid (pep'ton-oid). A substance resem- 
bling a peptone. 

Perception (per-sep'shun). The acquiring of 
impressions through the senses. 

Perceptivity _ (per-sep-tiv'i-te). Capacity to re- 
ceive impressions. 

Percolation (per-ko-la'shun). _ The process of 
extracting soluble constituents from pow- 
dered substances by allowing a solvent to 
trickle slowly through. 

Percussion (per-kusli'un). Diagnosis by strik- 
ing the body a sharp slight blow. 

Perflation (per-fla'tion). The act of blowing 
through. 

Perforate (per'fo-rate). To pierce with holes. 

Perforator (per'fo-ra-tor). An instrument to 
open the skull. 

Pericarditis (per-e-kar-di'tis). Inflammation of 
the pericardium. 

Pericardium (per-e-kar'de-um). Membranous 
sac around the heart. 

Perineum (per-i-ne'um). The space between the 
thighs from anus to genitalia. 

Periodic (pe-re-od'ik). Occurring at intervals. 

Periodicity _ (pe-re-o-dis'i-te). Recurrent at regu- 
lar intervals. 



1744 



GLOSSARY. 



Periodontitis (pe-re-o-don-ti'tis). Inflammation 
of the membrane of a tooth-socket. 

Periosteal (per-e-os'te-al). Pertaining to peri- 
osteum. 

Periosteitis (per-e-os-te-i'tis). Inflammation of 
the periosteum. 

Periosteum (per-e-os'te-um). The fibrous mem- 
brane investing the surface of bones ex- 
cept at the points of tendinous and liga- 
mentous attachment and on the articular 
surfaces where cartilage is substituted. 

Periostitis (per-e-os-ti'tis). See periosteitis. 

Peripheral (per-if'er-al). Pertaining to the peri- 
phery. 

Periphery (per-if'er-e). The circumference or 
bounding line. 

Peristalsis (per-isi-tal'sis). The vermicular mo- 
tion of the bowels. 

Peristaltic (per-i-stal'tik). Belonging to the ver- 
micular contraction arid motion of vas- 
cular canals, as the alimentary, the cir- 
culating, and the generative tubes. 

Peristole (per-is'to-le). The same as peristalsis. 

Peritoneal (per-i-to-ne'al). Pertaining to the 
peritoneum. 

Peritoneum (per-i-to-ne'um). Serous membrane 
lining of the abdomen. 

Peritonitis (per-i-ton-i'tis). Inflammation of the 
peritoneum. 

Perityphlitis (per-i-tif-li'tis). Inflammation 

around the cecum. 

Permanganate _ (per-man'ga-nate). A salt of per- 
manganic acid. 

Permeable (per'me-a-ble). Pervious; capable of 
being passed through without rupture, as 
solid matter. 

Permeate (per'me-ate). To pass through the 
pores of a substance; to saturate. 

Pernicious (per-nish'us). Highly destructive; 
fatal. 

Peroxid (per-oks'id). An oxid with the highest 
amount of oxygen. 

Perpetuation (per-pet-u-a'shun). The act of 
making perpetual or preserving from ex- 
tinction through an endless existence, or 
for an indefinite period of time. _ 

Perspiration (per-spi-ra'shun). Excretion of 
liquid from the skin; sweating. 

Pervious (per've-us). Permitting penetration. 

Pessary (pes'sah-re). An instrument placed in 
the vagina to support the uterus. 

Pestilence (pes'ti-lence). Any deadly epidemic 
disease. 

Petechia (pe-te'ke-ah). A small spot of dis- 
coloration beneath the epidermis. 

Petechial (pe-te'ke-al). Pertaining to petechias. 

Petrolatum (pet-ro-la'tum). Soft, unctuous sub- 
stance obtained from petroleum. 

Petrous (pe'trus). Resembling stone. 

Phagedena (faj-e-de'nah). Gangrenous ulcera- 
tion; a spreading obstinate ulcer. 

Pharmaceutic (far-mah-su'tik). Pertaining to 
drugs. 

Pharmacist (far'ma-sist). An apothecary or a 
druggist. 

Pharyngeal (far-in'je-al). Pertaining to the 
pharynx. 

Pharynx (far'ingks). The muscular sac behind 
the mouth. 

Phenol (fe'nol). Carbolic acid. 

Phenomenon (fe-nom'e-non). A symptom. Un- 
common occurence. 

Phlebitis (fleb-i'tis). Inflammation of a vein. 

Phlebotomy (fle-bot'o-me). The act or practice 
of opening a vein for letting blood. 

Phlegm (flem). Watery humor; mucus from 
the bronchi. 

Phlegmatic (fleg-mat'ik). Pertaining to phlegm. 
Slow, dull. 

Phlegmon (fleg'mon). Suppurative inflammation 
of areolar tissue. 

Phlegmonous (fleg'mon-us). Of the nature of a 
phlegmon. 



Phlogistic (flo-jis'tik). Inflammatory. 

Phlyctena (flik-te'nah). A vescicle with serous 
contents; a blister. 

Phlyctenular (flik-ten'ular). Having the nature 
of Phlyctenule. 

Phlyctenule (flik-ten'ul) . A minute vesicle or 
phlyctena. 

Phosphate (fos'fate). A salt of phosphoric acid. 

Phosphorated (fos'for-a-ted). Combined with 
phosphorus. 

Phosphorus (fos'for-us). One of the elements in 
bone and nerve tissue. 

Phrenic (fren'ik). Pertaining to the diaphragm. 

Phthisical (this'ik-al). Of, belonging to, or suf- 
fering from phthisis. 

Phthisis (thi'sis) or (ti'sis). A wasting or con- 
sumption. 

Physiognomy (fiz-e-og'no-me). The act of read- 
ing character by the study of the face. 

Physiology (fiz-e-ol'o-je). The science of the 
functions of the body. 

Physiolysis (fiz-e-ol'i-sis). The falling to pieces 
of dead tissue. 

Physostigma (fi-so-stig'mah). A genus of plants. 

Pigment (pig'ment). An organic coloring mat- 
ter. 

Pith (pith). The marrow of bones. The spinal 
cord. 

Pityriasis (pit-i-ri'a-sis). A scaly skin disease. 

Placenta (pla-sen'tah). The flat, round, spongy 
body forming the organ of nutrition for 
the fetus; the after birth. 

Plasma (plas'mah). The fluid part of the blood 
and lymph. 

Plasmodium (plas-mo'de-um). The motije mass 
of protoplasm formed by the organic fu- 
sion of two or more amebiform bodies. 

Plastic (plas'tik). Capable of being molded. 

Plasticity (plas-tis'i-te). The state of being 
plastic. 

Plethora (pleth'o-rah). Abnormal fullness of 
the blood-vessels. 

Plethoric (pleth'o-rik). Pertaining to plethora. 
Full blooded. 

Pleura (plu'rah). The serous membrane envel- 
oping the lungs. 

Pleurisy (plu'ri-se). See pleuritis. 

Pleuritis (plu-ri'tis). Inflammation of pleura. 

Pleurodynia (plu-ro-din'e-ah). Pain in the inter- 
costal muscles. 

Plexus (pleks'us). A union of fibers, vessels 
or nerves in the form of network. 

Pneumatothorax (nu-mat-o-tho'raks). See pneu- 
mothorax. 

Pneumogastric (nu-mo-gas'trik). Pertaining to 
the lungs and stomach. 

Pneumothorax (nu-mo-tho'raks). Gas or air in 
the pleural sac. 

Polluted (pol-lut'ed). Defiled; dishonored. 

Polygamous (po-lig'a-mus). Relating to or con- 
sisting in polygamy; having a plurality 
of wives. 

Polygamy (po-lig'a-me). The state of having 
more than one wife or husband at the 
same time. 

Polypus (pol'e-pus). A pedunculated tumor 
found in the nose, ear, rectum, etc. 

Pomade (po-made'). A perfumed ointment. 

Pons (ponz). A process of bridge or tissue 
connecting two parts. 

Pore (por). A minute circular opening as in 
the skin. 

Portable (port'a-ble). That may be carried. 

Posterior (pos-te're-or). Situated behind; to- 
ward the rear. 

Post-mortem (post mor'tem). An examination 
of a body made after death. 

Post-part um (post par'tum). Subsequent to 
child-birth. 

Posture (pos'chur). Position; attitude. 

Potable (po'ta-ble). Something that may be 
drunk; a beverage. 

Potash (pot'ash). Potassium hydroxid. 



GLOSSARY. 



1745 



Potassium (po-tas'se-um). The metallic base 
of potash. 

Potion (po'shun). A draft. A dose. 

Precipitate (pre-sip'i-tate). A substance sepa- 
rated by precipitation. 

Precipitation (pre-sip-i-ta'shun). The process 
of having solids fall to the bottom from 
liquids that hold them in solution. 

Predisposing (pre-dis-po'zing). Inclined to, as 
a disease. 

Predisposition (pre-dis-po-zish'un). A natural 
tendency. 

Pregnancy (preg'nan-se). The condition of 
being with child. 

Pregnant (preg'nant). Being with young, as a 
female; breeding. 

Prehension (pre-hen'shun). The act of grasp- 
ing. 

Premature (pre'ma-chur). Occuring before the 
proper time. 

Premonitory (pre-mon'i-to-re). Haying the char- 
acter of a warning; indicating the onset 
of a disease. 

Preservative (pre-serv'a-tiv). Tending to keep 
from decay. 

Preventative (pre-vent'a-tiv). See preventive. 

Preventive (pre-ven'tiv). Anticipating; tending 
to hinder; hindering the access of; as a 
medicine preventive of disease. 

Primipara (pri-mep'a-rah). A woman bearing 
or giving birth to her first child. 

Primitive (prim'i-tiv). Original. 

Primordial (pri-mor'de-al). Pertaining to the 
beginning. 

Probe (prob). To examine a wound or sore by 
piercing it with a sharp instrument. 

Process (pros'es). Experiment. Any protuber- 
ance or eminence. 

Procreation (pro-kre-a'shun). Reproduction or 
generation of young. 

Profunda (pro-fun'dah). A deep-seated artery. 

Prognosis (prog-no'sis). Prediction of course 
and end of a disease. 

Prognostic (prog-nos'tik). Pertaining to the 
prognosis. 

Prolapsus (pro'lap-sus). The falling down of a 
part. 

Proliferation (pro-lif-er-a'shun). Cell-genesis; 
reproduction. 

Prolific (pro-lif'ik). Fruitful; generating abun- 
dantly. 

Pronate (pro'nate). To render prone. 

Pronation (pro-na'shun). The downward turn- 
ing of the palm. 

Pronator (pro-na'tor). A muscle pronating a 
part. 

Prone (prone). Face downward. 

Propagate (prop'a-gate). To have young or 
issue; to increase and multiply. 

Propagation (prop-a-ga'shun). The spreading 
or extension of anything. 

Prophylactic (pro-fil-ak'tik). Pertaining to pro- 
phylaxis. 

Prophylaxis (pro-fil-aks'is). The prevention of a 
disease. 

Prostration (pros-tra'shun). Extreme nervous 
exhaustion. 

Proteid (pro'te-id). See protein. 

Protein (pro'te-in). An organic substance found 
in various forms of animals and plants; 
albumen. 

Protoplasm (pro'to-plazm). Primitive organic 
cell-matter; germinal matter. 

Protoplasmic (pro-to-plaz'mik). Pertaining to 
protoplasm. 

Protoplast (pro'to-plast). An embryonic cell; 

protoplasm. 
Protractor (pro-trak-tor). A muscle drawing 

forward. 
Protuberance (pro-tu'ber-ance). A projecting 

part. 
Prurigo (pru-ri'go). A chronic papular skin 
disease with intense itching. 



Pruritus (pru-ri'tus). Intense itching. 

Pseudo (su'do). False. 

Psoriasis (so-ri'a-sis). A cbronic inflammatory 
skin disease. 

Psychic (si'kik). Pe-rtaining to the mind or soul. 

Psychical (si'kik-al). See psychic. 

Ptyalistn (ti'a-lism). A morbid and copious ex- 
cretion of saliva. 

Ptyalin (ti'a-lin). An amylolytic ferment of 
saliva. 

Puberty (pu'ber-te). The age of capability of 
reproduction. 

Pubis (pu'bis). The pubic bone. 

Puerperal (pu-er'per-al). Pertaining to or fol- 
lowing child birth. 

Puerperium (pu-er-pe're-um). The period from 
delivery to the completion of involution. 

Pulmonary (pul'mo-na-re). Pertaining to the 
lungs. 

Pulmonic (pul-mon'ik). Pertaining to the lungs. 

Pulsation (pul-sa'shun). A beating or throbbing 
sensation. 

Pulse (pulse). The beating or rythmic throb- 
ing of the heart. 

Pultaceous (pul-ta'shus). Pap-like; mushy; 
soft. 

Pulverization (pul-ver-i-za'shun). The act of 
reducing to a powder. 

Pungent (pun'jent). Acid; penetrating; severe; 
biting. « 

Purgation (pur-ga'shun). Evacuation of the 
bowels; cleansing. 

Purgative (pur'ja-tive). An agent producing 
watery evacuations. 

Purify (pu'ri-fi). To cleanse, to free from ex- 
traneous matter. 

Purpura (pur'pu-rah). Hemorrhages into the 
true skin. 

Purpuric (pur'pu-rik). Pertaining to purpura. 

Purulent (pu'ru-lent). Having the character of 
pus. 

Pus (pus). The fluid product of suppuration. 

Pustular (pus'tu-lar). Consisting of pustules. 

Pustule (pus'tul). An elevation of the cuticle 
with an inflamed base containing pus. 

Putrefaction (pu-tre-fak'shun). Organic decom- 
position; decay. 

Putrid (pu'trid). Showing putrefaction; rot- 
ten. 

Pyemia (pi-e'me-ah). A condition in which pyo- 
genic bacteria circulate in the blood and 
form abscesses wherever they lodge. 

Pyogenic (pi-o-jen'ik). Developing or secret- 
ing pus. 

Pylorus (pi-lo'rus). The lower orifice of the 
stomach leading into the small intestines. 

Pyrosis (pi-ro'sis). A gastric burning pain with 
eructations or belching. 

Pyuria (pi-u're-ah). The pressure of pus in 
the urine. 

Radial (ra'de-al). Pertaining to the radius. 

Radicle (rad'ik-1). The primary root or stem 
of the embryo. 

Radius (ra'de-us). The small bone of the fore- 
arm. 

Ramification (ram-e-fi-ka'shun). Branching of an 
organ or a part. 

Ramollescence (ram-obles'sense). Softening of 

a part. 
Rancid (ran'sid). Fetid or sour, as fat. 

Rarefaction (rar-e-fak'shun). Decreasing the 
density of air. 

Reaction (re-ak'shun) . Responsive action. 

Recreation (rek-re-a'shun). Refreshment of 

strength and spirits after toil. 
Rectum (rek'tum). The lower part of the large 

intestine. 
Rectus (rek'tus). In a straight line. Name of 

certain muscles. 
Recumbent (re-kum'hent). Reclining. 
Recuperation (re-ku-per'a-shun). Convales- 

cence; return to health. 



1746 



GLOSSARY. 



Recurrent (re-kur'rent). Returning after in- 
termissions, as a fever. 

Reducible (re-du'si-bl). Capable of reduction. 

Refrigerant (re-frij'er-ant). A medicine that 
allays fever or heat. 

Regimen (rej'i-men). The methodic vise of 
food. 

Regurgitation (re-gur-ji-ta'shun). An eructa- 
tion or throwing back. Vomiting. 

Rejuvenescence (re-ju-ve-nes'sense). A renewal 
of youth. 

Relapse (re-laps'). A recurrence of a disease 
during convalescence. 

Relaxation (re-laks-a'shun). Diminution of ten- 
sion; languor; a looseness. 

Remission (re-mish'un). A temporary subsid- 
ence of disease or pain. 

Remittent (re-mit'ent). Alternately abating and 
returning. 

Renal (re'nal). Pertaining to the kidneys. 

Reproduction (re-pro-duk'shun). The begetting 
of young. 

Residual (re-zid'u-al). Remaining. 

Residue (rez'i-du). That which remains. 

Residuum (re-zid'u-um). The balance or re- 
mainder. 

Resin (rez'in). A somewhat hardened sub- 
stance usually of a brownish or amber 
color, existing in nearly all plants and 
abundant in many. 

Resinoid (rez'in-oid). Resembling resin. 

Resinous (rez'in-us). Having the nature of 
resin. 

Resolvent (re-solv'ent). That which has the 
power to disperse inflammation. 

Respiration (res-pi-ra'shun). Inspiration and 
expiration of air by the lungs. 

Respiratory (re-spir'a-to-re). Pertaining to res- 
piration. 

Restorative (re-stor'a-tive). Having the power 
to renew strength and vigor. 

Resuscitation (re-sus-si-ta'shun). The bringing 
to life of one apparently dead. 

Retching (rech'ing). An unsuccessful attempt 
at vomiting. 

Reticulated (re-tik'u-la-ted). Having net-like 
meshes. 

Retina (ret'i-nah). Internal membrane of the 
eye. 

Retinitis (ret-i-ni'tis). Inflammation of the ret- 
ina. 

Retraction (re-trak'shun). Shortening; draw- 
ing backward. 

Retroflexion (re-tro-flek'shun). A bending or 
flexing backward. 

Retrograde (ret'ro-grade). Receding or going 
backward. 

Retroversion (re-tro-ver'shun). A turning back. 

Revivification (re-viv-i-fi-ka'shun). Resuscita- 
tion; renewal of life; the act of recalling 
to life. 

Revulsion (re-vul'shun). The withdrawal of 
blood from a diseased to a healthy part. 

Rheum (room). An increased action of the ex- 
cretory vessels of any organ. 

Rheumatism (ru'ma-tism). A disease with fever, 
pain, inflammation and swelling of the 
joints. 

Rheumatoid (ru'ma-toid). Resembling rheuma- 
tism. 

Rhizome (ri'zom). A subterranean stem. 

Rhizomelic (re-zom'el-ik). Affecting the roots 
of members. 

Rhizopoda (ri-zo-po'dah). Same as sarcodina. 

Rhythm (rith'm). A measured periodic move- 
ment. 

Rigidity (ri-jid'i-te). Stiffness; immobility. 

Rigor (ri'gor). A violent chill. 

Rochclle Salt (ro-shel' salt). The tartrate of 
potash and soda. 

Roseola (ro-ze'o-lah). A rose-colored efflores- 
cence on the skin. 

Rotation (ro-ta'shun). Turning on the axis. 



Rotation-joint. (ro-ta'shun-joint). A lateral 
ginglymus. 

Rotator (ro-ta'tor). A muscle turning a part. 

Rubefacient (ru-be-fa'shent). A medicine that 
reddens the skin. 

Rudimentary (ru-di-men'ta-re). Undeveloped; 
not formed. 

Rupia (ru'pe-ah). A syphilitic eruption with in- 
crusted foul ulcers. 

Rupture (rup'chur). The breaking or lacera- 
tion of an organ. 

Sabadilla (sab-a-dil'ah). The dried seeds of 
schoenocaulon officinale. It is a drastic 
cathartic. 

Saccharine (sak'kah-rine). Containing sugar. 

Sacrum (sa'krum). The large triangular bone 
above coccyx. 

Salicylate (sal-i'sil-ate). A salt of salicylic acid. 

Saline (sa'lin). Salty; containing salt. 

Saliva (sa-li'vah). The secretion of the salivary 
glands. Spittle. 

Salivation (sal-i-va'shun). The act of produc- 
ing an increased secretion of saliva. 

Salutary (sal'u-ta-re). Promotive of health. 

Sanguine (san'gwin). Hopeful; cheerful. 

Sanies (sa'ni-ez). A thin, reddish discharge 
from wounds or sores. 

Sanitary (san'i-ta-re). Pertaining to health. 

Sanitation (san-i-ta'shun). The act of making 
healthy. 

Santonica (san-ton'i-ka). The flowerheads of 
Artemesia pauciflora; levant wormseed. 
It is a vermifuge. 

Santonin (san'ton-in). The active principle of 
santonica. 

Saphena (saf-e'nah). A name given to two 
large veins of the leg. 

Saprophyte (sap'ro-fite). A plant _ deriving its 
sustenance from dead organic matter. 

Saprophytic (sap-ro-fit'tik). Pertaining to sap- 
rophytes. 

Sarcodina (sar-ko-di'nah). A class of proto- 
zoa moving and feeding by means of 
pseudopodia. 

Saturated Compound (sat'u-ra-ted kom'pound). 
A chemic compotmd in which the com- 
bining capacities of all the elements are 
satisfied. 

Scapula (skap'u-lah). A large, flat, triangular 
bone of the shoulder. 

Schizomycetes (skiz-o-mi-se'tez). The fission 
fingi; bacteria. 

Sciatic (si-at'ik). Pertaining to the hip. 

Scirrhus (skir'us). A hard form of carcinoma. 

Scleroderma (skle-ro-der'mah). A chronic in- 
durated skin disease. 

Sclerotic (skle-rot'ik). The firm, white, outer 
coat of the eye. 

Scorbutic (skor-bu'tik). A person affected with 
scurvy. 

Scrofula (skrof'u-lah). A constitutional condi- 
tion with grandular tumor and a tuber- 
culous tendency. 

Scrofulous (skrof'u-lus). Affected with scrof- 
ula. 

Scrotum (skro'tum). The pouch containing the 
testes. 

Scurvy (skur've). A form of purpura due to 
deficient and improper diet. 

Scutiform (sku'ti-form). Having the form of 
a shield. 

Sebaceous (se-ba'shush). Pertaining to fat or 
suet. 

Seborrhea (seb-or-re'ah). An abnormal secre- 
tion of the sebaceous glands. 

Secretion (se-kre'shun). Function of glands 
and follicles. Substance secreted. 

Secretory (se'kre-to-re). Performing secretion. 

Sedative (sed'a-tive). Soothing. An agent al- 
laying irritability. 

Sedentary (sed'en-ta-re). Occupied in sitting. 

Sediment (sed'i-ment). Matter settling from a 
liquid. 



GLOSSARY. 



1747 



Seidlitz Powder (sed'litz pow'der). An aperi- 
ent compound effervescing powder con- 
taining potassium bitartrate and sodium 
carbonate. 

Semiflexion (sem-i-flek'shun). Bending half 
over. 

Seminal (sem'i-nal). Pertaining to seed or 
semen, or to the elements of reproduction. 

Senile (se'nil). Pertaining to old age. 

Sensitive (sen'si-tive). Capable of feeling. 

Sensual (sen'shu-al). Pertaining to or affect- 
ing the senses or bodily organs of per- 
ception. 

Sepsis (sep'sis). Infection of the human system 
from putrid matter in the blood. 

Septic (sep'tik). Relating to sepsis. 

Septum (sep'tum). A dividing membrane or 
wall. 

Sequel (se'kwel). A supervening disease. 

Sequela (se-kwe'la). The results of a disease. 

Seromucous (se-ro-mu'kus). Composed of se- 
rum and mucus. 

Serous (se'rus). Having the nature of serum. 

Serratus (ser-a'tus). A muscle of the thorax. 

Serum (se'rum). The fluid constituent of the 
blood separated by coagulation. 

Sewage (su'aj). The refuse matter carried off 
in a sewer. 

Sewerage (su'er-aj). The system of sewers. 

Sexual (seks'u-al). Pertaining to sex. 

Sexuality (seks-u-al'i-te). The collective dif- 
ferences which in individuals make one 
male and another female. 

Sialogogue (si-al'o-gog). A medicine which pro- 
motes the flow of saliva. 

Silica (sil'ik-ah). Silicon dioxia, found in 
quartz. 

Simulation (sim-u-la'shun). The counterfeiting 
of disease. _ 

Sinapism (sin'a-pism). A mustard plaster. 

Sinew (sin'u). The tough fibrous tissue which 
unites a muscle to a bone. 

Sinus (si'nus). A hollow, cavity, recess or 
pocket. 

Skeptic (skep'tik). One who doubts the truth 
of any statement. 

Slough (sluf). The separated dead matter in 
an ulceration. 

Sloughing (sluf'ing). The formation of a 
slough. 

Soda Bicarbonate (so'dah bi-kar'bon-ate). Bak- 
ing soda. It is antipyretic and antiseptic. 

Solidism (sol'id-ism). The theory that ascribes 
disease to condensation or rarefaction of 
the solid tissues. 

Soluble (sol'u-ble). Capable of being dissolved. 

Solution (so-lu'shun). The critical period of a 
disease. A dilution. 

Solvent (sol'vent). _ A fluid that dissolves or 
makes a solution of any other body. 

Somnolence (som'no-lense). The condition of 
drowsiness. 

Sonorous (so-no'rus). Resonant; ringing. 

Soporific (sop-or-rif'ik). A medicine that has 
the quality of inducing sleep. 

Sordes (sor'dez). Foul matter; execretions. 
The dark brown matter that gathers on 
the tongue and teeth in low fever. 

Spasm (spazm). A convulsive muscular con- 
traction. 

Spasmodic (spaz-mod'ik). Sudden; violent; 
over-strained; unnatural. 

Specific (spe-sif'ik). _ Peculiar; special. A 
remedy of peculiar value. 

Spectrum (spek'trum). A _ color-band from a 
ray of decomposed light. 

Speculum (spek'u-lum). An instrument for di- 
lating and keeping open certain parts of 
the body to facilitate examination. 

Spermaceti (sper-mak'se-te). A fatty substance 
from the head of the sperm whale used 
as an emollient. 

110 



Sphincter (sfmgk'ter). A muscle constructing 
an orifice. 

Spinal (spi'nal). Of or pertaining to the back- 
bone. 

Spinous (spi'nus). Pertaining to the spine. 

Spontaneous (spon-ta'ne-us). Taking place with- 
out aid or volition. 

Sporadic (spo-rad'ik). Occurring singly _ or 
apart from other things of the same kind; 
separate. 

Sputum (spu'tum). Expectorated matter. 

Spittle. 

Squamous (skwa'nms). Covered with or con- 
sisting of scales. 

Stagnation (stag-na'shun). Cessation of mo- 
tion. 

Stearin (ste'ar-in). A compound of stearic acid 
and glyceryl found in the harder animal 
fats. 

Stench (stench). An ill smell; an offensive 
odor. 

Stercoraceous (ster-ko-ra'shus). Having the na- 
ure of feces. 

Sterility (ster-il'i-te). The condition of being 
barren. 

Sterilization (ster-il-iz-a'shun). The destruc- 
tion of germs. 

Sternum (ster'num). The flat bone of the 
breast. 

Stertorous (ster'tor-us). Breathing with a son- 
orous sound. 

Stethoscope (steth'o-skope). A tube for con- 
veying sounds in auscultation. 

Sthenic (sthen'ik). Strong; active. 

Stiff-neck (stif-nek). See torticollis. 

Stigmatism (stig'ma-tizm). A condition of the 
refractive media of the eye in which rays 
of light from a point are accurately 
brought to a focus on the retina. 

Stimulant (stim'u-lant). Anything which stim- 
ulates. 

Stimulate _ (stim'u-late). To excite the organic 
action of. Incite; urge; instigate. 

Stimulus (stim'u-lus). Anything exciting an or- 
gan. 

Stomach (stum'ak). The chief digestive organ 
of the body. 

Stomachic (sto-mak'ik). A stimulant to the 
stomach. 

Stomatitis (stom-a-ti'tis). Inflammation of the 
mouth. 

Stool (stul). A discharge from the bowels. 

Strabismus (stra-bis'mus). A condition in 
which the visual axes fail to meet at the 
objective point from inco-ordination of 
the eye-muscles; squint. 

Strangulation (stran-gu-la'shun). A choking or 
throttling. 

Strangury (stran'gu-re). A painful discharge of 
urine. 

Strata (strat'ah). Plural of stratum. 

Stratum (stra'tum). A layer of lamina. 

Stricture (strik'tur). The morbid contraction 
of a passage of the body. 

Stroma (stro'mah). The foundation tissue of 
an organ. 

Strumous (stru'mus). Scrofulus. 

Strychnia (strik'ni-ah). An alkaloid of mix 
vomica. 

Stupor (stu'por). The condition of insen- 
sibility. 

Styloid (sti'loid). Resembling a stylus. 

Stylomastoid (sti-lo-mas'toid). Pertaining to 
the styloid and mastoid processes. 

Stylus (sti'lus). A sound. 

Stype (stip). A cotton tampon. 

Styptic (stip'tik). Having the property of 
checking hemorrhage. A medicine' that 
causes vascular contraction of the blood- 
vessels. 

Subacid (sub-as'id). Slightly acid. 

Subclavian (sub-kla've-an). Under the collar- 
hone. 



1748 



GLOSSARY. 



Subcutaneous (sub-ku-ta'ne-us). Under the 
skin. 

Sublimate (sub'li-mate). The product of sub- 
limation. 

Sublimation (sub-li-ma'shun). Vaporization 

and recondensation. 

Sublingual (sub-lin'gwal.). Beneath the tongue. 

Submaxillary (sub-maks'il-a-re.) Beneath the 
inferior maxilla. 

Subnormal (sub-nor'mal). Below the normal. 

Subordination (sub-or-di-na'shun). Under con- 
trol. 

Subsultus (sub-sul'tus). Any morbid tremor or 
twitching. 

Sudamina (su-dam'i-nah). Minute transnarent 
vesicles arising on the skin toward the 
favorable termination of various diseases 
which have been attended by perspiration. 

Sudoriferous (su-dor-if'er-us). Carrying sweat. 

Sudorific (su-dor-if'ik). A medicine which pro- 
duces sweat. 

Suffocation (suf-fo-ka'shun). A stoppage of 
respiration. 

Sulphate (sul'fate). A salt of sulphuric acid. 

Sulphid (sul'fidj. A combination of sulphur 
with an element. 

Sulphurated (sul'fu-ra-ted). Combined with 
sulphur. 

Superficial (su-per-fish'al). Confined to the sur- 
face. 

Supernatural (su-per-nat'u-ral). Above the 
power of natural laws. 

Supervene (su-per-vene')- To come upon as 
something extraneous; to be added to. 

Suppository (sup-poz'i-to-re). A solid medicine 
melting at body temperature for intro- 
duction into the rectum or the vagina. 

Suppression (sup-presh'un). Concealment; re- 
tention. 

Suppurate (sup'pu-rate). To generate pus. 

Suppuration (sup-pu-ra'shun). The formation 
of pus. 

Surgery (sur'jer-e). Branch of treatment by 
operative procedures. 

Susceptible (sus-sep'ti-ble). Sensitive to an in- 
fluence; liable to become affected with a 
disease. 

Suture Csu'ture). Junction of cranial bones. 
In surgery, a stitch. 

Symmetry fsim-me-tre). A harmonious corre- 
spondence of parts. 

Sympathetic (sim-pa-thet'ik). Reciprocal ac- 
tion by different parts of the body. 

Symptom (simp'tum). Any affection which ac- 
companies disease. A perceptible change 
in the body or its functions. 

Symptomatic Csimp-to-mat'ik). Pertaining to a 
symptom. 

Synchronous (sin'kro-nus). Occurring at the 
same time. 

Syncope (sin'ko-pe). Swooning or fainting; a 
temporary suspension of respiration and 
circulation. 

Syphilis (sif'il-is). A chronic, infectious ven- 
ereal disease, which may also be heredi- 
tary. 

Syphilitic (sif-i-lit'ik). Pertaining to or in- 
fected with syphilis. 

Syphon (si'fonj. A tube or pipe. 

Syrup (sir'up). A concentrated solution of 
sugar in an aqueous fluid. 

System (sis'tem). Methodic arrangement of 
parts. The animal economy. 

Systole Csis'to-le). The contraction of the heart 
and arteries. 

Taenia Solium Cte'ne-ah so'le-um). The com- 
mon long tapeworm. 

Taint (taint). An infection; spot; blemish. 

Tampon (tam'pon). A plug of lint or cotton, 
etc. 

Tartar (tar'tar). A deposit incrusting the teeth, 
composed chiefly of phosphate of calcium. 



Teichopsia (ti-kop'se-ah). Temporary dullness 
of sight with subjective images, often an 
accompaniment of migraine. 
Temple (tem'ple). Flat, depressed portion of 

the head between the eye and the ear. 
Temporal (tem'po-ral). Pertaining to the 

temple. 
Temporalis (tem-po-ra'lis). The temporal 

muscle. 

Tenacious (te-na'shus). Adhesive; tough. 

Tepid (tep'idj. About blood heat. 

T erotism (ter'a-tism). An anomaly of confor- 
mation, whether congenital or acquired; a 
monstrosity. 

Tetanic (te-tan'ik). A medicine which acts on 
the nerves and through them on the 
muscles. 

Tetanus (tet'a-nus). A disease with spasmodic 
and continuous contraction of the mus- 
. cles. 

Textural (teks'tur-al). Pertaining to any tissue. 

Thalamus (thal'a-musj. A mass of gray mat- 
ter at the base of the brain projecting 
into and bounding the third ventricle. 

Thein (the'in). Active principle of tea; same 
as caffein. 

Theobroma (the-o-bro'mah). A genus of trees. 
The seeds of theobroma-cacas furnish 
chocolate and cocoa. 

Therapeutics (ther-a-pu'tiks). That branch of 
medical science which relates to the dis- 
covery and application of remedies for 
diseases. 

Thoracic (tho-ras'ik). Pertaining to the chest. 

Thorax (tho'raks). The bones of the chest. 

Thrombus (throm'bus). A blood clot in a vessel 
at the point of obstruction. 

Thyme (time). See thymus. 

Thymus (thi'mus). A genus of labiate plants. 
A granular organ in the anterior superior 
mediastinum, usually disappearing in adult 
life. 

Thyroid (thi'roid). Scutiform; shield-shaped. 

Tincture (tink'tur). Spirits containing medicinal 
substances in solution. 

Tissue (tish'u). An aggregation of similar cells 
and fibers forming a distinct structure. 

Tonic (ton'ik). A medicine which tends to re 
store normal tone. 

Tonsils (ton'sils). The glands in the sides of 
the throat. 

Torpid (tor'pid). Having lost motion or the 
power of exertion and feeling; dull; 
sluggish. 

Torpor (tor'por). Abnormal inactivity. 

Torsion (tor'shon). The act of twisting. 

Torticollis (tor-ti-kol'lis). Contraction of cer- 
vical muscles with bending of head. 

Tourniquet (toor'ni-ket). An instrument to 
compress arteries. 

Toxin (toks'ine). A poisonous albumin pro- 
duced by bacterial action. 

Trachea (tra'ke-ah). The wind-pipe. 

Tracheotomy (tra-ke-ot'o-me). The operation of 
making an opening into the wind-pipe, as 
in cases of suffocation. 

Trachoma (tra-ko'mah). Granular lids; a form 
of conjunctivitis. 

Transection (tran-sek'shun). A cross-section. 

Translucent (trans-lu'sent). Partly transparent. 

Transpiration (tran-spi-ra'shun). The act or 
process of transpiring. 

Transudate (trans'u-date). A substance result- 
ing from transudation. 

Transudation (trans-u-da'shun). An oozing of 
a fluid through a membrane, especially a 
serum through vessel walls. 

Transude (tran-sued'). To pass through the 
pores. 

Transverse (trans-vers'). Lying across. 

Traumatic (traw-mat'ik). A medicine useful in 
the cure of wounds. 



GLOSSARY. 



1749 



Traumatism (traw'ma-tizm). The condition of 
one suffering from injury. 

Tremor (trem'or). An involuntary trembling. 

Triturate (trit'u-rate). To bruise. To rub or 
grind to a powder. 

Tubercle (tu'ber-kl). A small eminence. A 
small nodule of granular cells constitut- 
ing the specific lesion of the tubercle 
bacillus. 

Tuberculosis (tu-ber-ku-lo'sis). An infectious 
disease due to a specific bacillus, charac- 
terized by the formation of tubercles. 

Tumefaction (tu-me-fak'shun). A swelling of a 
part. 

Turbidity (tur-bid'i-te). The condition of be- 
ing troubled or disturbed. 

Turpentine (tur'pen-tine). A substance taken 
from the pine tree. It is antiseptic and 
stimulant. 

Tympanic (tim-pan'ik). Pertaining to the tym- 
panum. 

Tympanum (tim'pa-num). The drum of the ear. 

Typhlitis (tif-li'tis). Inflammation of the ce- 
cum. 

Typhoid (ti'foid). A condition of great muscu- 
lar weakness. 

Typhus (ti'fus). A contagious fever. 

Typical (tip'ik-al). Characteristic. 

Tyrotoxicon (ti-ro-toks'i-kon). A ptomaine from 
decomposed milk and cheese. 

Ulcer (ul'ser). Suppuration upon a free sur- 
face; an open sore. 

Ulcerate (ul'ser-ate). To produce an ulcer. 

Ulceration (ul-ser-a'shun). The process of ul- 
cer-formation. 

Ulcerous (ul'ser-us). Having the character of 
an ulcer. 

Ulna (ul'nah). The large bone of the forearm. 

Ulnar (ul'nar). Pertaining to the ulna. 

Umbilicated (um-bil'i-ka-ted). Having a depres- 
sion like the navel. 

Umbilicus (um-bi-li'kus). The navel; the round 
depressed cicatrix in median line of abdo- 
men. 

Unction (ungk'shun). The act of anointing, 
an ointment. 

Unctuous (unk'shus). Greasy. 

Unguentum (un-gwent'um). An ointment; a 
soft, fatty medicated mixture. 

Unilateral (u-ne-lat'er-al). Affecting but one 
side. 

Urate (u'rate). A combination of uric acid 
with a base. 

Urea (u're-ah). An animal substance found in 
urine. 

Uremia (u-re'mi-ah). The symptoms due to a 
tonic condition of the blood from accu- 
mulation of substances normally excreted 
by the kidneys. 

Uremic (u're-mik). Due to or marked by ure- 
mia. 

Ureter (u-re'ter). The excretory duct of the 
kidneys. 

Urethra (u-re'thra). The excretory canal of the 
bladder. 

Urethral (u-re'thral). Pertaining to the ure- 
thra. 

Urethritis (u-re-thri'tis). Inflammation of the 
urethra. 

Uric Acid (u'rik a'sid). The acid contained in 
the urine. 

Urinary (u'ri-na-re). Of or pertaining to urine 
or the organs which secrete it. 

Urine (u'rin). The excretion of the kidneys. 

Urinemia (u-ri-ne'mi-ah). The presence of uri- 
nary constituents in the blood. 

Uriniferous (u-ri-nif'er-ous). Producing and 
carrying urine. 

Urticaria (ur-ti-ka'ri-ah). Nettle-rash; a skin 
eruption with itching lasting only a short 
time. 

Uterine (u'ter-in). Pertaing to the uterus. 

Uterus (u'te-rus). The womb; the hollow fe- 
male organ of gestation. 



Uvula (u-vu-la). The soft part of the palate. 

Vaccination (vak-si-na'shun). Inoculation with 
vaccine to protect against small-pox. 

Vaccine (vak'sine). Any substance containing 
the virus of cow-pox. 

Vagina (va-je'nah). The canal from the vulva 
to the uterus. 

Valerian (va-le're-an.) A plant of the genus 
Valeriana. 

Valeriana (va-le-re-a'nah). A genus of plants; 
also the rhizome and rootlets of Valeriana 
officinalis; it is an antispasmodic and 
stimulant. 

Valerianate (val-e're-an-ate). A salt of valer- 
ianic acid. 

Varicose (var'i-kos). Swollen; knotted. 

Varioloid (var'e-o-loid). The slight form of 
small-pox as modified by vaccination* 

Vascular (vas'ku-lar). Pertaining to vessels. 

Venesection (ve-ne-sek'shun). The opening of 
a vein for the purpose of letting blood. 

Venous (ve'nus). Pertaining to a vein. 

Ventilation (ven-ti-la'shun). The supplyiing of 
fresh air. 

Ventral (ven'tral). Belonging to the belly. 

Ventricle (ven'trik-1). A small belly-like cavity. 

V erbascum (ver-bas'kum). A genus of plants. 

Vermicular (ver-mik'u-lar). VVorm-like. 

Vermiform Appendix (ver'mi-form ap-pen'diks). 
A worm-shaped tube opening into the ce- 
cum. 

Vermifuge (ver'mi-fuj). An agent expelling in- 
testinal worms. 

Vertebra (ver'te-bra). A bone of the spinal 
column. 

Vertigo (ver'ti-go). Giddiness; dizziness. 

Vesicant (ves'i-kant). A blistering application 
or plaster. 

Vesication (ves-i-ka'shun). The production of 
a blister. 

Vesicle (ves'i-kl). A small blister or sac. 

Vesicular (ve-sik'u-lar). Having vesicles. 

Vesiculation > (ve-sik-u-la'shun). The formation 
of vesicles. 

Veterinary (vet'er-i-na-re). Pertaining to the 
art of healing or treating the diseases of 
domestic animals. 

Vibration (vi-bra'shun). A swinging back and 
forth or rapidly repeated oscillatory move- 
ment. 

Vicarious (vi-ka're-us). Taking the place of 
another. The assumption of the function 
of one organ by another. 

Vidian Artery (vid'i-an ar'ter-e). A branch of 
the internal maxillary artery which passes 
through the vidian canal and is distrib- 
uted to the pharynx and Eustachian tube. 

Virile (vir'il). Pertaining to a man as dis- 
tinguished from a woman. 

Virulence (vir'u-lence). _ Noxiousness; malig- 
nity; injurious to life. 

Virulent (vir'u-lent). Having the nature of 
poison. 

Virus (vi'rus). Contagious poisonous matter, 
especially that produced by and capable 
of transmitting a disease. 

Viscera (yis'se-ra). The contents of the body 
cavities. 

Visceral (vis'sur-al). Pertaining to the viscera; 
that cavity of the body which contains 
the viscera. 

Viscid (vis'sid). _ Sticky; having a thick or 
sticky consistency. 

Viscus (vis'kus). Any organ inclosed within 
the cranium, thorax, abdominal cavity or 
pelvis. 

Vision (vizh'un). Sight. 

Visionary (vi'zhun-a-re). Imaginary; unreal; 
fantastic; fanciful; dreamy; whimsical. 

Visual (viz'u-al). Pertaining to vision. 

Vita (vi'tah). Life. 

Vital (vi'tal). Pertaining to life. 



GLOSSARY. 



Vitalism (vi'tal-izm). The theory that bodily 
functions are due to a distinct vital prin- 
ciple. 

Vitality (vi-tal'i-te). The vital principle of life. 

Vitals (vi'talz). The organs essential to life. 

Vitiate (vish'e-ate). To render vicious, faulty, 
defective or impure. 

Vivacity (vi-vas'i-te). Natural vigor. Power of 
living; longevity. 

Vivisection (viv-i-sek'shun). Scientific dissec- 
tion of or experimentation upon living 
animals. 



Void (void). To emit; to send out; to evacuate. 

Volatile (vol'a-til). Having the quality of pass- 
ing off by spontaneous evaporation. 

Voluptuous (vo-lup'tu-us). Given to the enjoy- 
ment of luxury and pleasure. Indulging 
to excess in sensual gratifications. 

Voracious (vo-ra'shus). Having an insatiable 
appetite. 

Vulva (vul'vah). The external female genitals. 



GENERAL ARRANGEMENT 



Although contained in one volume this work is 
divided into twenty Books, which in their turn are 
subdivided into chapters or parts. 

At the back of the whole work will be found a 
complete General Index of all matters contained in 
the different Books and their subdivisions, so that 
any disease or any remedy in any part of the work 
may be quickly located. But, in addition to this 
General Index, each chapter or part is prefixed with 
a special index of its own, thus giving immediate 
location of items to be consulted in the special sub- 
ject at the time under consideration. For example, 
let us take the common disease Asthma. On con- 
sulting the General Index we find the main article 
to be on page 523. Turning to the index at the be- 
ginning of this chapter (Part VI of Book IV) we 
may find the causes, symptoms and varieties of 
Asthma. 

If what we wish is not found in this general 
article, we again refer to the General Index; and we 
have special treatments of the disease in other parts 
of the work, such as Simple Remedies, Prescriptions, 
Homeopathic Treatment, Exercises, etc. This plan 
has been carried out all through the work. 

1751 



INDEX 



A 

Abdomen. The 

Strength of 

Abdominal Aorta 

Dropsy 

Muscles 

Organs, Exercise for 

Ablution, Hydropathic 

Abortion 678 

Abscess 

of Breast 

in the Ear 

of the Gum 559, 

Homeopathic Treatment 

of the Liver 

Prescription for 

Simple Remedy 

of Tonsil 

Within a Joint 

Absorbent Cotton 

Absorption 104 

Accidents 

Factory 

Mining 

Railroad 

Acetanilid 

Acetic Acid 

Acetozone 

Aching Gums 

Tooth 

Acid, Arsenous 

Boric 

Burns 829 

Hydrochloric 

Nitric 

Sulphuric 

Acne, Diagnosis of 

Rosacea 

Diagnosis of 953 

Aconite 

Adalin 

Addison's Disease 

Adenoids 

Diagnosis of 

Aesophagus, Diseases of 

Affinity 

Affusion, Hydropathic 

Afsal 

Afterbirth, The 699, 

Agaricin 

Aged, The 

Clothing for 

Foods for 

Organs in 

Ague 

Diagnosis of 

German Treatment 

Root 1386, 

Simple Remedy 

Agurin 

Air Baths 

Impure 

Poisoning 



93 

1654 

110 

593 

752 

1704 

1529 

, 681 

802 

675 

480 

1319 

1497 

591 

1233 

1259 

565 

742 

1206 

, 218 

823 

864 

851 

864 

1385 

1385 

1251 

1326 

1323 

1376 

1377 

, 830 

1378 

1380 

1382 

961 

488 

, 961 

1385 

1251 

506 

489 

974 

566 

1107 

1532 

1251 

1125 

1251 

1089 

1094 

1092 

1089 

322 

940 

1579 

1404 

1259 

1251 

1665 

186 

186 



Air, Pure, Necessity of 


PAGE. 

181 

185 


in Soil 


248 




116 


Akaralgia 


1251 




1251 




.1203, 1386 


Effects of 


1481 




1479 


Use of 


1479 


Alcoholism 


1479 


Gold Cure for 


..... 1482 


Keely Cure for 


14S2 


Simple Remedy 

Allspice 


1259 

1387 


Almond 


1387 


Aloes 


1383 




. 1376 




1376 


Alveolar Abscess, Diagnosis of 

Amaurosis 


952 

463 


Amenorrhea 


640 


Diagnosis of 

Prescription for 


949 

1243 

1376 




1251 




13S7 




1251 




73 


of the Ear 


473 




483 




183 




389 


Diagnosis of 


. . .9-12, 967 
158S 




1542 


Simple Remedy 


1259 

814 




317 




814 




508 


of Aorta, Japanese Treatment. 

Angina Pectoris 

Diagnosis of 


1568 

519 

943 

1568 


Simple Remedy 


1259 

223 




1388 




737 




1489 




344 




960 




889 




1251 




1251 




801 


Antiseptic Gauze Bandage 


1206 

589 




1497 




108 




110 




109 


Apetol 


1252 






1754 



jyDEX. 



PAGE. 

Aphasia 423 

Aphonia 529 

Aphthous Stomatitis 556 

Apioline 1251 

Apoplexy 422, 826 

Congestive 422 

Hemorrhagic 423 

Homeopathic Treatment 1497 

Simple Remedy 1259 

Appendicitis 575 

Diagnosis of 956 

Appendix, Description of 55 

Function of 575 

Inflammation of 575 

Apple 1345 

Approximate Equivalents, Table of .... 1224 

Aphthae, Simple Remedy 1260 

Aqueous Humor, The 454 

Arachnitis 416 

Arbutus 1410, 1470 

Argyrol 1252 

Aristol 1252 

Arm Bones 83, 735 

Description of 43 

Fracture of 807 

Arnica 1388 

Aromatic Spirits of Ammonia 1201 

Arsenic 1376 

in Water 156 

Arteries, The 108 

of the Body (See Index, p. 67) 

Arteritis 520 

Arthritic Rheumatism 361 

A_rtichoke, Garden 147 7 

Artificial Food 1093 

Respiration 852 

in Anesthesia 817 

Teeth, Soreness from 1328 

Asafetida 1388 

Ascites 593 

Asiatic Cholera, Diagnosis of 923 

Japanese Treatment 1564 

Asparagus 1398, 1414 

Asphvxia 826, 844 

Aspirin 1252 

Assimilation 218 

Asthenopia 463 

Asthma 523 

Diagnosis of 928 

Diet in 1063 

Eclectic Treatment 1555 

Exercise for 1705 

Grinders 201 

Hav 525 

Heart 520 

Homeopathic Treatment 1497 

Japanese Treatment 1567 

Prescriptions for 1233, 1245 

Simple Remedy 1260 

Astigmatism 469 

Astringents in Inflammation 800 

Athletics, Limitations of 1659 

Atlas, The 80 

Atophan 1252 

Atresia of the Vagina 657 

Atrophy of the Brain 426 

of the Liver 592 

of the Muscles 746 

Progressive Muscular 431 

Auditory Canal 473 

Auricles of the Heart 106 

Auricle, Eczema of 478 

Hematoma of 479 

lltation 490 

Auxiliary Remedies 1125 

Avenine 1252 



Baby Clothes Prepared before Birth.... 1147 

Bacilli, Transmission of 278 

of Typhoid 278 



PAGE. 

Bacilli of Tuberculosis 784 

Backache, Simple Remedy 1261 

Back, Muscles of 91 

Pains in, Homeopathic Treatment... 1499 

Strength of 1654 

Bacteria 238, 783 

in Air 187 

Bacteriology 783 

Baldness 1100 

Balsam Apple 1388 

Bandages 873, 1206 

Bandaging 805, 873 

Barberries 1432 

Barber's Itch . . . ! 724 

Diagnosis of 966 

Simple Remedy 1261 

Barren Periods, Table of 1112 

Bathing New-Born Infant 1146 

for Rheumatism 174 

Baths 169 

Air and Sun 1665 

Cold 169 

and Exercise 1664 

Hot ■ 17 6 

for the Sick 1009 

for Women, Cold 1677 

Baume Analgesique 1252 

Bean 1389 

Beauty, Cultivation of 1623 

Beauty Culture 1623 

Beauty and Health 1623 

Beauty and Youth 1625 

Bed Bugs • 138 

Bed in Confinement 1145 

Sick 998 

Sores 286 

Homeopathic Treatment 1498 

Wetting 775 

Prescription for 1244, 1248 

Simple Remedy 1282 

Beet 1389, 1399 

Belladonna 142S, 1445 

Bends, The 551 

Benzine 1389 

Benzoin 1389 

Beri-Beri 391 

Diagnosis of 969 

Betol 1252 

Bicarbonate of Soda 1205 

Bicuspid Teeth 1306 

Bilberry 1438 

Bile, The 217 

Deficiency of, Simple Remedy 1262 

Bilious Colic, Diagnosis of 955 

Fever, Simple Remedy 1261 

Biliousness, Diagnosis of 950 

Prescription for 1233 

Simple Remedy 1262 

Birth 695 

in Absence of Physician 1125 

of Child 695 

Marks 693, 1637 

Table of 1227 

Bismuth 1376 

Subnitrate of 1204 

Bites 827 

Eclectic Treatment 1553 

of Insects 797 

and Stings, Simple Remedy 1262 

Bitter Ash 13S9 

Sweet Nightshade 1434 

Blackberry 1426 

Black Briony 1436 

Blackheads 1631 

Black Mustard 1390 

Black Snakeroot 1390 

Black Vomit 294 

Bladder, Description of 56 

Homeopathic Treatment » . . . . 1498 

Inflammation of 607, 673 

Diagnosis of 922, 957, 974 

Homeopathic Treatment 1503 

Simple Remedy 1262, 1283 



IXDEX. 



1755 



PAGE. 

Bladder, Irritable, Simple Remedy 1262 

in Pregnancy 694 

Stone in 608, 674 

Blandine Liquid 1251 

Bleeding : 847 

Homeopathic Treatment 1498 

from Lungs, Simple Remedy 1262 

from Nose, Simple Remedy 1262 

from Stomach, Simple Remedy 1263 

of the Vulva 654 

Blisters 1003 

Blood, The 104 

Function in Digestion 220 

Poisoning 347 

Diagnosis of 927 

Homeopathic Treatment 1499 

Simple Remedy 1263 

Vessels, Description of 57 

Tying of 795 

Bloody Tumor 508 

Urine 603 

Blue Disease, Diagnosis of 967 

Bodily Organs 73 

Body Building 1649, 1667, 1679 

Composition of 1228 

Contour of 1626 

Framework of 77 

The Human, Description of 35 

Manikin of 40 

Muscles of, Description of 42 

Boils 480, 715, 803 

Diagnosis of 962 

German Treatment 1580 

Homeopathic Treatment 1498 

Prescription for 1233, 1246 

Simple Remedy 1263 

Bones 733 

Ankle 737 

Arm 735 

of the Body (See Index p. 67) 

Brittleness of 740 

Chest 739 

Diseases of 733, 740 

Dislocation of 739 

Face 738 

Inflammatory Affections of 740 

Knee 737 

Leg 737 

Marrow of 734 

Nodes of 740 

Number of 733 

of the Nose 484 

of Skull 737 

of Spine 73S 

Softening of 740 

Structure of 734 

of Thorax 739 

of the Trunk and Arms, Descrip- 
tion of 43 

of Wrist 735 

Boneset 1390 

Bony Tumor of the Ear 481 

Boric Acid 787, 1206, 1377 

Borolyptol 1252 

Bowels, Inflammation of 574 

Diagnosis of 922, 924, 926, 955 

Homeopathic Treatment 1503 

Simple Remedy 1283 

Brain, The 117 

Atrophy of 426 

Compression of 832 

Concussion of 832 

Congestion 420 

Dropsy of 421 

Fever 409 

Simple Remedy 1263 

Hypertrophy of 426 

Manikin of 36 

Nerves of 119 

Paralysis 404 

S3ftening of 401 

Weight of 118 

Bramble 1426 



PAGE. 

Break-bone Fever 274 

Diagnosis of 937 

Breast, Abscess of 675 

Cancer of 676 

Diagnosis of 930 

Changes in 1129 

Feeding 1153 

Inflammation of 675 

Milk 704 

Tumors of 676 

Breath, Foul 1327 

Science of 1680 

Breathing 116 

Diaphragmatic 1655 

Exercises 1655 

Frequency of 1S5 

Full or Complete 1693 

High 1692 

Low 1693 

Mid 1693 

Mouth 1691 

Nose 1691 

Restoration of 852 

Bright's Disease, Acute 395, 600 

Caused by Water Impurities 153 

Chronic 395, 602 

Diagnosis of 925, 934, 975 

Diet in 1063 

German Treatment 1573 

Simple Remedy 1263 

Broken Bones 804, 840 

Bromide in Insomnia 821 

of Soda 1204 

Bronchial Catarrh 530 

Bronchitis 532 

Acute 533 

Capillary 532 

Chronic 533 

Diagnosis of 929. 931 

Eclectic Treatment 1554 

Exercise for 1705 

Homeopathic Treatment 1498 

Japanese Treatment 15C7 

Prescription for 1234 

Simple 532 

Simple Remedy 1263 

Broths 1032, 1060 

Brown Mixture 1204 

Brush, Flesh 1633 

Brushing the Teeth 1640 

Bruises S33 

Homeopathic Treatment 1499 

Bubonic Plague 301 

Diagnosis of 938 

Buchu 1390 

Bunions 719. 1104 

Prescription for 1234 

Simple Remedy 1263 

Burdock 1390 

Burning Clothing, How to Put Out 831 

Burns S29. S30 

Homeopathic Treatment 1499 

Japanese Treatment 1570 

Prescription for 1234 

and Scalds, Simple Remedy 1263 

Bust Development 1674 

Buttock Presentation 696 

C 

Cabinet for Medicine 1207 

Cachenia, Malarial 320 

Cachexia in Cancer of the Womb 663 

Caffeine 1391 

Caries 1319 

Caisson 551 

Calabar Bean 1391 

Calamint 1412 

Calamus 1391 

Calcium 1377 

Calculus 608 

Diagnosis of 922. 957 



1756 



IXDEX. 



PAGE. 

Calisthenics 1660 

Calomel 1205 

Camphor, Spirits of 1203 

Tree 1391 

Camphorated Soap Liniment 1203 

Cancer 363, 373 

of Brain 371 

of the Breast 676 

Diagnosis of 930 

Colloid 372 

Diagnosis of 959 

of Duodenum 371 

German Treatment 1575 

Homeopathic Treatment 1499 

of Kidney 371 

of the Lip 555 

of Liver 371 

Membranous 373 

Prevention of 364 

Simple Remedy 1263 

Skin 373 

Soft 373 

of the Spleen 371 

of the Stomach 571 

Diagnosis of 971 

Japanese Treatment 1569 

of the Tongue 560 

Transmission of 367 

of Uterus 371 

of the Vagina 658 

of the Womb 662 

Diagnosis of 979 

Cancerous Dropsy 372 

Cancrum Oris 557 

Diagnosis of 951 

Canine Rabies, Japanese Treatment 1562 

Canine Teeth 1306 

Cann-Aven 1252 

Capillary Bronchitis 532 

Capsicum Annum 1392 

Capsolin 1252 

Caraway Seed 1434 

Carbolic Acid 786, 1392 

Poisoning, Japanese Treatment 1570 

Carbuncles 716, 803 

Diagnosis of 963 

Homeopathic Treatment 1499 

Prescription for 1234 

Simple Remedy 1264 

Urethral 657 

Carcinoma 363 

Cardamon 1392 

Cardiacs 108 

Insufficiency, Japanese Treatment... 1568 

Plexus, The 1515 

Carditis, Diagnosis of 928, 942 

Care of the Aged 1087 

Caries 1319 

Caroid 1255 

Carriage, Correct 1669 

Carriers of Disease 130 

Carrot 1425 

Cartilages of the Nose 484 

Castor Oil 1392 

Catalepsy 439 

Diagnosis of 945 

Cataract 463 

Catarrhal Conjunctivitis 456 

Laryngitis 526 

Stomatitis 1181 

Catarrh, Acute Nasal, Diagnosis of 953 

Bronchial 530 

of the Child's Mouth 1181 

Chronic Nasal, Diagnosis of 953 

Contagious, Diet in 1076 

Electricity for 1588 

Exercise for 1705 

Fetid 487 

Diagnosis of 953 

German Treatment 1576 

in the Head, Homeopathic Treatment 1499 

Nasal 485. 525 

Prescription for 1234, 1235 



PAGE. 

Catarrh, Simple Remedy 126 i 

of the Stomach, Homeopathic Treat- 
ment 1499 

Catch in the Breath, Simple Remedy... 1264 

Cathartics for Inflammation 801 

Cathartic Ramno 1408 

Catheter, Use of 610 

Cavity in Tooth 1323 

Cayenne Pepper 1392 

Celery 1392, 1402 

Cellasin . 1252 

Cells, Forms of 73 

Nourishment 210 

Organization 210 

Cementum 1308 

Cerebral Congestion 420 

Cerebellum 119 

Cerebritis 413 

General 414 

Suppressed Menstruation 420 

Cerebro-Spinal Fever 287 

Diagnosis of 932 

Diet in 1069 

Meningitis, 287 

Japanese Treatment 1563 

Typhus, Diet in 1069 

Cerebrum „ 118 

Cerumen, Impacted 481 

Cervical Plexus 121 

Chafing, Simple Remedy 1265 

Chalk Mixture 1204 

Chamomile 1434, 1442 

Chancre 1 . . . . 620 

Japanese Treatment 1565 

Chancroid Sore 618 

Change of Life 679 

Diagnosis of 949 

Simple Remedy 1265 

Chapped Face, Simple Remedy 1265 

Hands 1644 

Simple Remedy 1265 

Chart, Sick-room 1019 

Chemical Disinfection 786 

Chest, The 82 

Bones 739 

Compress, The 1535 

Expansion 1698 

Muscles 752 

Pains in, Simple Remedy 1265 

Stitches in, Homeopathic Treatment 1499 

Strength of 1654 

Chigger 140, 727 

Chilblain 1104 

Prescription for 1235 

Simple Remedy 1265 

Chicken-Pox 767 

Diagnosis of 936 

Eclectic Treatment 1552 

German Treatment 1572 

Homeopathic Treatment 1500 

Japanese Treatment 1562 

Simple Remedy 1265 

Childbed, Easy 1124 

Fever 702 

Diagnosis of 940 

Child Birth 695 

Pain in r 1124 

Presentation in 695 

Twilight Sleep in 1106 

Child Blemishes 693 

Delivery of 698 

Development of 1129 

Position of at Birth 57 

Premature Birth of 1148 

Children, Advice to in Sexual Matters... 143 

Convulsions in 833 

Diseases of 757 

Teeth of 213 

Chill, Congestive 326 

Chills and Fever, Homeopathic Treatment 1500 

Simple Remedy 1265 

Chiropractic 1524 

Principles of 1525 



IXDEX. 



175' 



PAGE. 

Chittim Bark 1404, 1442 

Chloral 1442 

As a Soporific 821 

Chlorate of Potash 1206 

Chlorine 1377 

Chlorinated Lime 1205 

Chloroform 817, 1443 

Liniment 1203 

Chlorosis, 'Diagnosis of 950 

Choking- 831 

Simple Remedy 1266 

Chola-sal 1252 

Cholera, Asiatic 328 

Japanese Treatment 1564 

Diagnosis of 923 

Caused by "Water 156 

Infantum 1185 

Diagnosis of 927 

Homeopathic Treatment 1500 

Hydropathic Treatment 1541 

Prescription for 1235 

Simple Remedy 1266 

Cholera Morbus 327 

Diagnosis of 926, 943, 956 

German Treatment 1576 

Homeopathic Treatment 1500 

Simple Remedy 1267 

Nostra, Japanese Treatment 1562 

Prescription for 1235, 1246 

Chondroma 740 

Chorea 438 

Choroiditis 463 

Christian Science 1602 

Principles of 1602 

Chronic Gastritis, Diet in 1074 

Cigarette Habit 1485 

Cilia of Windpipe 74 

Cimicifuga 1390 

Circulation, Course of 222 

Restoration of 832 

Stimulation of 1699 

Circulatory System 104 

Cirrhosis of the Liver 592 

Diagnosis of 957 

Citric Acid 1443 

Cleansing Breath 1696 

Teeth 1313 

of Wounds 795 

Cleft Palate 1182, 1303, 1319 

Clergyman's Sore Throat 561 

Climate, Influence on Health 233 

Clitoris, Description of 56 

Clothing 187, 232 

for the Aged 1094 

for the Infant 1151 

Coal Gas Poisoning 249 

Coca 1443 

Cocaine Hydrochlorate 819 

Coccus of Erysipelas 785 

Coccygodynia 857 

Cochineal 1443 

Cockroaches 137 

Cod Liver Oil 1444 

Coffee 1444 

Cold— 

As a Cause of Disease 231 

Cream 1206. 1633 

Eclectic Treatment 1553 

Exposure to 832, 837 

Feet, Simple Remedy 1267 

Feverish, Simple Remedy 1268 

Full Bath 1536 

German Treatment 1581 

Homeopathic Treatment 1500 

in the Head 525 

Simple Remedy 1268 

Rose 525 

Rub 1533 

Simple Remedy 1267 

Colic 587 

Cures 1489 

Homeopathic Treatment 1500 



PAGE. 

Colic, Hepatic 592 

Infantile 1182 

Prescription for 1236 

Simple Remedy 1269 

Liver 592 

Painter's, Simple Remedy 1269, 1288 

Renal or Nephritic 606 

Simple Remedy 1268 

Colitis 574 

Collargolum 1252 

Colloid 378 

Colored Light as a Curative Agent 232 

Colt's Foot 1418, 1444 

Columnar Epithelium 74 

Column, Spinal 79 

Coma, Uremic 864 

Common Rush 1444 

Complete Breathing 1693 

Complexion, Care of 1628 

Composition of Blood 104 

of Body 1228 

of Foods 1215 

Compressed Air Disaese 551 

Compresses 1003 

How to Make 1475 

Conception 679, 685 

Period of 1109 

Table of 1112 

Concussion of Brain 832 

Condiments, Use of 1093 

Confinement 1142 

Preparations for 1142 

Congenital Syphilis 620 

Congestion, Cerebral 420 

of Liver 591 

of the Lungs, Diagnosis of 927 

Congestive Apoplexy 422 

Fever, Diet in 1070 

Conjunctivitis 455 

Catarrhal 456 

Diphtheritic 458 

Phlyctaenular 456 

Prescription for 1243 

Connective Tissue 75 

Constipation 583, 648 

Diet in 1064 

Exercise in 1672 

Homeopathic Treatment 1500 

Jiu-Jitsu for 1710 

Nausea 649 

in Pregnancy 694 

Prescription for 1236, 1246 

Simple Remedy 1269 

Treatment for 651 

Constitutional Diseases, The 353 

Exercise 1657 

Construction of Healthy Home 247 

Consumption 543 

Chronic Pulmonary 544 

Coal Dust, Cause of 200 

Due to Damp Soil 248 

Diagnosis of 927, 92S. 932 

Diet in 1079 

Electricity for 1588 

German Treatment 1580 

Galloping 543 

Hoff Prescription for 547 

Homeopathic Treatment 1500 

Hydropathic Treatment 1542 

Inherited 1087 

Saw-Grinder's 201 

Contagion 233 

Contagious Catarrh, Diet in 1076 

Contagious Diseases, Table of 981 

Continued Fever 325 

Eclectic Treatment 1548 

Contour of Face and Body 1626 

Contusions 789, 833 

Convalescence (See p. 1041 for complete 
index on the subject). 

Diet in 1061 

Convulsions 864 



1758 



IXDEX. 



PAGE. 

Convulsions in Children , 833 

Infantile 435 

Japanese Treatment 1570 

• Prescription for 1236 

Puerperal 703 

Scarlet Fever 763 

Simple Remedy 1270 

Copaiba 1445 

Copa-kava 1252 

Copious Menstruation, Homeopathic Treat- 
ment 1502 

Copper 1378 

Cord, Spinal 120 

Cornea, The 452 

Inflammation of 459 

Corns 719, 1103 

Simple Remedy 1271 

Corpuscles 105 

Corrective Exercise 1651, 1682 

Corsets a Non-Necessity 1670 

Corydallis 1252 

Coryza 525, 1204 

Eclectic Treatment 1553 

Cosmetics 1099, 1635 

Costiveness 583 

Cotton Pledgets for Confinement 1144 

Cough 530 

Homeopathic Treatment 1500 

Simple Remedy 1271 

Counter-irritation 801 

Courtship 1107 

Cow-Pox 272 

Coxalgia 742 

Crab Lice 140, 656 

Crabs 656 

Cramps, Homeopathic Treatment 1500 

Muscular 834 

Simple Remedy 1271 

in Stomach 1184 

Writer's 428 

Cranberry 1445 

Cranesbill 1445 

Creolin 786, 1252 

Creosote 1445 

Cretinism 384 

Croup 528 

Diagnosis of 927 

German Treatment 1582 

Homeopathic Treatment 1500 

Japanese Treatment 1564 

Prescription for 1236, 1246 

Simple Remedy 1272 

Spasmodic 437 

Croupous Pneumonia, Japanese Treatment 1563 

Crow-Foot 1430 

Crushed Feet 868 

Hands 868 

Limbs 864 

Crystalline Lens 453 

Cupping 834, 1005 

Currants 1418 

Cuspid Teeth 1306 

834 



497 
967 
669 



Cuts 

Cyanosis 

Diagnosis of 

Cystic Tumors of the Ovary 

Cystitis 607, 673 

Chronic 608 

Diagnosis of 322, 957 

Urine in 607 

Cystogen 1253 



Daily Record 1019 

Dandelion 1426 

Wine 1445 

Dandruff 1638 

Day-Blindness 470 

Deadly Nightshade 1445 

Dead Pulp in Cavity of Tooth 1323 

Death, Natural 1095 



PAGE. 

Death Rate Table 1226 

Statistics 1227 

Debility, Diet in 1065 

Decay of Tooth 1310 

Decoctions 1475 

Delirium Tremens 443 

Delivery Pads for Confinement 1143 

Dementia 446 

Dengue 274 

Diagnosis of 937 

Dentine 1308 

Dentition, Difficult 559 

Table 1226 

Diabetes 385 

Diet in 1065 

Diagnosis of 924 

Electricity for 1589 

Mellitus 385 

Simple Remedy 1272 

Diagnosis of Disease by Symptoms 917 

Diaper, Rubber 1152 

Diaphragm, The 92 

Diaphragmatic Breathing 1655 

Diarrhoea 581 

Diagnosis of 926, 955 

Diet in 1067 

Due to Impure "Water . . 159 

Homeopathic Treatment 1501 

Infant 1184 

Prescription for 1236, 1237, 1246 

Simple Remedy 1272 

Dictionary of Drugs 1713 

Diet 207, ,1061 

for Children 1174 

Effects of, on Teeth 1315 

in Relation to Disease 1059 

for the Sick 1028 

and the Teeth 1639 

Vegetable 1083 

Difficult Dentition 559 

Digestibility of Various Foods, Relative. .225, 

[1211 

Digestion, Table of 1213 

Digestive Apparatus 9 8 

Description of 51 

Organs 1301 

Digitalis 1430 

Dilatation of the Heart 514 

of the Stomach, Japanese Treatment. 1569 
Dill 1436 



ill 

Dioxogen 

Diphtheria 

Diagnosis of 

Diet in 



, 1253 

335, 764, 768 

930, 973 

... 1066 



Eclectic Treatment 1552 

German Treatment 1581 

Homeopathic Treatment 1501 

Japanese Treatment 1564 

Prescription for 1237 

from Sewer-Gas 199 

Simple Remedy 1273 

Diphtheritic Conjunctivitis 458 

Paralysis 430 

Disease, Cause of 1512 

Diseases of Bones and Muscles 731 

of Children 755 

of Circulatory and Absorbent Systems 491 

Classification of 

Constitutional 

Contagious and Infectious, Tabic of.. 

Diagnosis of 911 

of Digestive System 553 

Eruptive 259 

of Eye, Ear and Nose 449 

of Genito-Urinary System 597 

Nervous 399 

Occupational 1329 

of Respiratory System 521 

of Skin, Hair and Nails 709 

Surgical 7 81 

of the Teeth 1299 

of Women 635 



261 
351 
981 



IXDEX. 



1759 



PAGE. 

Disinfection 786 

Chemical 786 

Mechanical 787 

Thermal 7 S 6 

Dislocated Jaw 1328 

Dislocations 739, SOS, x 835 

Displacement of the Womb, Backward, 

Diagnosis of 9S0 

Forward, Diagnosis of 979 

Distension of the Lungs 537 

Dizziness, Simple Remedy 1273 

Doctor, What to do in Absence of 1259 

Doses of Medicine. Table of 1719 

Douche, The 647 

Hydropathic 153S 

Xasal 1692 

Douches 1014 

Drainage, House 257 

of Wounds 79 6 

Dressing of Wounds 7S9, 796 

Drink Habit, Cure for 1482 

Drinking Cup, Public 141 

Drip Sheet Bath 1533 

Dropsical Laryngitis 526 

Dropsy 1246 

Abdominal 593 

Acute General 39 3 

of the Brain 421 

Cancerous 372 

Diagnosis of 972 

Homeopathic Treatment 1501 

Local 392 

Prescription for 1246 

Simple Remedy 1273 

Drowning, Rescue from 852 

Drug, Fractional Doses of 1225 

Habit, The 14SS 

Drugs, Dictionary of 1713 

Harmful 1511 

Importance of 1375 

Drum, Ear 476 

Drunken Stupor 850 

Drv Heat for Inflammation 801 

Dumb-Bells 1660 

Duodenum 100 

Dust as a Cause of Disease 200 

Dysentery 579 

Diagnosis of 926, 955 

Diet in 1068 

Due to Impure Water 159 

Eclectic Treatment 1556 

Homeopathic Treatment 1501 

Japanese Treatment 1562 

Prescription for 1237, 1247 

Simple Remedy 1273 

Dysmenorrhea 641 

Diagnosis of 949 

Dvspepsia 568 

Diagnosis of 942, 970 

Diet in 1068 

Electricity for 15S8 

German Treatment 1582 

Homeopathic Treatment 1501 

Hydropathic Treatment 1543 

Jiu-Jitsu for 1710 

Prescription for 1237 

Simple Remedy 1273 

E 

Earache 482 

Prescription for 123S, 1247 

Simple Remedy 1274 

Ear, Abscess in 4S0 

Anatomy of 473 

Bony Tumor of 4S1 

Care of 109S. 1643 

Description of 59 

Diseases of 473 

Drum 476 

Perforation of 4S2 

Thickening of 483 



Ear, Foreign Objects in 477, 481, S3u 

Insects in 477 

Tumors of ] 473 

Wax '.'.'.'.'.'.'.'.'. 476 

Eclectic Diagnosis 1545 

Medicine '/[ 1543 

Treatment 1546 

Ectopic Pregnancy egg 

Eczema of the Auricle 473 

Eczema / ' 7^3 

Diagnosis of ..'...'.'.'.'.'.'. '.946, 961 

Homeopathic Treatment 1501 

Eczema, Simple Remedy 1074 

Edema ' 34- 

Egg Dishes for the Sick ' .' .' .' .' .' ...'.'. 1033 

Elder " 1 _ t3 .-> 

Electricity. Accidents from'.'.'.'.'.'.' S36 

in Medicine 233,' 158S 

Elephantiasis 379 

Embolism 507 

Embrocations ' 1007 

Emergencies . . . . .'.'.'.' ..........'. 3 °3 

Emetics 1013 

Emissions, Inyoluntary ..... 626 

Emotion and Secretion 1110 

Emphysema ...*". 537 550 

Enamel 130s 

Endocarditis 502 

Diagnosis of '.'.'.'.'.'928, 942 

Japanese Treatment '.'. ,. 'i56S 

Endometritis ! ! . ! 659 

Diagnosis of 973 

Endothelium 75 

Enema, Feeding by .......... 1061 

Enemata joil 

Eneuriasis. Diagnosis of 973 

Enlargement of the Heart 515 

Enteric Feyer, Eclectic Treatment 1543 

Enteritis 574 

Ephemeral Feyer '.'.'.'.'. 29 3 

Diagnosis of . ' ' 933 

Epidermic Medication 1015 

Epididymitis .'.'..'. 615 

Diagnosis of ••••• ^_^ 

Epilepsy ..." 436 

Diagnosis of 944 

Electricity for ' , \ 1555 

Simple Remedy . . . ' 1270 

Epileptic Fits 337 

Epinephrin ...... 1233 

Epistaxis 435 

Epithelium 74 

Epulis 559 

Ergot of Rye 144,5 

Eruptiye Diseases 261 

Erysipelas 345 

Coccus of 785 

Diagnosis of 96O 

Homeopathic Treatment 1503 

Japanese Treatment 1563 

Prescription for , 123$ 

Simple Remedy 12:4 

Erythema 711 

Essence of Ginger 1202 

Estiyo-Autumnal Feyer 320 

Ether sio, 1446 

Ethyl Bromide gig 

Chloride as an Anesthetic S19 

Eucaine Hydrochlorate 819 

Eucalyptus Oil 1446 

Europhen 1253 

Eustachian Tube. Inflammation of 483 

Evacuations of Child 1172 

Exercise and Age 1664 

Amount of 16S3 

for Babies .' .' i6S5 

and Bodily Weight 1663 

for the Brain-Worker 1654 

Breathing 1655 

Complete Breathing 1701 

in Constipation 1672 

Constitutional 1657 



1760 



IXDEX. 



PAGE. 

Exercise for Correct Carriage 1652 

Corrective 1651, 1682 

Facial 1627 

for Fatigue 1653 

for Functional Strength 1657 

for the Hands 1646 

Housework as 1668 

Occupational 1663 

Organic 1654 

Physiological, Effects of 1650 

Pregnancy 69 3 

Rapidity of 1662 

Recreational 1675 

Relaxation 1676 

Remedial 1704 

Stimulating 1663 

Stretching 1661 

Tensing 1660 

for "Worry 1676 

Exostosis 481 

Exposure to Cold 832, 837 

External Remedies 1001 

Extremity, Lower 85 

Upper 82 

Eye, The 451 

Care of 1095 

Description of 59 

Diseases, Contagious 1097 

Effect of Light on • 232 

Exercise for 1643 

Foreign Bodies in 839 

Glasses, Use of 1097 

Massage for 1643 

Removing Cinders from 1097 

Salt Water Baths for 1642 

Socket, The 451 

Sore, Prescription for 1243 

Structure of 451 

Eyelashes, The 1643 

F 

Face Bones 738 

Muscles 745, 752 

Pale 1634 

Paralysis of 404 

Red 1634 

Shine, Removing 1099 

Washing of 1629 

Facial Contour 1626 

Palsy 427 

Fainting Fit 518, 794, 838 

Homeopathic Treatment 1503 

Simple Remedy 1275 

Falling of the Anus 589 

Palate, Simple Remedy 1275 

Sickness 436 

Electricity for 1588 

of the Womb 666 

Diagnosis of 980 

Farcy 343 

Fatty Degeneration of the Heart, Diag- 
nosis of 943 

Foods 224 

Favus, Diagnosis of 966 

Features, Beautiful 1624 

Febricula 293 

Febrile Diseases, Eclectic Treatment.... 1546 

Febris Recurrens 291 

Diagnosis of 939 

Feeding, Table of 1158 

Feet, Care of 1102, 1646 

Felon 802 

Diagnosis of 959 

German Treatment 1582 

Homeopathic Treatment 1502 

Simple Remedy 1275 

Female Child Desired 1112 

Fennel 1408 

Ferbicular Fever, Diagnosis of 938 

Fetid Catarrh 487 



PAGE. 

Fever and Ague, Simple Remedy 1265, 1275 

Break-bone 274 

Cerebro-Spinal 287 

Child-bed 702 

Continued 325 

Diet in 1069 

Ephemeral 293 

Estivo- Autumnal 320 

Germs in Ice 161 

Gibraltar 294 

Hay ..." 525 

Intermittent 322 

Irregular 325 

Malarial 316 

Xursing 1021 

Perincenis Malarial 320 

Pernicious Malarial 326 

Protracted Simple Continued 293 

Puerperal 702 

Purpuric 288 

Relapsing 291 

Remittent 325 

Rheumatic 353 

Sailors' 294 

Scarlet, Diagnosis of 931 

Sores, Simple Remedy 1275 

Spotted 287 

Typhoid 277 

Typhus 275 

Yellow 294 

Fibrous Tissue 76 

Filth as a Cause of Disease .' 257 

First Aid to the Injured 825 

Fish Hooks, Extraction of 838 

Fissure of the Lip 555 

Fistula in Ano 589 

Diagnosis of 924 

Simple Remedy 1275 

Fits 435, 837 

Electricity for 1588 

Infantile, Prescription for 1236 

Flatulence, Prescription for 1238 

Flatulent Colic, Diagnosis of 955 

Flaxseed 1425, 1446 

Fleas 136 

Flesh Brushes 1633 

Worms 720 

Flexor Muscles 745 

Floating Kidney 605 

Flooding 700 

in Childbirth 700 

Floor Coverings 253 

Fly, The 132 

Blisters 1003 

Follicular Stomatitis 556 

Fomentations 1003 

How to Make 1475 

in Inflammation 800 

Food, Amount Required 211 

Animal 223 

Classification of 223 

Compositions 1215 

and Their Digestion 1211 

and Drinks 207 

Hygiene 12H 

Milk 212 

Mixed 212 

Nutrition in Various 1219 

in Pregnancy 692 

Saccharine and Starchy 224 

Strength from 1220 

Warmth from 1220 

Foot, Description of 62 

Muscles 752 

Sole of , 98 

Forearm, The 83 

Muscles 752 

Foreign Bodies in the Ear 477, 481, 839 

in Eye 839 

in Nose 839 

in Throat 809, 839 

Formalin 1253 



IXDEX. 



1761 



PAGE, 

Formin 1253 

Compound, Use of in Gonorrhea .... 614 

Formulas, Medical 1245 

Foul Breath 1327 

Foxglove 1430, 1446 

Fractional Doses of a Drug 1225 

Fractured Jaw 1321 

Fractures 804, 840 

of Arm 807 

of Leg 808 

Fragilitis Ossicum 740 

Framework of the Body 77 

Freckles 720, 1634 

Simple Remedy 1276 

Friction Rubs 1666 

Frost-bite 843, 1104 

Simple Remedy 1276 

Frozen Limbs 843 

Simple Remedy 1276 

Fume Poison 203 

Function of Arteries 108 

of Nerves 116 

of Veins 113 

Functional Strength, Exercise for 1657 

Fungus, Diagnosis of 965 

Furuncles 803 

Furunculosis 480 

G 

Gallic Acid 1447 

Galloping Consumption 543 

Gall-Stones 590, 592 

Diagnosis of 957 

Simple Remedy 1276 

Games. Competitive 1684 

Gangrene 803 

Diagnosis of 967 

Gangrenous Stomatitis 557 

Garlic 1416, 1447 

Gas Poison. Examples of 199 

Gas Poisoning 844 

Gastralgia 1184 

Diagnosis of 971 

Gastric Catarrh, Japanese Treatment . . . 1568 

Indigestion, Diet in 1074 

Juice 100, 217 

Ulcer, Japanese Treatment 1569 

Gastritis, Acute 567 

Diagnosis of 970 

Gauze Sponges for Confinement 1144 

Genital Organs 653 

External 653 

Geranium 1434 

Germ Theory of Disease 237 

Germs '. 783 

Avoidance of 243 

Pus-Producing 784 

Size of 242 

German Measles 273, 761 

German Medical Treatment , 1571 

Gestation, Period of 1120 

Gibraltar Fever 294 

Giddiness, Simple Remedy 1277 

Ginger 1447 

Essence of 1202 

Glanders 343 

Diagnosis of 952 

Glandular Epithelium 74 

Glands. Enlarged, Simple Remedy 1277 

Salivary 214 

Glaucoma 465 

Gleet, Simple Remedy 1277 

Glossary 1719 

Glottis, The 216 

Glycerine 1448 

Glycoline 1251 

Goitre 507 

Simple Remedy 1277 

Water as a Cause of 152 

Gold 1378 

Cure for Drink Habit 1482 

Golden Thistle 1410 



PAGE. 

Gonorrhea ■ 611, 671 

Diagnosis of 950 

Formin Compound in 614 

German Treatment 1579 

Japanese Treatment 1565 

Prevention of 143 

Sanmetto Treatment 614 

Secondary Treatment 613 

Simple Remedy 1277 

Third Treatment 613 

Gonorrheal Complications 615 

Rheumatism 361 

Good Health, Picture of 33 

Gout 361 

Chronic 362 

Diagnosis of 94S 

Diet in 1072 

German Treatment 1583 

Hereditary 362 

Homeopathic Treatment 1503 

Hydropathic Treatment 1542 

Prescription for 1247 

Rheumatic, Diagnosis of 948 

Granulated Eyelids 472 

Grape Fruit 1395 

Grape-like Tumors 488 

Grapevine 1397, 1448 

Gravel 608 

Diagnosis of 957 

Prescription for 1247 

Simple Remedy 1277 

Grave's Disease 507 

Gravometer, The 634 

Grayness of Hair 1100 

Great Mullein 142S 

Green Sickness, Diagnosis of 950 

Grinder's Asthma 201 

Consumption 201 

Grippe, The 342 

Diagnosis of 931 

Homeopathic Treatment 1502 

Japanese Treatment 1564 

Gristle 76 

Ground Mustard 1205 

Gruels 1035 

Gullet, The 99, 216 

Stricture of 566 

Gum. Abcess of 559 

Boil 559, 1319 

Diagnosis of 952 

Inflammation of 558 

Diagnosis of 952 

Red, Diagnosis of 963 

Tumors 559 

Gums, The 1303 

Gun-Shot Wounds 797, 868 

Gutta Serona 463 

Gymnasium Work 1662 

H 

Hair. Brittle 1630 

Care of 1099, 1637 

Cutting 1639 

Falling 163S 

Grayness 1100, 1639 

Superfluous 1637 

Washing of 1638 

Half-Bath, The 1531 

Hammock Bath 1538 

Hand. The S4 

Care of 1644 

Chapped 1644 

Description of 60 

Exercise for 1646 

Muscles 752 

Perspiring 1645 

Red 1645 

Handkerchief, Substitute for Tourniquet. 793 

Hanging 844 

Hare-Lip 555, 1181 

Hay Asthma 525 

Diagnosis of 953 



1762 



IXDEX. 



PAGE. 

Hay Fever 525 

Diagnosis of 953 

Exercise for 1705 

Prescription for 1238 

Simple Remedy 1278 

Head Compress, The 1535 

Manikin of 36 

Muscles 752 

Headache, Homeopathic Treatment 1503 

Powders 1489 

Prescription for 1238 

Simple Remedy 1278 

Healing of Wounds 790, 867 

Health, Climate and Soil 233 

Health, Effect of Soil on 248 

Enemies to 231 

Influence of Winds on 192 

Preservation of 1087 

As Preventative of Disease 128 

in Relation to Beauty 1623 

Healthy Dwelling Houses 247 

Heart, The 105, 221 

Asthma 520 

Description of 48 

Disease, Diagnosis of 928 

Diet in 1073 

Failure, Simple Remedy 1281 

Fatty Degeneration of, Diagnosis of. 928 

Palpitation of 497 

Diagnosis of 928 

Homeopathic Treatment 1505 

Pang 519 

Troubles, Diagnosis of 958 

Simple Remedy 1280 

Heartburn, Diagnosis of 950 

Homeopathic Treatment 1503 

Prescription for 1239, 1247 

Simple Remedy 1280, 1294 

Heat as a Cause of Disease 231 

Exhaustion 426, 845 

Rash, Prescription for 1241 

Heatstroke 844 

Simple Remedy 1281 

Hedge Mustard 1406 

Nettle 1406 

Hedgewort 1438 

Hedonal • *. 1253 

Hellebore 1420 

Helmitol 1253 

Hemabaloids 1253 

Hematemesis, Prescription for 1242 

Hematoma, Diagnosis of 976 

of the Auricle 479 

of the Vulva 654 

Hematuria 603 

Hemicrania 441 

Hemiplegia 428 

Hemlock 1432, 1448 

Hemoptysis, Prescription for 1242 

Hemorrhage 792, 845, 847 

Arm Artery, Pressure on 792 

Arrest of 791 

Collar Bone, Pressure on 793 

Handkerchief Treatment 793 

of the Lungs, Diagnosis of 933 

Simple Remedy 1281 

Spanish Windlass 793 

of the Stomach, Diagnosis of 933 

Thigh Artery, Pressure on 794 

Thigh Wounds 794 

Tourniquet 793 

Wounds below knee 794 

Hemorrhagic Apoplexy 423 

Diagnosis of 944 

Hemorrhoids 588 

Diagnosis of 924 

Hemostyptie 1253 

Henbane 1412 

Hepatic Colic 59 2 

Diagnosis of 957 

Hepatitis, Diagnosis of 926. 927. 956 

Herbs, How to Prepare 1473 

Hereditary Gout 362 



PAGE. 

Hermotone 1253 

Hernia 584, 810 

Diagnosis of 923 

Strangulated 858 

Diagnosis of 923 

Heroin 1253 

Herpes 714 

Diagnosis of 962 

Hiccough, Prescription for 1239 

Simple Remedy 1282 

Hip Disease 742 

Diagnosis of 959 

Socket 85 

Hives, Diagnosis of 960 

Homeopathic Treatment 1503 

Simple Remedy 1282 

Hoarhound, White 1418 

Hoarseness, Prescription for 1247 

Simple Remedy 1282 

Hoff Prescription for Consumption 547 

Home Medicine Chest 1199 

Remedies 1259 

Homeopathy 1495 

Honey 1448 

Hookworm 309 

Hops 1414, 144S 

Hordeolum 471 

Horse Chestnut 1425 

Radish 1416 

Hot Climates, Traveling in 231 

Compress, The 1536 

Fomentation Compress 1536 

Hound's Tongue 1448 

House Drainage 257 

Sanitary 247 

Household Remedies * 1201 

Housework as Exercise 1668 

Human Body, Internal Wonders of 40 

Science 1604 

Hydrassan 1253 

Hydrastis 1253 

Hydrocephalus 421 

Hydrochloric Acid 1378 

Hydrometer, The 634 

Hydropathy 173, 1527 

Hydrophobia 433, 798, 828 

Hydrotherapy 1527 

Hydrothorax 550 

Hygiene of Food and Drink 207, 1211 

Hygiene during Pregnancy 1130 

Hygienic Measures 801 

Hymen, Description of 56 

Hyperemesis of Pregnancy 694 

Hypertrophy of the Brain 426 

of the Muscles 746 

Hypnotics, 820 

Hypnotism 1595 

Hypochondriasis 439 

Hypodermics 1013 

Hysteria 439, 849 

Diagnosis of .. r 945 

Simple Remedy 1282 

Suppression of Urine in 605 

Hysterical Paralysis 429 

I 

Iatrol 1253 

Tee as an Anesthetic 819 

As Cause of Disease 160 

As a Cosmetic 1630 

Tchthalbin 1253 

Ichthyol 1253 

Ideal Home Medicine Chest 1199 

Idiocy 447 

111 Health and Marriage 1108 

Imbecility 447 

Impacted Cerumen 481 

Immoderation, Effects of 1087 

Impetigo 715 

Diagnosis of 962 

Impotency 628 

Diet in 1073 



IXDEX. 



1763 



PAGE. 

Impregnation 686 

Impure Air 181, 186 

Incisors 1305 

Incontinence of Urine, Diagnosis of 975 

Prescription for 1244 

Simple Remedy 1282 

Incubation 1148 

Indian Hemp . . . . 1449 

Indigestion, Diagnosis of 943 

Acute, Diagnosis of 970 

Gastric, Diet in 1074 

Intestinal, Diet in ; 1076 

Jiu-Jitsu for 1710 

Simple Remedy 1282 

in Young Children 1176 

Indigo, "Wild , 1472 

Industrial Poisons, Table of 1334 

Infantile Colic, Japanese Treatment .... 1570 

Convulsions 435 

Prescription for 1236 

Fits, Simple Remedy 1270 

Paralysis 431, 777 

Infant Bathing 1150 

Care of 1145 

Clothing for 1151 

Diarrhoea in 11-84 

Management of 704 

Infection of "Wounds 789 

Infectious Diseases, Acute 757 

from Impure Water 156 

Japanese Treatment 1561 

Table of 981 

Infiltration Anesthesia 819 

Inflammation, Acute 798 

of the Appendix 575 

of the Bladder 607 

Homeopathic Treatment 1503 

Bowels 574 

Homeopathic Treatment 1503 

of the Brain 413 

of the Breast 675 

Chronic 798 

of the Cornea 459 

of the Eustachian Tube 483 

of the Gum 558 

of the Lachrymal Gland 470 

of the Larynx 526 

of the Lungs 534 

of the Lymphatic Glands 512 

of the Mouth 555 

of the Oviducts 667 

of the Spinal Marrow 421 

of the Stomach 567 

of the Tonsils 561 

of the Vagina 658 

of the Veins 509 

of the Vulva 653 

of the Walls of the Womb 660 

Influenza 342 

Diagnosis of 931 

Diet in 1076 

Eclectic Treatment 1553 

Prescription for , 1239 

Inflammatory Colic, Diagnosis of 955 

Ingluvin 1254 

Ingrowing Toe-Nails 1103 

Injections, Hypodermic 1013 

Rectal 1011 

Vaginal 647, 1014 

Injured, Transportation of 858 

Injuries Far from Home 805 

Inorganic Material •. . 1385 

Insanity 444 

Insect Bites and Stings 797 

in the Ears 477 

Stings, Simple Remedy 1294 

Insensibility 863 

Insomnia 820 

Jiu-Jitsu for 1710 

Prescription for 1243 

Simple Remedy 1283 

Internal Remedies 1015 

Wonders of the Human Body 40 

111 



PAGE. 

Intercostal Muscles 745 

Neuralgia 441 

Intermittent Fever 322 

Eclectic Treatment ., 1547 

Simple Remedy 1265 

Internal Use of Water 1543 

Intestinal Anthrax 345 

Canal 218 

Catarrh, Japanese Treatment 1569 

Colic, Diagnosis of 955 

Indigestion, Diet in 1076 

Obstruction 578 

Worms 586 

Eclectic Treatment 1556 

Intestines, The 100, 217 

Intoxication 850 

Involuntary Emissions 626 

Muscles 743 

Iodex 1254 

Iodoform 787 

Iodoformal 1254 

Ipecac 1449 

Syrup of 1201 

Iris, The 452, 1426 

Iritis 462 

Iron 1379 

in Water 156 

Irregular Fever 325 

Itch 727 

Diagnosis of 945, 966 

German Treatment 1574 

Mite 140, 241 

Simple Remedy 1283, 1291 

Itching 720 

of Anus, Simple Remedy 1283 

Skin 1633 

Ivy Poisoning 851 

J 

Japanese Treatment of Diseases 1557 

Jaundice ? 59 

Diagnosis of 934, 964. 975 

German Treatment 1584 

Homeopathic Treatment 1503 

Japanese Treatment . . . t 1569 

Prescription for 1239 

Simple Remedy 1283 

Jiu-Jitsu 1709 

Deep Breathing in 1710 

Joints, The 86 

Juniper 1418 

K 

Kaolin 1254 

Keely Cure, The 1482 

Keratitis 459 

Kerosene 1449 

Kidney Complaint, Diagnosis of 958 

Description of 5S 

Disease, Diagnosis of 975 

Electricity for 15S9 

Simple Remedy 1284 

Floating or Movable 605 

Diagnosis of .. 925 

Functions of 599 

Inflammation of, Diagnosis of 925 

Prescription for 1239 

Movable, Diagnosis of 925 

Stone in, Diagnosis of 925 

Kinazyme 1254 

Knee-Cap 85 

to-Ankle Bones 737 

Kneipp Cure 1571 

Labor 694 

Dress in 69 6 

Duration of 695 

Premature 695 

Preparations for 696 



1764 



INDEX. 



PAGE. 

Labronium 1254 

Lactone 1254 

Labyrinth, The 476 

Laceration of the Perineum, Diagnosis of 978 

Lachrymal Gland, Inflammation of 470 

Lacing, Tight 678 

Lacteals 104 

Lactic Acid 1450 

Lactopeptine 1254 

Ladies' Slipper 1450 

La Grippe 342 

Diagnosis of 931 

Diet in 1076 

Prescription for 1239 

Simple Remedy 1284 

Land Scurvy 386 

Language of the Hand 1613 

Lard 1451 

Laryngeal Catarrh, Japanese Treatment.. 1567 

Diphtheria 337 

Laryngitis 526 

Acute 526 

Catarrhal 526 

Chronic 526 

Diagnosis of 974 

Dropsical 526 

Laryngoscope, The 528 

Larynx 115, 183, 529 

Inflammation of 526 

Laudanum 1202 

Administering 1224 

and Lead Water 1203 

Laurel 1436 

Laxol 1254 

Lead Colic, Diagnosis of 932 

Simple Remedy 1284 

Lead Palsy 430 

Poisoning, Diagnosis of 956 

Water as Cause 153 

Leg Bones 85, 737 

Description of 63 

Fracture of 808 

Massage of the 1522 

Muscles 752 

Lemon 1394, 1451 

Length of Life, Table of 1227 

Lens, Crystalline 453 

Leopard's Bane 1388 

Leprosy 379 

Dry 379 

Japanese Treatment 1565 

Leucocythemia 514 

Leucorrhea 645 

Diagnosis of 949, 977 

Homeopathic Treatment 1503 

Prescription for 1244 

Simple Remedy 1285 

Lice 729 

Body 139 

Crab 140 

Head 139 

Itch, Diagnosis of 967 

Lichen 717 

Diagnosis of 963 

Licorice 1426 

Life, Expectation of at Various Ages... 1229 

Ligaments of the Vertebrae 80 

Light, Effect of on the Eyes 232 

Lightning Stroke 851 

Lily of the Valley 1422 

Limbs, Torn off 868 

Lime Tree 1406, 1411 

Water 1204 

Liniments 1007 

Linseed 3446 

Lint Bandages 1206 

Lip, Cancer of 555 

Diseases of 555 

Fissure of 555 

Ulceration of 555 

Liquid Measurements 1223 

Medicines 1201 

Tonic 1092 



PAGE - 
Liver, The 102, 217 

Abscess of 591 

Diagnosis of .' 927 

Atrophy of 592 

Cirrhosis of 592 

Colic 592 

Diagnosis of 957 

Complaint 594 

Diagnosis of 926, 927, 933, 956, 964, 975 

Simple Remedy 1286 

Congestion of 591 

Diseases of 599 

Gin-Drinker's, Diagnosis of ........ 957 

Diet in 1077 

Waxy 592 

Liverwort 1454 

Locked Jaw 1321 

Lock-Jaw '. 432, 784 

Diagnosis of 948 

Simple Remedy 1286 

Locomotor Ataxia 431 

Loins, Pains in, Simple Remedy . . 1286 

Loss of Memory 404 

of Speech ..'. 423 

of Voice 529 

Longevity and Marriage 1108 

Lousewort 1410 

Lotions 1007 

Lumbago 358 

Diagnosis of 925, 947, 948 

Homeopathic Treatment 1504 

Prescription for 1240 

Simple Remedy 1286 

Lupus 378 

Lung Cell Stimulation 1697 

Distension ; . . . 537 

Troubles, Diagnosis of 958 

Lungs, The 115, 183 

Description of 45 

Bleeding from 845 

Prescription for 1246 

Inflammation of 534 

Weak, and Complete Breathing .... 1702 

Lymph Orchitis Compound 1254 

Lymphatic Glands, Inflammation of .... 512 

Lymphatics, The » 219 

Lysol 7S6, 1254 



M 

Made Ground, Dangers of 50 

Madness 444 

Magnesia 1379 

Malaria 320 

Homeopathic Treatment 1504 

Mosquito 133 

Prescription for 1240 

Simple Remedy 1286 

Malarial Cachenia 320 

Fevers 316 

Diagnosis of 940 

Japanese Treatment 1563 

Male Child Desired 1112 

Fern 1454 

Malformation of Mouth 1181 

Malignant Disease 363 

Pustule 344 

Diagnosis of 960 

Quinsy, Diet in 1066 

Malt 1454 

Extracts 1036 

Mammary Gland 689 

Mammitis 675 

Diagnosis of , 929 

Man, Stature of 1228 

Weight of 1228 

Manganese 1379 

Mania 446 

Puerperal 703 

Manikin of the Body 40 

of Eye, Ear, Hand, Foot and Leg... 60 

of the Head and Neck 3G 



IXDEX. 



1763 



PAGE. 

Marasmus, Prescription for 1240 

Marriage Estate 1107 

Table 1227 

Marrow of the Bones 734 

Marshmallow 1414, 1455 

Massage 1518 

for the Eyes 1522, 1643 

Facial 1626 

General 1522 

for Inflammation 800 

Methods of 1519 

Treatment of Abdomen 1521 

Master-wort 1455 

Mastitis 675 

Diagnosis of 929 

Mastoiditis 479 

Diagnosis of 933 

Mate*h-Maker's Diseases 203 

May Apple 1455 

Meadow Saffron 1416, 1455 

Measles 757 

Diagnosis of 931,936 

Diet in 1078 

Eclectic Treatment 1550 

German 273, 761 

Homeopathic Treatment 1504 

Hydropathic Treatment 1540 

Japanese Treatment 1561 

Prescription for 1240 

Simple Remedy 1286 

Swollen Glands in 758 

Measures, Table of 1223 

Measuring Medicine 1200 

Meat Food 212 

For the Sick 1033 

Mechanical Disinfection 787 

Mechanism of Lungs, Description of ... . 45 

Medicine Chest 1199 

Medicines and Doses, Table of • 1745 

Medulla Oblongata 119 

Melachol 1254 

Melancholia 445 

Simple Remedy 1286 

Melanosis 373 

Melubrin 1254 

Membrane, Lung 116 

Schneiderian 484 

Membranous Cancer 373 

Croup, Simple Remedy 1286 

Memorv, Loss of 404 

Meningitis 287 

Chronic 412 

Diagnosis of 933 

Diet in 1069 

Spinal 421 

Menopause 679 

Diagnosis of 949 

Menorrhagia 643 

Diagnosis of 949 

Menses, Cessation of 640 

Menstrual Period 678 

Menstruation 639, 641 

Cessation of 1129 

Delayed 641 

Diagnosis of 949 

Excessive 643 

Homeopathic Treatment 1502 

Simple Remedy 1287 

Painful 641 

Diagnosis of 949 

Homeopathic Treatment 1503 

Suppressed 640 

Simple Remedy 1286 

Tardy, Homeopathic Treatment .... 1502 

Mental Healing 1591 

Mercauro 1254 

Mercurial Palsy 430 

Stomatitis 558 

Mercury 1380 

Mesmerism 1592 

Methylene Blue 1254 

Metric System 1225 

Metritis 660 



PAGE. 

Metritis, Diagnosis of 978 

Metrorrhagia 643 

Mezereon 143b 

Microbes 783 

Micro-Organisms "S3 

Midwife, The ; 698 

Migraine 441 

Milk Food 212 

Germs in 131 

Leg 703 

Mother's .04 

Preparations 1030 

Mind Cure 159 8 

Mineral Materials 1375 

Miscarriage 6S1, 1141 

Moderation 10S7 

Moist Tetter 713 

Moles 1637 

Molar Teeth 213, 1306 

Monkshood 1385 

Morning Sickness 6SS, 1129 

Homeopathic Treatment 1304 

Morphine Poison, Japanese Treatment... 1570 

Morrhual 1254 

Mosquito, The 133 

Mother and the Child 1129 

Mountain Balm 1412 

Fever Due to Snow Water 162 

Mouth, The 98 

Breathing 1691 

Care of 1102, 1164 

Inflammation of 555 

Japanese Treatment 1568 

Washes 1102, 1314 

Movable Kidney 605 

Moving Patient 1020 

Mucous Membrane of the Intestine 218 

Mumps 773 

Diagnosis of 934 

German Treatment 1585 

Homeopathic Treatment 1504 

Japanese Treatment 1562 

Prescription for 1241 

Simple Remedy 12S7 

Muscles , 742 

Abdominal 752 

Atrophy of 746 

Attachments 88 

of the Body (See Index p. 6S). 

of the Chest 732 

Degeneration of 753 

Diseases of 746 

of the Face 743. 752 

Flexor 745 

of the Foot 752 

of the Forearm 752 

of the Hand 752 

of the Head 752 

of the Hip 752 

Hypertrophy 746 

Inflammatory Diseases of 746 

Intercostal 745 

Involuntary 743 

of the Leg 752 

of the Xeck 752 

of the Shoulder 752 

of the Spinal Column 745 

Swallowing 215 

of the Thigh 752 

of the Trunk, Description of 42 

Voluntary 743 

Muscular Atrophy 431 

Rheumatism 358 

Tissue 7 7 

Musk-Root 1455 

Mustard 1412 

Ground 1205 

Hedge 14O6 

Plasters 1 206 

Myelitis 421 

Myopia 466 

Myositis 753 

Myrrh 1456 



1766 



IEDEX. 



N 

Nails, Care of 1645 

Napthal Bismuth 1254 

Narcotics 1485, 1488 

Nasal Catarrh 485, 525 

Diphtheria 336 

Douche 1692 

Polyps 488 

Diagnosis of 953 

Nausea in Constipation C49 

Menstruation 642 

Simple Remedy 1287 

Navel Cord, in Childbirth 1125 

Dressing the 701 

Navy Bean 1456 

Near-Sightedness 1095 

Necessity of Pure Air 181 

Neck Muscles 752 

Stiff 358 

Necrosis 740, 1321 

Neosalvarsan 1255 

Nephritic Colic 606 

Diagnosis of 925 

Nephritin 1255 

Nephritis, Acute 600 

Chronic 602 

Nerves of the Body (See Index p. 68). 

Olfactory 484 

Vitalizing Breath 1696 

Nervous Affections, Diet in 1078 

Debility, Electricity for 1588 

Diseases 401 

Disorders, Diagnosis of 942 

Dyspepsia, Japanese Treatment .... 1569 

Palpitation, Japanese Treatment . . . 1568 

Prostration, Diagnosis of 926 

System 116 

Tissue 76 

Nervousness, Simple Remedy 1287 

Nettle 1428 

Rash 713 

Diagnosis of 960 

Simple Remedy 1287 

Neuralgia 440, 1322, 1327 

Electricity for 1589 

Facial, Diagnosis of 934 

Heart, Diagnosis of 943 

Homeopathic Treatment 1504 

Hydropathic Treatment 1542 

Intercostal 441 

Prescription for 1241, 1248 

Simple Remedy 1287 

of Stomach, Diagnosis of 971 

Neurasthenia 447 

Diagnosis of 926 

Homeopathic Treatment 1504 

Neuritis 448- 

Neurotina 1255 

New-born Infant 1146 

Care of 1146 

New Remedies 1251 

Nicotine 1485 

Xight-Blindness 470 

Nightshade 1445 

Night Sweats, Simple Remedy 1288 

Nipples, Cracked 702 

Sore, Simple Remedy 1288 

Nitre, Spirits of 1202 

Nitric Acid 1380 

Nitrous Oxide 818 

Nodes 740 

NoH Me Tangere 378 

Noma 557 

Diagnosis of 951 

Normal Birth Infants 1150 

Nose, Anatomy of 483 

Bleed 485, S47 

Homeopathic Treatment 1504 

Bones 484 

Breathing 1691 

Cartilages 484 



^ PAGE, 

JNose, Foreign Bodies in 839 

Red 1634 

Warts on 439 

Nurse, Appearance of 989 

Qualifications of 987 

The Wet 705 

Nursing 935 

the Baby H86 

Fever 1021 

Time for 705 

Nutgall i45 6 

Nutmeg 1456 

Nutriment, Distribution of 219 

Nux Vomica 1460 

O 

Oak Tree , 1432 

Oatmeal Water 1645 

Oats 1456 

Obesity, Diet in 1078 

Jiu-Jitsu a Cure for 1711 

Objects in the Ear 477 

Occupational Diseases (See Index, p. 1329) 

Occupational Exercise 1664 

Offensive Breath, Simple Remedy 1288 

Oil of Cassia 1255 

Oily Skin 1630 

Ointments 1007 

Olfactory Nerve, The 484 

Olive Oil 1456 

Omoform 1255 

Onion 1400, 1458 

Operating Room ' 787 

Operation, Preparations for 787 

Ophthalmia 143, 382, 455 

Neonatorum 457 

Purulent 457 

Pustular 456 

Strumous 456 

Opium Graveoleus 1392 

Habit, Japanese Treatment 1570 

Orange 1458 

Orchitis, Diagnosis of 956 

Oregon Wild Grape 1396, 1458 

Organs, Bodily 73 

Structure of 210 

Organic Exercise 1654 

Materials 1385 

Orgasm 687 

Ossicles 476 

Ossification 753 

Osteoma ; 740 

Osteomalacia 740 

Osteomata 741 

Osteopathy 1508 

Essential Principles of 1513 

Osteopathic Diagnosis 1512 

Examination 1512 

Treatment 1517 

Outdoor Sleeping in Tuberculosis 541 

Ovaries 667 

Description of 56 

Diseases of 667 

Exercise for 1704 

Ovaritis 667 

Diagnosis of 954 

Ovary, Displacement of 669 

Function of 1110 

Inflammation of, Diagnosis of 954 

Prolapsus of 669 

Tumor of 669 

Diagnosis of 954 

Overeating in Children 1193 

Effects of 1090 

Oviducts 667 

Inflammation of, Diagnosis of 954 

Ovoferrin 1255 

Ovule, The 685 

Oxygen 1380 

Oxygenized Blood 116 



INDEX. 



1767 



Ozena 487 

Diagnosis of 953 

Ozone 194 

Importance of 194 

P 

Packs 1004 

Pain in Childbirth 1124 

of Labor 697 

in the Side 358 

Painful Menstruation, Homeopathic Treat- 
ment 1503 

Painter's Colic, Diagnosis of 932, 956 

Palate, The 1303 

Cleft , 1303, 1319 

Perforation of 559 

Pale Face 1634 

Palmistry 1613 

Palpitation of the Heart 497, 518 

Homeopathic Treatment . 1505 

Simple Remedy 1288 

Palsy 427 

Electricity for 1589 

Facial 427 

Homeopathic Treatment 1505 

Lead 430 

Mercurial 430 

Scrivener's 431 

Wasting 432 

Pancreas, The 102, 217 

Pancreatic Fluid , 217 

Panopepton 1255 

Papain 1255 

Papoid 1255 

Paralysis ., 427 

Agitans 430 

of the Brain 404 

Diphtheritic 430 

Electricity for 1589 

Facial 404 

Hysterical 429 

Infantile 431, 777 

Reflex ' 429 

Syphilitic 430 

from Trichinae 748 

of the Vocal Chords 528 

Paraplegia 428 

Parasitic Growth, Vegetable, Diagnosis of 965 

Stomatitis 557 

Paregoric 1202 

Parsley 1430 

Parturition 695 

Passions, The 1112 

Pasteur Germ Theory of Disease 237 

Patient, Moving 1020 

Peach Leaves . . = 1459 

Pellagra : 314 

Pemphigus 714 

Diagnosis of 962 

Pennyroyal 1420 

Peony 1422 

Pepper 1459 

Peppermint 1436, 1459 

Pepsin 1204, 1459 

Peptonoids Liquid 1255 

Perforation of the Ear Drum 482 

of Palate 559 

Pericarditis 497 

Chronic 502 

Diagnosis of 928, 942 

Japanese Treatment 1568 

Perincenis Malarial Fever 320 

Perineum 670 

Laceration of 670 

Periosteum 75 

Peritoneum - 103 

Peritonitis 573 

Diagnosis of 922, 930, 955 

Simple Remedy 1288 

Periwinkle 1438 

Permanent Teeth 1305 



946 



16, 



Pernicious Malarial Fever , 

Diet in 

Peroxide of Hydrogen 

Perspiration Odor, Simple Remedy. 

Perspiring Hands 

Pertussis, Eclectic Treatment 

Prescription for 

Peruvian Bark 

Pharyngeal Diphtheria 

Pharynx 

Phenacetin 

Phenol Phthalein 

Phlebitis 

Phlebitis, Diagnosis of 

Phlyctenular Conjunctivitis 

Phosphorus 

Phrenology 

Phthisis, Acute 

Diet in 

Pulmonary 

Phycologen 

Physical Culture for Children 

for Men 

for Women , 

Physiognomy 

Physiology 

in Hydropathy 

Respiratory Tract 

Physostigma 

Picture of Good Health 

Piles 

Diagnosis of 925, 932 

Homeopathic Treatment 

Prescription for 

Simple Remedy 

Pills 

Pimples , 

Pin-Worms 

Pineapple 

Pink Root 

Piperazine 

Pituitrin 

Pityriasis 

Diagnosis of 

Plague, The, Japanese Treatment 

Plantain 

Plasters 1008, 

Pleurisy 

Diagnosis of 92S, 929 

Homeopathic Treatment 

v Japanese Treatment 

Prescription for 

Simple Remedy 

Pleurodynia 

Diagnosis of 

Plexus, Cervical 

Pneumonia 

Diagnosis of 927, 930, 932 

Diet in 

Homeopathic Treatment 

Hydropathic Treatment 

Prescription for 

Simple Remedy 

Pneumothorax 

Podagra 

Poise, Bodily 

Poisons and Antidotes 

Corrosive 

Food or Ptomaine 

Fume 

Gases and Volatile Substances 

Metals, Minerals, Metallic Salts .... 

Morbid 

Nut 

Sewer Gas 

Vegetable 

Wall-Paper 

White-Lead 

Poisoned Clothing 

Wounds 

Poisoning, Air 

in Constipation 

Pollantin 



326 

1070 

1203 

1288 

1645 

1555 

1245 

1460 

335 

99 

1255 

1255 

509 

972 

456 

1381 

1606 

543 

1079 

543 

1255 

1680 

1649 

1667 

1610 

73 

1528 

184 

1391 

35 

588 

957 

1505 

1248 

12SS 

1015 

1631 

587 

1460 

1460 

1255 

1255 

718 

964 

1563 

1420 

1206 

548 

930 

1505 

1567 

1241 

12S9 

358 

947 

121 

534 

933 

1081 

1505 

1540 

1241 

1290 

550 

361 

1669 

S83 

898 

905 

203 

ssT 

893 

234 

1460 

199 

901 

203 

203 

232 

797 

186 

649 

1255 



17GS 



IXDEX. 



Polluted Air, Sources of . , 257 

Water, Sources of 257 

Polyps, Nasal 488 

Polypus Tumor of the Womb 661 

"Simple Remedy 1290 

Polyomyelitis, Acute 777 

Poppy 1420 

Pores, Enlarged 1632 

Position of Child at Birth 57 

Posture, Correct 1652 

Influence of 1652 

Potato for Aches and Pains 1460 

Pott's Disease 742 

Poultices 1001 

for Inflammations 800 

Powders 1015 

Predigested Foods 1036 

Pregnancy 6S8, 1129 

Baths in 1132 

Bladder in 694 

Blood-Poisoning in 1140 

Breasts, Condition of 1134 

Constipation in 694 

Diagnosis of 949 

Diet in 1080, 1133 

Duration of G89, 1130 

Ectopic » 686 

Enlarged Veins in 694 

Exercise in 693, 1673 

Extra Uterine 707 

Food in 692 

Heartburn in 113S 

Hyperemesis of 694 

Leucorrhea in 1140 

Morning Sickness of 688 

Xausea 1137 

Japanese Treatment 1570 

Signs of 1129 

Table 692, 1121 

Toothache in 69 4 

Vomiting in 693 

Premature Labor 695 

Prematurely-born Children 1148 

Premolars 1306 

Prescriptions 1233 

Prickly Heat 717 

Diagnosis of 963 

Prescription for 1241 

Progressive Muscular Atrophy 431 

Prolapsus Anus 589 

Diagnosis of 924, 932 

of Ovarv 669 

of Womb 666 

Diagnosis of 980 

Prolapsed Organs. Exercise for 1705 

Properties of Water 1529 

Prostate Gland 611 

Protargol 1252 

Protoplasm 73, 210 

Protracted Simple Continued Fever 293 

Diagnosis of 939 

Proud Flesh 791 

Simple Remedy 1290 

Pruritis 720 

Diagnosis of 963, 964, 976 

Vulva 654 

Psoriasis 717 

Diagnosis of # . . . 964 

Ptomaine Poisoning 905 

Puberty, Development of 1194 

in Women 639 

Public Drinking Cup 141 

Towel 142 

Puerperal Convulsions 703 

Fever 702 

Diagnosis of 940 

Mania 703 

Pulmonal Kmphysemata, Japanese Treat- 
ment 1567 

Pulmonary Phthisis 543 

i'lcxus, The 1515 

Troubles, Jlu-Jitsu for 1710 

Pulmotor, The 855 



Pulsation ; 108 

Heart 221 

Pulse 995 

Rate 1225 

of Children 1171 

and Temperature, Table of 934 

Pumpkin 1400, 1462 

Punctured Wounds 797 

Pupil, The ...'.'. 452 

Purple Willow Herb 1462 

Purpura 386 

Purpura, Diagnosis of 968 

Purpuric Fever 288 

Purulent Ophthalmia 457 

Pus Blood Poison 348 

Producing Germs 784 

In the Urine 604 

Pustular Eruption 715 

Ophthalmia 456 

Putrid Sore Mouth 557 

Diagnosis of 951 

Sore Throat, Diet in 1066 

Simple Remedy 1290 

Pyemia 348 

Diagnosis of 927 

Pyorrhoea Alveolaris 1322 

Pyosalpinx 668 

Pyrosis, Prescription for 1245 

Pyuria 604 

Q 

Qualifications of Nurse 987 

Quickening 689, 1130 

Quinsy . . . 56 5 

Diagnosis of 973 

Homeopathic Treatment 1505 

Prescription for 1243 

Simple Remedy . ^ 1290 

R 

Rabies , 433, 798 

Recipes of Food for the Sick 1028 

Record, Keeping of 1019 

Recreation, Value of 1088 

Recreational Exercise 1675 

Rectal Injections ion 

Red-Berried Trailing Arbutus 1410 

Face 1634 

Hands 1645 

Nose 1634 

Pepper 1403, 1462 

Root 1463 

Reflex Paralysis 429 

Refuse, Removal of Necessary to Health. 257 

Relapsing Fever 291 

Diagnosis of \' m ' m 939 

Japanese Treatment 1563 

Relaxation Exercise 1676 

Remedial Exercises , 1704 

Remedies, Household 1201 

Simple 1259 

Remittent Fever 325 

Diagnosis of 941 

Removing Cinders from Eye ... 1097 

Renal Colic ° 606 

Diagnosis of '.'.'.'.'. 925 

Rescue from Drowning 852 

Respiration, Artificial 852 

in Anesthesia 817 

Respiratory Apparatus , 115 

System, Diseases of 523 

Tract ti i 8 3 

Restoration of Breathing 852 

Retained Breath ' " 1697 

Retina, The .'.'.'.', 451 

Structure of . . . 453 

Retinitis \ 452 

Rheumalgine 1255 

Rheumatic Diseases, Japanese Treatment 1563 

Fever 353 

Diagnosis of . ° 947 

Gout, Acute, Diagnosis of . . . 948 

Joints, Japanese Treatment , 1570 



INDEX. 



1769 



PAGE. 

Rheumatism 1242 

Acute or Inflammatory 353 

Diagnosis of 947 

Arthritic 361 

Bathing- for 174 

Chronic 359 

Diagnosis of 947 

Diet in ; 1081 

Electricity for 1589 

German Treatment 1585 

Gonorrheal 361 

Homeopathic Treatment 1505 

Hydropathic Treatment 1542 

Muscular 358 

Diagnosis of 925 

Prescription for 1242 

Simple Remedy 1290 

Syphilitic 361 

Rhigolene as an Anesthetic 819 

Rhubarb 1463 

Rhynitis 1204 

Rhythmic Breathing 1699 

Ribs, The 82 

Rickets 383 

Diagnosis of 942 

Diet in 1081 

Rigg's Disease 1322 

Ringworm 1242 

of the Body 724 

Diagnosis of 965 

of the Head 723 

Diagnosis of 965 

Simple Remedy 1291 

Rose Cold 525 

Diagnosis of 953 

Rosemary 1428 

Rotheln 273 

Round-Worm 586, 776 

Japanese Treatment 1569 

Rubella 273 

Rubeola, Eclectic Treatment 1550 

Rupture 584, 810 

Simple Remedy 1291 

Rush. Common 1444 

Russian Bath 1539 



S 



Saccharine Foods 

Sacrum, The 

Saffron 1406, 1416, 

Sage 

Sailor's Fever 

St. Anthony's Fire 

St. John's Wort 

St. Vitus' Dance '. 438 

Simple Remedy 

Saletin 

Saliva 

Salivary Glands 

Salivation • 

Diagnosis of 

Simple Remedy 

Salo Santol 

Salpingitis 

Diagnosis of 

Salt as an Anesthetic 

in Medicine 

Remedy for Sunstroke 

Solution as Antiseptic 

Salvarsan 

Use of, in Syphilis 

Salvia 

Sanitary House 

Regulations 

Kanmetto Treatment for Gonorrhea 

Santal Wood 

Sarsaparilla 

Saw Grinders' Consumption 

Scabies lf r 

Diagnosis of 94i5 



224 

80 

1455 

1412 

294 

346 

1422 

774 

1294 

1256 

214 

214 

558 

951 

1291 

1256 

667 

954 

819 

1463 

1466 

787 

1256 

625 

1412 

247 

242 

614 

1404 

1466 

201 

727 



PAGE. 

Scabies, Simple Remedy 1291 

Scalds \ 829 

Prescription for 1234 

Scald Head 726 

Diagnosis of 966 

Scalp, Care of 1099 

Disease 718 

Scapula, The 83 

Scarlatina 762 

Eclectic Treatment 1551 

Hydropathic Treatment 1540 

Scarlet Fever 762 

Diagnosis of 931, 936 

Diet in 1070 

Eclectic Treatment , 1551 

German Treatment 1586 

Homeopathic Treatment 1505 

Japanese Treatment 1561 

Prescription for 1243 

Scarlet Red 1256 

Schneiderian Membrane 484 

Sciatica 441 

Electricity for 1589 

Simple Remedy 1291 

Sclerotic Coat, The 452 

Sclerotitis 462 

Scopolamin Treatment in Childbirth.... 1106 

Scorbutus 388 

Scrofula 381 

Diagnosis of 968 

Prescription for 1248 

Simple Remedy 1292 

Scurvy 388 

Diagnosis of 969 

Grass 1416 

Land 386 

Diagnosis of 968 

Simple Remedy 1292 

Scrivener's Palsy 431 

Seat Worm, Japanese Treatment 1569 

Seborrhea 720 

Diagnosis of 965 

Secretion and Emotion 1110 

Seidlitz Powders 1205 

Self Care for Women 1623 

Self Defense, Japanese System 1709 

Semicircular Canals, The 477 

Senna 1466 

Septicemia 347 

Diagnosis of 927 

Setting of Broken Bones 805 

Sewer-Gas 199 

Diphtheria from 199 

Poison Through Water 160 

Typhoid from 199 

Vomiting from 199 

Sex of the Child, Control of 1111 

Sexual Matters, Advice to Children in... 143 

Sexology 1107 

Sheet Bath 1532 

Sheets, Changing 999 

Shingles 714 

Diagnosis of 962 

Simple Remedy 1292 

Shock 855 

Shoes 1102 

Short Sight 466 

Shoulders, The 82 

Muscles 752 

Presentation 696 

Sick Room, The 801 

Diets 1028 

in the Home 985 

Utensils 997 

Sick Stomach, Simple Remedy . .1287, 1292 

Sight, Weak 465 

Silver 1381 

Simple Bronchitis 532 

Remedies 1259 

Stomatitis 556 

Six-o-Six (606) Treatment in Syphilis... 625 
Skin, Arrangement of 74 



1770 



IXDEX. 



PAGE. 

Skin Cancer 373 

Care of 1098 

Chapped 1633 

Diseases " 711 

Dry 1632 

Excretions 1528 

Functions of 1528 

Glands, Diseases of 720 

a Heat Regulator 1528 

Itching 1633 

Oily 1630 

in Pregnancy 677 

Redness 711 

Skull, The 80 

Bones 737 

Skullcap 1467 

Sleep 1628 

Producers 820 

Required for Infant 1172 

Sleeping Room, Ventilation of 197 

Sickness 306 

Sleeplessness, Homeopathic Treatment... 1506 

Prescription for 1243 

Simple Remedy 1292 

Small-Pox 265 

Diagnosis of 935 

German Treatment 1586 

Homeopathic Treatment 1506 

Japanese Treatment 1562 

Simple Remedy 1292 

Smoke Habit 1485 

Snake Bites 797 

Japanese Treatment 1570 

Soap-wort 1467 

Socket of the Eye 451 

Hip 85 

Shoulder 83 

Soda 1205 

Sodium 1381 

Sofe-Chancre 618 

Softening of Bone 740 

of the Brain 401 

Soils and Health 233 

Air, Composition of 248 

Effect of on Health 248 

Solar Plexus, The . . . = 1515 

Sole of the Foot , 98 

Solid Measurements 1223 

Soothing Syrups 1489 

Soporifics 820 

Sorbefacients in Inflammation 800 

Sore Eyes, Prescription for 1243, 1248 

Simple Remedy 1292 

Mouth, Baby's 555 

Putrid 557 

Simple Remedy 1293 

Nipples, Homeopathic Treatment . . . 1506 

Throat 561 

Clergyman's 561 

Homeopathic Treatment 1506 

Prescription for 1243, 1248 

Simple Remedy 1290, 1294 

Soreness from Artificial Teeth 1328 

Sour Stomach, Simple Remedy 1294 

Spermatorrhea 62b 

Spermatozoids ■ 686 

Spanish Flies 1467 

Windlass 793 

Spasm of the Glottis 437 

Homeopathic Treatment 1506 

Infantile. Prescription for 1236 

Spasmodic Croup 437 

Spinal Anesthesia 820 

Column 79 

in Osteopathy 1516 

Cord 120 

Meningitis 421 

Nerves 121 

Vertebrae 79 

Spine, The 79 

Rones 738 

Spirits of Camphor 1203 



PAGE. 

Spirits of Turpentine 1203 

of Wine 1386 

Spleen, Description of 58 

Enlarged, Simple Remedy 1274 

Splenitis 513 

Splints 807, 841 

Sports, Value of 1088 

Spotted Fever 287 

Diet in 1069 

Diagnosis of 932, 937 

Sprains 737, 857 

Simple Remedy 1294 

Squinting 471 

Staphisagria-Specific 1256 

Starch 1467 

Starchy Foods 224 

Stavesacre 1410 

Steam Bath 1538 

Sterility 687 

Sterilization 786 

Sterilizing, Mode of 1144 

Stiff Neck 358 

Diagnosis of 947 

Stimulants for Inflammation 802 

Stimulating Exercise 1663 

Stings of Insects 797, 857 

Eclectic Treatment 1553 

Simple Remedy 1294 

Stirrup, The 477 

Stomach, The 99, 216 

Bleeding from, Prescription for 1242 

Cancer of 571 

Inflammation of *. 567 

Simple Remedy 1283 

Troubles, Diagnosis of 958 

Fleer of 571 

Stomatitis 555 

Acute 556 

Diagnosis of 950 

Aphthous 556 

Diagnosis of 950 

Follicular 556 

Diagnosis of 950 

Gangrenous , 557 

Diagnosis of 951 

Mercurial 558 

Diagnosis of 951 

Parasitic 557 

Diagnosis of 951 

Simple 556 

Ulcerative 557 

Diagnosis of 951 

Stone in Bladder 608, 674 

Diagnosis of 922, 957 

Stone Root 1404, 1468 

Strabismus 471 

Strains , ." 857 

Strangulated Hernia 858 

Strawberry, Wild 1438 

Straw Lily '. 1426 

Strength of Back, Chest and Abdomen.. 1654 

Stricture of the Gullet 566 

Stricture of the Urethra 609 

Diagnosis of 976 

Strong Eyes 1641 

Strophulus 716 

Diagnosis of 963 

Strumous Ophthalmia 456 

Stunning 832 

Stupes '.'.'.'. 1003 

for Inflammation 800 

Stye 471 

Stypticin 1256 

Subluxations 1516 

Subnitrate of Bismuth 1204, 1376 

Suckling the Baby 704 

Suffocation 826, 852 

Sugar ' 1468 

Sulphate of Quinnine 1204 

Sulphonol 1256 

for Insomnia 821 

Sulphur 1382 



INDEX. 



1771 



PAGE. 

Sulphuric Acid 1382 

Summer Catarrh, Diagnosis of 953 

Complaint 1185 

Sun Baths 1665 

Cholera, Prescription for 1235 

Sunburn 1635 

Sunstroke 231, 426, 844 

Sunstroke, Hydropathic Treatment .... 1541 

Simple Remedy 1281, 1294 

Sunlight and Bacteria 784 

Superfluous Hair 1637 

Suppositories 1014 

Suppressed Menses, Prescription for 1243 

Suppression of the Menses, Homeopathic 

Treatment 1502 

of the Urine 604 

in Hysteria 605 

Surgical Cases, Nursing of 1024 

Surgical Diseases 783 

Swallowing 215 

Sweetbread 102 

Sweet Fern 1468 

Flag 1391 

Oil and Spirits of Turpentine 1203 

Spirits of Nitre 1202 

Swelled Testicle 615 

Swollen Glands in Measles 758 

Symptoms, Diagnosis by 917 

Table of 922 

Syncope 518 

Synovial Fluid 735 

Synovitis 741 

Syphilis 617 

Chancroid Sore 618 

Congenital 620 

Constitutional Treatment 620 

Conveyed by Conception 621 

Diagnosis of 961 

Eruptions 619 

German Treatment 1583 

Hand and Feet Eruptions 619 

Hereditary 622 

Japanese Treatment 1565 

Mercury Unreliable in 625 

Prevention of 143 

Salvarsan Treatment 625 

Secondary Constitutional Symptoms. 618 

Secondary Treatment 620 

606 Treatment 625 

Sofe-Chancre 618 

Transmission of 622 

Vegetable Treatment 625 

Syphilitic Cleft 1320 

Marriage of the v.. 621 

Paralysis 430 

Rheumatism 361 

Syringes 647 

Syrup of Ipecac 1201 

Syrups 1017 

System, Circulatory 104 

Nervous 116 

Respiratory 115 

T 

Table for Administering Laudanum 1224 

Approximate Equivalents 1224 

Birth 1227 

Death Rate 1226 

Death Statistics 1227 

Dentition 1226 

of Digestion 1213 

Doses of Medicine 1224 

of Industrial Poisons 1334 

of Infectious and Contagious Dis- 
eases 981 

Marriage 1227 

of Medicines and Doses 1719 

Poisons and Antidotes 885 

of Pregnancy 692, 1121 

Pulse and Temperature 934 

of Symptoms for Diagnosis 922 



PAGE. 

Table of Temperate and Intemperate Life 

Chances 1484 

of Urinary Constituents 633 

Weights and Measures 1223 

Tablets 1204 

Tablogestin 1256 

Taka Diastase 1256 

Tannic Acid 1468 

Tansy 1408 

Tape Worms .587, 776 

Diagnosis of 924 

Japanese Treatment 1569 

Tardy Menstruation, Homeopathic Treat- 
ment 1502 

Tartar 1312 

Tartaric Acid 1469 

Tea 1469 

Teeth, the 1304 

Brushmg 1640 

Care of 1301, 1639 

Diet in Relation to 1639 

Diseases of 1318 

in Digestive Process 213 

Teething 559, 1163 

Telepathy 1601 

Temperate and Intemperate Life Chances 1484 

Temperature, Bodily 994 

Effects of 197 

Temporary Teeth 1305 

Tensing Exercise 1661 

Tertiary Syphilis 619 

Treatment of 621 

Testing the Milk 705 

Testicle, Swelled 615 

Diagnosis of ' 956 

Tests for Urine 631, 634 

for Water 166 

Tetanus 432 

Diagnosis of 948 

Japanese Treatment 1565 

Tetronal for Insomnia 821 

Tetter 717 

Diagnosis of 964 

Prescription for 1248 

Moist, Diagnosis of 946 

Theobrimine Sodium 1251 

Theobromine 1256 

Therapeutics of Osteopathy 1513 

Thermal Disinfection 786 

Thigh Muscles 752 

Wounds 794 

Thistle, Golden 1410 

Thoracic Aorta 109 

Thorax, the 82 

Bone 739 

Thorn Apple .: 1414 

Thread Worms 776 

Throat Compress, the 1535 

Foreign Bodies in S09 

Sore 561 

Ulcers 528 

Thrush 557 

Diagnosis of 951 

Tinctures 1016 

How to Make 1474 

Tissue of Bones 75 

Change of 208 

Connective 75 

Fibrous 76 

Muscular 77 

Nervous 76 

Toast Dishes 1034 

Tobacco 1469 

Habit, Cure of 1485 

Toe-nails, Ingrowing 1103 

Tomato 1401, 1469 

Tonics, use of, in Syphilis 621 

Tongue, the 99, 214, 562 

Cancer of 560 

Function of 214 

Ulceration of 560 

Tongue-tie 560,1182 



1772 



IJSDEX. 



PAGE. 

Tonsillitis 561 

Diagnosis of 972 

Eclectic Treatment 1553 

Simple Remedy 1294 

Tonsils — 

Abscess of 565 

Inflammation of 561 

Toothache 1322 

Home Remedies for 1323 

Toothache, Homeopathic Treatment.... 1506 

Plasters 1206 

Prescription for 1244 

Simple Remedy 1294 

Tooth Pastes 1314 

Tooth Powders 1314 

Formula for 1102 

Tooth Rash, Diagnosis of 963 

Tourniquet 793, 846 

Towel, Public 142 

Trance, Hypnotic 1597 

Trachea, the . 183 

Trachoma 459, 472 

Transmission of Disease 241 

Transportation of Injured 858 

Trichiasis 471 

Trichinae 747 

Paralysis from 748 

Trichiniasis 746 

Diagnosis of 946 

Trional 1256 

for Insomnia 821 

Tri-septic Douche Tablets 1256 

Trunk, Muscles of, Description of ..'..... 42 

Bones of, Description of 43 

Trypsogen 1256 

Tub Bath 1536 

Tuberculosis 538 

Bacilli 784 

Japanese Treatment 1563 

Outdoor Sleeping in 541 

Pulmonary, Diagnosis of 927, 932 

Tumor 753 

Bloody 508 

Grape-like 488 

Diagnosis of 953 

of the Ear 478 

Bony 481 

of the Gum 559 

of the Ovary 669 

of the Uterus 66& 

of the Vagina 658 

in Vocal Cords 528 

of the Vulva 655 

of the Womb 661 

Fibrous, Diagnosis of 978 

Polypus, Diagnosis of 979 

Turkish Bath 1539 

Turpentine Tree 1470 

Spirits of 1203 

Twilight Sleep 1106 

Typhoid Fever 277 

Bacilli 278 

Diagnosis of 931, 940 

Diet in 1070 

Eclectic Treatment 1548 

from Impure Water 157 

Homeopathic Treatment 1506 

Hydropathic Treatment 1539 

Japanese Treatment 1564 

Tympanites, Simple Remedies 1295 

Tympanum, the 476 

Typhus Fever 275 

Diagnosis of 931 

Eclectic Treatment 1550 

U 

Ulceration 1323 

of the Lip 555 

of the Tongue 560 

of the Womb 661 



PAGE. 

Ulcerated Womb, Diagnosis of 979 

Ulcerative Stomatitis 557 

Ulcer 803 

Diagnosis of 968 

Homeopathic Treatment 1506 

Simple Remedies 1295 

of the Stomach 571 

Diagnosis of 970 

Throat 528 

Unconsciousness 963 

Unicorn Root 1470 

Uraemia 397, 603 

Uraemic Coma 864 

Poisoning 397 

Urethra, Description of 56 

Inflammation of 611 

Stricture of the 609 

Urethral Carbuncle 657 

Diagnosis of 977 

Uric Acid Diathesis, Diet in 1082 

Urinary Constituents 633 

Difficulties, Homeopathic Treatment.. 1506 

Urination, Disturbances in 1130 

Urine, The 631 

Bloody 603 

in Cystitis 607 

in Health and Disease 631 

Home Tests for 634 

Incontinence of 775 

Pus in 604 

Simple Remedies 1295 

Suppression of 60* 

Urinometer, The \ 634 

Upper Extremity 82 

Urotropin 1253 

Urticaria 713 

Diagnosis of 960 

Uterus 659 

Cancer of 662 

Fibrous Tumor of 660 

Inflammation of 659 

Polypus Tumor of 661 

Ulceration of 661 

Uvula 1303 

V 

Vaccina , 272 

Vaccination 270 

Vagina 657 

Atresia of 657 

Cancer of 658 

Contraction of 656 

Diagnosis of 977 

Description of 56 

Inflammation of 658 

Plugging 644 

Tumors of 658 

Diagnosis of 977 

Vaginal Injections 647, 1014 

Vaginismus , t 656 

Diagnosis of .' 977 

Vaginitis 658 

Diagnosis of 977 

Valerian 1430, 1470 

Valerianate of Ammonia 1201 

Valves in Heart 221 

Valvular Disease, Chronic 516 

Varicella, Eclectic Treatment 1552 

Varicocele 616 

Varicose Veins, Diagnosis of 972 

Hemorrhage of 847 

Homeopathic Treatment 1507 

Simple Remedies 1295 

Variola 265 

Vaseline 1206, 1251 

Vegetable Diets 1083 

Foods for the Sick 1034 

Materials 1385 

Parasitic Growth, Diagnosis of 965 

Treatment in Syphilis 625 



INDEX. 



1773 



PAGE. 

Veins, The 220 

Enlarged in Pregnancy 694 

Inflammation of 509 

of the Body (See Index p. 69). 

Structure 113 

Ventilation 194 

Importance of 194 

Ventricle, Left 107 

Right : 106 

Vermiform Appendix, Description of..., 55 

Vertebrae, the 1516 

Ligaments of 80 

Spinal 79 

Vertigo, Homeopathic Treatment 1506 

Simple Remedies 1277 

Vesicles, Air 116 

Vitality Building 1658 

Vitreous Humor, The 454 

Vocal Breath 1697 

Cords 528 

Paralysis of 528 

Tumors in 528 

Voice, Loss of 529 

Voluntary Muscles 743 

Vomiting in Pregnancy 69 3 

Prescription for 1244 

Sewer Gas 199 

Simple Remedies 1295 

Vulva, The 653 

Bleeding of 654 

Diagnosis of 976 

Inflammation of 653 

Itching of 654 

Diagnosis of 976 

Skin Diseases of 655 

Tumors of 655 

Vulvitis 653 



W 



Wahoo 1470 

Walking Typhoid 286 

Wall Coverings 253 

Pellitory 1470 

Walls of the Stomach 99 

Warm Full Bath 1537 

Warts 719, 1637 

Homeopathic Treatment 1507 

on the Nose 489 

Simple Remedies 1295 

Washing the Face 1629 

the Hair 1638 

Wasting Palsy 432 

Water, Air and Gases in 148 

from Artesian Wells 165 

Brash, Diagnosis of 950 

Prescription for 1245 

Simple Remedy 1296 

Contamination, Detection of 165 

Cure 173, 1527 

Diseases from 151 

Distilled 148 

for Drinking, Sources of 149 

Hemlock 1471 

Human Need of 147 

in its Hygienic Relations ...„ 147 

Internal Use of 1543 

Iron in 156 

Lead Poison in 153 

Properties of 15 29 

Rain 149 

Tests of 166 

Value of 1529 

Varieties of 150 

Wax 481, 1471 

in the Ear 476 

Plugs 476 

Waxy Liver 592 

Weak Sight 465. 1095 

Weaning ' 706, 1156 



PAGE. 

Weather, Providing Against 189 

Weight Lifting 1660 

Weights, Table of 1223 

Wen, Simple Remedy 1296 

Wet Compress, the 1535 

Nurse, The 705 

Pack, The 1534 

Wetting the Bed 775 

What to do in Absence of Doctor 1259 

Wheat Foods for the Sick 1034 

Whiskey 1201 

White Hoarhound 1418 

Lead poison 203 

Oak Bark 1471 

Pond Lily 1471 

Whites, The 645 

Diagnosis of 949, 977 

Prescription for 1244 

Simple Remedy 1285 

Whitlow 802 

Diagnosis of 959 

Whooping-Cough 772 

Diagnosis of 929 

Eclectic Treatment 1555 

German Treatment 1587 

Homeopathic Treatment 1507 

Japanese Treatment 1562 

Prescription for 1245 

Simple Remedy 1296 

Wild Hairs 471 

Windpipe, The 115 

Cilia of 74 

Winds, Influence on Health 192 

Wines, Cautious Use of 1094 

Wintergreen Tea Berry 1472 

Witch-Hazel 1203 

Wolf's Bane 1422 

Womb, The 659 

Cancer of 66? 

Description of 56 

Displacements of 664 

Falling of 666 

Simple Remedy 1296 

Fibrous Tumors of 660 

Inflammation of 659 

Polypus Tumor of 661 

Prolapsus of 666 

Ulceration of 661 

Simple Remedy 1297 

Women, Diseases of, Homeopathy in . . . 1507 

Facts Interesting to 677 

Physical Culture for 1667 

AVood Sorrel 1408 

Woodwork 253 

Wool Sorter's Disease 345 

Worms 776, 1245 

Diagnosis of 922, !>24, 946 

German Treatment ir,73 

Homeopathic Treatment 1507 

from Impure Water ", J 1(53 

Intestinal 586 

Eclectic Treatment 1556 

Japanese Treatment 1569 

Prescription for 1245 

Simple Remedy 1297 

Wormseed 1472 

Wormwood 14 24 

Worry, Exercise for 1676 

Wounds 7S9, 864 

Below Knee 794 

Cleansing of 795 

Closing of 796 

Danger from 790 

Drainage of 796 

Dressing of 796 

Dressings for 789 

Gun-Shot 797 

Healing of 790 

Infection of 789 

Japanese Treatment 1570 

Poisoned 797 

Punctured 797 



1774 



INDEX. 



PAGE. 

Wrinkles 1634 

Wrist, The 84 

Bones 735 

Drop 430 

Writer's Cramp 428 

Wry Neck, Diagnosis of .- 947 

X 

X-Ray, The 1589 

Y 

Yam, Wild 1472 

Yeast Germs 783 



PAGE. 

Yellow Fever 294 

, Diagnosis of 941 

Japanese Treatment 1563 

Yellow Goat's Beard 1406 

Root 1472 

Yerba Reuma 1473 

Yohimbin 1256 

Youth and Beauty 1625 

Z 

Zinc Ointment 1206 









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